Minneapolis Foundation
Report date
February 2022
What has been most instrumental to your progress?
Deep Partnerships. When we initiated the Muslim Pre-Clinical Pastoral Education program, we had a few tenuous connections to existing chaplaincy programs and hospital leadership. These last few years we have developed deep and sustained relationships with healthcare leaders. We began with connections to chaplain leadership in both Children’s and MHealth. Both leaders are no longer in these roles. We have come to expand our relationships to those systems that focus upon diversity and inclusion and improving clinical outcomes. An example is we have now developed a model of spiritual care with Hennepin Health Psychiatry team to improve outcomes with Muslim patients, developing what we believe is the first inpatient/outpatient cultural and spiritual support program of its kind. We have 4 Muslim spiritual care providers who, as HHS staff, meet with Muslim patients upon entry, during their stay, help shape the care plan with psychiatric staff and then work on outpatient success through sustaining their and community support. This work is born of the partnerships formed from the chaplaincy work.
Flexibility. The COVID pandemic forced dramatic shifts in the healthcare environment. The killing of George Floyd sent shockwaves through community and healthcare. Adapting to these shifts has been a central tenant to the work and a sustained sense of change. Almost every aspect of our program design was challenged or made irrelevant due to these major social upheavals. OPR was fortunate in that we had a great deal of prework and community support to ensure that the work was based on deep values and interest in systemic change, it was less important that we followed a specific programmatic model, that we kept our goals in sight: improving healthcare outcomes through greater inclusion of Muslim community in shaping the healthcare experience. It was shocking to us how important our work was seen by hospitalists and staff on the front lines. Numerous meetings where MDs openly wept, talking about the gap in care they feel for Somali and other populations of patients. Doctors in both Hennepin and Allina systems raised funds to contract for support from OPR, our flexibility allowed us to follow their call for change.
Reimagining chaplaincy as a part of equity and inclusion. We have come to see that in many healthcare systems many leaders, staff, and patients perceive the role of hospital chaplaincy to be the domain of White Christian men and so these stakeholders tend to see chaplaincy’s decline as inevitable and not a significant loss to meaningful healthcare. Our work has called for chaplaincy’s change rather than its demise. Our Muslim community strongly wish that faith be included in their healthcare plans and a part of how hospitals provide care. We have worked to see Chaplaincy to be MUCH more culturally inclusive, not simply a system of White Christian men and women who are trained to be culturally sensitive. We have innumerable stories of the important impact that a Muslim spiritual care provider, who is a part of the hospital system, brings increased trust, openness to understanding, and directly addresses concern of systemic racism and Islamophobia.
Key lessons learned
We were unable to get our second Pre- CPE cohort started due to the dramatic shift in openings in this role (due to healthcare crisis) and due to the inability to meet as a full cohort. We strongly believed that the complexity of the learning experience would not accommodate an online experience. Due to the pandemic and its impact upon hospital systems, our planned training experiences in the hospitals (a critical experience) was not possible. Limitations on how many could visit the hospital, and meeting restrictions made it impossible. We had many false starts when we thought the pandemic was easing, but just as we had gathered another group of Muslim faith leaders, we faced another wave. It has been incredibly disappointing because the community interest is so high, the candidates who’ve applied were clearly committed, coming from diverse backgrounds and of great competency for the work. Muslim faith leaders were witnessing tremendous suffering in community due to COVID, individuals isolated in hospitals without culturally or spiritually competent care, it broke our hearts that we had not started this program years before the pandemic came.
Employment opportunities became scarce. When we initiated this program, we saw well over 50 openings for hospital chaplains and spiritual care support across the region. We had strong interest for Muslim chaplains and all signs were that we would be successful in placing chaplains into systems. After the pandemic hit and hospitals found themselves in unprecedented economic crisis, losing millions every month, hiring freezes took hold, program initiatives disappeared and many program ideas were scrapped. We are immensely proud of the 8 individuals we trained in the Pre CPE program who have been employed in the Twin Cities, 1 at Children’s Hospital in Minneapolis, 2 at Abbott Northwest, 1 at M Health Fairview in Mpls, 1 at Anoka Residential Mental Health Center, and 3 in Hennepin Health. There is a huge need for more patient support and those now serving in these roles frequently speak to how overwhelmed they are but the number and degree of need. They are frequently called into critical conversations where conflict between patient and staff are at times, life and death decisions being made. More must be done to prevent patients and families falling through the cracks of the system.
