title: Operationalizing the Measuring What Matters Spirituality Quality Metric in a Population of Hospitalized, Critically Ill Patients and Their Family Members.
abstract: Measuring What Matters (MWM) quality indicators support measurement of the percentage of patients who have spiritual discussions, if desired.
  
  
  
  The objective of this study was 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.
  
  
  
  Electronic medical record (EMR) review and cross-sectional survey of intensive care unit (ICU) patients and their family members from October to December 2015. Participants were in four adult ICUs 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.
  
  
  
  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 although 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.
  
  
  
  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.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA; Department of Oncology and Palliative Care Program in the Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA; Department of Health, Behavior & Society, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. Electronic address: raslaks1@jhmi.edu.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Aslakson
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
authors.forename: Josephine
authors.initials: J
authors.lastname: Kweku
authors.affiliation: Department of Oncology and Palliative Care Program in the Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA.
authors.forename: Malonnie
authors.initials: M
authors.lastname: Kinnison
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
authors.forename: Sarabdeep
authors.initials: S
authors.lastname: Singh
authors.affiliation: Department of Spiritual Care and Chaplaincy, The Johns Hopkins Hospital, Baltimore, Maryland, USA.
authors.forename: Thomas Y
authors.initials: TY
authors.lastname: Crowe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002977:Clergy; D003422:Critical Care; D016638:Critical Illness / Q000628:therapy*; D003430:Cross-Sectional Studies; D005190:Family / Q000523:psychology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011787:Quality of Health Care; D029181:Spirituality; D055815:Young Adult
keywords: Measuring What Matters quality indicators; chaplaincy; intensive care units; spiritual care