Palliative Care Needs Assessment for a Chaplain

Please answer each question as honestly and with as much detail as you can. Thank you!
Name (optional): 


  1. Are you completing a Spiritual Care assessment on your initial visit?
    Yes
    No


  1. What is the process for completion of the spiritual assessment ?


  1. Estimate how often you assess spiritual needs?
    every visit
    once per patient
    not done
    other


  1. How do you access the Chaplain for patient needs?


  1. What is the response when you contact a Chaplain?


  1. Are Chaplains participating as active team members?
    Attending IDTs
    Family meetings
    Daily rounds


  1. Are you providing spiritual care in lieu of a Chaplain?
    Yes
    No


  1. Estimate how much of your time is spent providing spiritual needs and services ( % time in general)


  1. Compared to today, estimate what your productivity would be with a dedicated Chaplain. Productivity would increase:
    < 10%
    20%
    30%
    > 30%
    Other %
    Would not increase
    Would not decrease


  1. Any other comments?





Abbe Leffel
IL