A hundred years ago, in the middle of the Spanish flu epidemic that would take more than 50 million lives around the globe, a local doctor in Houston began treating sick patients in his home. The operation eventually morphed into a permanent clinic, which the doctor later sold to the Methodist church.
Today, that once-tiny clinic is known as Houston Methodist, a network of hospitals, health centers, clinics and research institutes across the Houston area. It has nearly 24,000 employees, almost 7,000 affiliated physicians and topped more than 1.2 million outpatient visits in 2018 alone. The sprawling health system has come long way from its modest origins, but there is one aspect that’s remained constant: A guiding belief that faith and spirituality are essential ingredients in people’s health care.
“For us, it’s a mission that not only informs our direct care, but helps set the culture of the hospital,” said Robert Kidd, director of Spiritual Care and Values Integration at Houston Methodist. “We want to make sure that whatever faith a person is — or if a person is of no faith — that that’s folded into their care.”
Spiritual care has a long tradition inside Texas hospitals, both those rooted in a particular denomination, like Houston Methodist, and those without religious origins. Nationwide, the majority of hospitals offer pastoral care, often via chaplains, who are specially trained to work in health care settings and with people of diverse faith backgrounds. Research has uncovered a variety of positive benefits associated with the practice, such as higher patient satisfaction scores and greater quality-of-life among patients with terminal illnesses. In fact, the Joint Commission, the country’s leading health care accreditation agency, recognizes spiritual care as a prime opportunity for quality improvement, and many medical schools teach about the intersections between spirituality and health.
While spiritual care is typically associated with the end of life, the reality is that chaplains are often core members of today’s interdisciplinary health care teams, whether it’s at the bedside, in the break room or out in the community.
At Houston Methodist Hospital, for example, chaplains are on call 24 hours a day. Some days, as many as 16 chaplains can be found working the floors, visiting patients and their families, said Stacy Auld, the hospital’s director of Spiritual Care. Chaplains regularly check in with staff too, often leading prayer huddles at their request. The hospital, like many of the system’s facilities, is dotted with sacred spaces — some overtly Christian, but many of them not — to give people a quiet, secluded space to pray or reflect.
Such comfort can be especially important in the face of community trauma. In the aftermath of Hurricane Harvey, for instance, when hundreds of Houston Methodist staff couldn’t reach their homes, chaplains erected a prayer wall inside the hospital. Over the following week, Auld said it filled up entirely — “you could spend hours there, just reading the prayers.”
“Sometimes, our responsibility is just to create spaces like that,” Auld said.
But spiritual care is more than just religion and faith, said George Colón, director of Spiritual Care at Houston Methodist Baytown Hospital. Last year, for example, after weeks of emergency room surges at the Baytown hospital, staff began reporting serious feelings of burnout and compassion fatigue — an issue impacting health care capacity nationwide. In response, management called on chaplains, who organized trainings in compassionate self-care and resiliency. In 2018, Colón said, the effort reached nearly 600 staff, and now the hospital is talking with chaplains at local police and fire agencies about the possibility of offering the training to their first responders as well.
“The presence of spiritual care is everywhere in our hospitals,” Colón said.
Connecting with the Community, Caring for the Whole Person
While hospitals excel at providing care for people after they get sick or injured, it’s much more difficult to influence on the factors that keep people healthy and safe at home, otherwise known as the social determinants of health. But in Dallas, chaplains are hoping to shift that dynamic with help from organizations already embedded in the community: local houses of worship.
Launched in 2017, the DFW FaithHealth Collaborative is a partnership between four hospitals — Parkland, Baylor Scott & White, Methodist Health System and Children’s Medical Center — and area faith communities that helps patients navigate complex health systems, access health resources and education, and find support in times of crisis. The collaborative, which has nearly 300 houses of worship as members, receives individual patient referrals and addresses community-based needs, such as providing resources on how to access affordable healthy foods or offering tips on managing chronic diseases like diabetes.
To date, nearly 150 patients have been referred to the collaborative for follow-up, which can range from helping patients access low-cost primary care to serving as caregivers to families struggling with catastrophic illness, said Freedom McAdoo, Faith Health community chaplain at Parkland Health & Hospital System and a collaborative leader. McAdoo said a key to the collaborative’s work is listening to and building relationships with people and communities — “it’s the theology of being present, of letting people know they’re not alone,” she said. Another key is focusing on interventions that break down barriers to timely care and prevention.
McAdoo reported that recent hospital data already show a significant reduction in emergency room use among collaborative referrals.
“Where you live, work, play and pray is truly where health takes place,” she said. “But we weren’t tapping into the cultural and social resources innately found in congregations. They were already working in the community; they had already built trust in communities. The gap we faced was truly understanding that by partnering with (faith communities), we could help alleviate the social stressors that were negatively impacting people’s health.”
While Parkland doesn’t have religious roots, spiritual care is “very much alive and integrated throughout the system,” said Stacey Merlin, Trauma/Surgical Division coordinator chaplain in Parkland’s Pastoral Care Department. In addition to meeting with patients and families, chaplains also provide support to staff. Earlier this year, for example, the system launched Supporting Parkland Staff, or SPARKS, a round-the-clock support line to help providers cope with workplace stress. The line is manned by an interdisciplinary team of peer responders, including chaplains.
“Never underestimate the power of connection,” Merlin said.
Like Houston Methodist, CHRISTUS Health, based in Irving, Texas, also has faith origins, going back to the mid-1800s when a small group of nuns from France opened a clinic on the Galveston coast. Fast forward more than a century, and faith still informs day-to-day operations at the system of hundreds of hospitals, clinics and health ministries across the United States, Mexico, Chile and Colombia.
Today, every CHRISTUS hospital has a spiritual care department staffed with trained chaplains, of which there are 120 throughout the system, according to Lawrence Chellaian, system director for Spiritual Care Services at CHRISTUS Health. Hospital patients are routinely asked about their spiritual needs, he said, and chaplains work as part of interdisciplinary health care teams, recording patient meeting outcomes in official medical records so physicians and nurses can get a fuller picture of a patient’s circumstances.
CHRISTUS also trains the next generation of spiritual care providers at its Clinical Pastoral Education Centers in Tyler, Corpus Christi and San Antonio, where every student takes part in one-year hospital residencies.
“Caring for the whole person is an integral part of our healing ministry,” Chellaian said. “Religion and faith can help people find meaning in everything, even in their suffering and pain.”
At University Medical Center of El Paso, Robert S. Kobe was among responders who reported to the hospital in the wake of the August mass shooting that killed 22 people. A chaplain at the hospital, Kobe offered comfort to the frightened families waiting for news, visited with patients, and later checked in with providers who cared for the 15 shooting victims treated at UMC. A hospital chaplain for more than 30 years, Kobe said his guiding task is to simply “be there” for those in need.
“There’s a quiet strain of spirituality in everybody, and trauma can bring it out more than normal,” Kobe said. “Everybody wants to be reminded that they’re okay, that what they’re feeling is normal. What people are really looking for is presence.”