Evaluation of a Chaplain Residency Program and Its Partnership with an In-Patient Palliative Care Team.

In 2009 a Consensus Conference of experts in the field of spiritual care and palliative care recommended the inclusion of Board-certified professional chaplains with at least 1,600 hours of clinical pastoral education as members of palliative care teams. This study evaluates a clinical pastoral education residency program's effectiveness in preparing persons to provide spiritual care for those with serious illness and in increasing the palliative care team members' understanding of the chaplain as part of the palliative care team. Results showed chaplain residents felt the program prepared them to provide care for those with serious illness. It also showed that chaplain residents and palliative care team members view spirituality as an integral part of palliative care and see the chaplain as the team member to lead that effort. Suggested program improvements include longer palliative care orientation period, more shadowing with palliative care team members, and improved communication between palliative care and the chaplain residents.

Coaching patients to succeed in adhering to a renal diet.

As nephrology dietitians, we have the responsibility to provide useful information in understandable terms. This may involve different methods of education depending on the patients learning preferences. Once this is accomplished and we have checked for patient understanding, it is then the responsibility of the patient to adhere to the recommendations. Not all patients will follow our advice, even if they understand the rationale and know what they need to do. That is their choice. However, it is our responsibility to ensure we have provided patients with the tools they need in a way that is most conducive to modifying their behavior.

The "big bang" implementation: not for the faint of heart.

Replacing a hospital's obsolete mainframe computer system with a modern integrated clinical and administrative information system presents multiple challenges. When the new system is activated in one weekend, in "big bang" fashion, the challenges are magnified. Careful planning is essential to ensure that all hospital staff are fully prepared for this transition, knowing this conversion will involve system downtime, procedural changes, and the resulting stress that naturally accompanies change. Implementation concerns include staff preparation and training, process changes, continuity of patient care, and technical and administrative support. This article outlines how the University of Missouri Health Care addressed these operational concerns during this dramatic information system conversion.