Operationalizing the Measuring What Matters Spirituality Quality Metric in a Population of Hospitalized, Critically Ill Patients and Their Family Members.

Aslakson RA, Kweku J, Kinnison M, Singh S, Crowe TY, AAHPM Writing Group
J Pain Symptom Manage. 2016 Dec 29;:

Measuring What Matters (MWM) quality indicators support measurement of the percentage of patients who have spiritual discussions, if desired.

OBJECTIVES: To 1) determine the ease of, and barriers to, prospectively collecting MWM spirituality quality measure data and 2) further explore the importance of spirituality in a seriously ill, hospitalized population of critically ill patients and their family members.

METHODS: Electronic medical record (EMR) review and cross-sectional survey of ICU patients and their family members from October-December 2015. Participants were in four adult intensive care units totaling 68 beds at a single academic, urban, tertiary care center which has ICU-assigned chaplains and an in-house, 24-hour, on-call chaplain.

RESULTS: All patients had a "Spiritual Risk Screen" which included two questions identifying patient religion and whether a chaplain visit was desired. Approximately 2/3 of ICU patients were eligible and there were 144 respondents (50% female; 57% patient and 43% family member), with the majority being Caucasian or African American (68% and 21%, respectively). Common religious identifications were Christian or no faith tradition (76% and 11%, respectively). Approximately half of patients had an EMR chaplain note though it did not document presence of a "spiritual discussion". No study patients received palliative care consultation. A majority (85%) noted that spirituality was "important to them" and that prevalence remained high across respondent age, race, faith tradition, or admitting ICU.

CONCLUSION: Operationalizing the MWM spirituality quality indicator was challenging as elements of a "spiritual screening" or documentation of a "spiritual discussion" were not clearly documented in the EMR. The high prevalence of spirituality among respondents validates the importance of spirituality as a potential quality metric.

More...