Helping people feel whole: AdventHealth CEO Terry Shaw on why the system screens for spiritual well-being

In 2018, Altamonte Springs, Fla.-based AdventHealth launched an outpatient program that screens patients to assess their personal sense of love, joy and peace in their lives. The program, called clinical mission integration, aims to address patients' care needs beyond just the physical element.

The screening includes asking patients three questions:

• Do you have someone that loves you and cares for you?
• Do you have a source of joy in your life?
• Do you have a sense of peace today?

If the patient answers no to any of the questions, they are automatically referred for a follow-up with an AdventHealth team member, who then helps connect the patient to support and resources.

So far, more than 5 million patients have undergone the screening.

Here, AdventHealth CEO Terry Shaw discusses the program, why they implemented it and the response from patients.

Note: Responses have been lightly edited for length and clarity.

Question: Why did AdventHealth decide to implement the 'wholeness screening' process at its outpatient facilities?

Terry Shaw: Our healthcare philosophy at AdventHealth centers on providing whole-person care — for body, mind and spirit. As a faith-based health system, we recognize that the non-physical aspects of a person's health, such as their mental, emotional and spiritual health, play a key role in their overall wellness. So if you look at some of the social ills and issues plaguing society today, such as depression, loneliness, anxiety, substance abuse, suicide and violence, it was clear to us that as a healthcare provider, we had to do more to meet patients where they are to make the impact that we want to make in the communities we serve. Implementing this program gave us the ability to immediately impact a large number of people.

Q: How many patients approximately have needed referrals after the screening?

TS: Since the program began, we have screened more than 5 million patients and generated approximately 20,000 referrals through the screening process. These referrals range from people struggling to cope with chronic health conditions, to people dealing with depression and loneliness, to people grieving the loss of loved ones and quite honestly, people who are struggling with the everyday trials of life.

That is one of the great things about the questions in the screening. They are very open-ended. Love, joy and peace are things that everyone can relate to. In turn, people don't feel limited to what they can open up about.

We have established a call center where team members trained to provide spiritual and emotional support follow up directly with individuals who express a need during the initial screening process. Sometimes the initial follow-up call is enough to help resolve the issue, and sometimes, the patient needs additional support. Depending on patients' specific needs, they could be connected with additional resources like family or grief support groups, local faith communities, food banks or housing assistance programs. A report is also sent back to their physician that details the interaction and any recommendations that were made so that the staff can continue to engage that patient the next time the patient visits.

Q: What has been the patient reaction to the screenings?

TS: Overall, the response has been positive. Patients seem to really appreciate the fact that their caregivers are taking a vested interest in their mental, emotional and spiritual health. Some patients choose not to engage with their caregiver on these topics, and we fully respect their choice. But for those who do, this is an avenue for them. In fact, there is a good amount of research that says most patients welcome discussions with their doctors about their spiritual needs. I think patients really appreciate being able to open up about these deep, personal feelings in a confidential and safe environment with their caregiver.

Q: In 2019, AdventHealth implemented the program in the inpatient setting. Has the screening process changed at all from the process in the outpatient settings?

TS: Yes, we recently introduced the screening in our inpatient facilities, and we are excited about that. The screening is still done during the intake process and patients are asked the same questions about love, joy and peace. However, in the inpatient setting, our chaplains are highly involved with the process. Since we have mission and ministry team members locally in each hospital, referrals don't go to our call center for follow up, they are routed directly to the facility's chaplaincy team, and a chaplain follows up with the patient in person while they are still at the hospital. From there, the chaplain documents the patient interaction in the EMR.

Q: What are some key considerations and lessons learned for other health organizations looking to begin similar programs?

TS: For us, it's about being true to our mission. We want to do everything we can to help people feel whole, and I think implementing a program that enables us to come alongside our patients in an even more meaningful way and meet them wherever they are in their health journey helps us foster wholeness.

We believe the program is making an impact and at the same time, we are still early in this work and learning as we go. As the program matures, and we continue to understand its impact and patients' needs, we can fine-tune what we are doing around training, engagement, solutions, resources and other aspects. I think it's important to understand your 'why' from the beginning and solidify your infrastructure, then have an open mind and be willing to learn and adapt along the way.

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