title: Communicating Chaplains' Care: Narrative Documentation in a Neuroscience-Spine Intensive Care Unit.
abstract: Chaplaincy care is different for every patient; a growing challenge is to ensure that electronic health records function to support personalized care. While ICU health care teams have advanced clinical practice guidelines to identify and integrate relevant aspects of the patient's story into whole person care, recommendations for documentation are rare. This qualitative study of over 400 free-text EHR notes offers unique insight into current use of free-text documentation in ICU by six chaplains integrated into the healthcare team. Our research provides insight into the phenomena chaplains record in the electronic record. Content analysis shows recurrent report of patient and family practices, beliefs, coping mechanisms, concerns, emotional resources and needs, family and faith support, medical decision making and medical communications. These findings are important for health care team discussions of factors deemed essential to whole person care in ICUs, and, by extension have the potential to support the development of EHR designs that aim to advance personalized care.
authors.affiliation: a Buehler Center on Aging, Health & Society , Northwestern University , Chicago , Illinois , USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Johnson
authors.affiliation: b Northwestern Memorial Hospital , Chicago , Illinois , USA.
authors.forename: M Jeanne
authors.initials: MJ
authors.lastname: Wirpsa
authors.affiliation: c Buehler Center on Aging, Health & Society , Northwestern University , Chicago , Illinois , USA.
authors.forename: Lara
authors.initials: L
authors.lastname: Boyken
authors.affiliation: d Northwestern University Feinberg School of Medicine , Chicago , Illinois , USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Sakumoto
authors.affiliation: e HealthCare Chaplaincy Network , New York , New York , USA.
authors.forename: George
authors.initials: G
authors.lastname: Handzo
authors.affiliation: f Northwestern University Feinberg School of Medicine , Chicago , Illinois , USA.
authors.forename: Abel
authors.initials: A
authors.lastname: Kho
authors.affiliation: g Buehler Center on Aging, Health & Society , Northwestern University , Chicago , Illinois , USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Emanuel
mesh_terms: D002604:Chaplaincy Service, Hospital; D003142:Communication; D004282:Documentation / Q000379:methods; D057286:Electronic Health Records; D006801:Humans; D007362:Intensive Care Units; D033262:Narration; D009488:Neurosciences; D010327:Pastoral Care; D010348:Patient Care Team / Q000458:organization & administration; D036301:Qualitative Research
keywords: Chaplaincy care; documentation; electronic health record; spiritual care; team communication