Reflections on the community innovation process
When we began activities as a part of this grant, we had already developed our innovation into later stages but as we did a few national and regional presentations regarding our work, we used the diagram as an effective tool to describe our processes in developing and implementing the innovations. The diagram helps us and others to see the logic model behind our efforts. It reminds us of the tremendous amount of work it took to get to the place of our application. That work was collecting community insights and interests. That work set a clear mission statement for our organization that was defined by community interests. As we worked on our Bush grant funded program, we ran into many roadblocks, COVID, the Uprising, hiring freezes, etc. As we sought to adapt, we understood that we were obligated to go back and reference that community provided mission statement. We had to reimagine and hold tight to the core principals. As we did this that diagram helped to keep us focused on process.
Progress toward an innovation
We believe we are in the very center of critical innovations taking place in healthcare, regarding improved health outcomes for marginalized populations. While our work is concentrated in providing improved care for Muslim and East African immigrant communities, it has also drawn interest from healthcare institutions in Chicago, and Los Angeles. It has sparked initial conversations about a partnership between our region’s indigenous communities and OPR’s work. Contracts have been signed with two major hospital systems with OPR to help them navigate the processes to improving clinical care for Somali and Muslim patients and families. We are in process of signing a third contract for the same work in another major healthcare system. It was this initial program that sparked this relationship and vision for change. We are greatly increasing community voice and authority in shaping our region’s healthcare models.
What it will take to reach an innovation?
N/A
What's next?
This grant was critical to allowing OPR to assert leadership in both community and within healthcare systems. We provided both vision and resources to advance that vision. It is one thing to call out a system for its failure in issues of diversity and inclusion. It is another to have done the organizing, tested an initiative, and then be able to provide that system with an alternative. We are now a growing part of several healthcare systems plans to rethink and restructure how they can improve health outcomes for marginalized populations they serve. By coming in and having done the work we have, we are able to approach large systems with a tested model and therefore develop contracted relationships. We have always aimed to move from a primarily “grant driven” organization to one that can contract for services – essentially for the very same work. We believe we are on the front end of that shift for OPR.
When the pandemic and its necessary public safety requirements ease, we truly hope to host a second Pre CPE cohort. We wish to see greater diversity included to ensure that we develop a whole community ownership over this care model.
When the pandemic and its necessary public safety requirements ease, we truly hope to host a second Pre CPE cohort. We wish to see greater diversity included to ensure that we develop a whole community ownership over this care model.
If you could do it all over again...
We think we should have better prepared for a major pandemic, social justice outcry, and economic crisis. It is amazing to us that were held a meeting in the police precinct just two weeks or so before the uprising, discussing with the officers the need for a Muslim chaplain on staff. We did not make much headway in that meeting and that precinct house is now gone. Our vision for greater cultural inclusion while being part of the system is one we advocated for that day. The response was, “We just don’t have the funds.” To us it seemed it just wasn’t a high priority. We wonder if in hindsight, we all might have had a different conversation had we known what price would be paid for those choices.
It is easy to see the tension that existed between public safety and community as well look back. We assert that this same tension has surfaced between community and healthcare providers. Hospital care is a commonly used pawn in our nation’s political/culture wars. We wish we would have acted with a greater urgency what seems like much more than 2+ years ago.
It is easy to see the tension that existed between public safety and community as well look back. We assert that this same tension has surfaced between community and healthcare providers. Hospital care is a commonly used pawn in our nation’s political/culture wars. We wish we would have acted with a greater urgency what seems like much more than 2+ years ago.
One last thought
We want to stay in relationship with you. OPR believes that all important work is relational. We were so happy to have occasional meetings with Bush staff, sharing our insights, asking for guidance and shared vision. That somehow has gotten lost over time -certainly both of our organizations had to make dramatic shift in focus to address the pandemic and the social justice imperatives. But it remains for us a desire to stay connected, be informed by your work and let our work inform yours where you see value. We are unclear how to do this and would welcome further conversations.