The Institute of Medicine, Education, and Spirituality at the Ochsner Health System. Spiritual Culture and Transformation in Medicine and in the Healthcare Workplace
The Ochsner Health System enjoys an excellent clinical reputation throughout the country. It serves patients that come from many parts of the United States and many other countries. This clinical culture of care extends beyond the physical and includes the spiritual culture of healing. This spiritual culture is built on the practice of human values and virtues which, taken together, foster a spirituality of healing, meaning and purpose. A spiritual culture is what can be described as the “spiritual foundation of medicine.” This culture at Ochsner is energized by the work of the Institute of Medicine, Education, and Spirituality (IMESO) and many other programs and services supported by the System.
Mission, Vision, and Goals of IMESO
We believe that when individuals in healthcare connect with others with their hearts, minds and spirits, we are better healers and we have a greater ability to advance the organization's mission.
We desire to:
We help individuals to:
- Enhance Character and Spirit*
- Express workplace Goodness**
- Promote Meaningful Connections
We help the organization to:
- Education for development of workplace character, the expression of goodness and ability to connect meaningfully at work
- Research for discovery of the linkages between workplace spirituality** and Healing
- Spirit and Culture*** for the enhancement of Ochsner's Mission and Values
*“Spirit is that aspect or essence of a person that gives him or her power and energy, and motivates the pursuit of virtues such as love, truth, and wisdom.”
-Denise D. McKee and John N. Chappel, Spirituality and Medical Practice
** Goodness: It is more than excellence of character, it is character energized, expressing itself in active good behaviors.
*** Culture: An organization’s ability to maintain a competitive advantage may be a function of its ability to encourage a sense of interconnectedness and meaning among its employees.
**** Spirituality: The experience of conscious involvement in the project of life integration through self-transcendence toward the ultimate value one perceives.”
Sandra Schneiders, Religion and Spirituality: Strangers, Rivals, or Partners?
Rev. Anthony J. De Conciliis, C.S.C., D. Min. Ph.D.
Vice President - IMESO: Spiritual Culture and Transformation
Institute of Medicine, Education, and Spirituality Ochsner Health System
History of IMESO
IMESO was established in 2011, an appointment made by the Chief Executive Officer and the Chief Educational Officer. It is a unique educational and research program for modern day healthcare that supports the growth and development of a spiritual culture mainly through teaching, research and consultation. It is unique because it stands at the interconnection of a clinical culture of care and a spiritual culture of well-being for employees and by extension to all patients. Its programs and services stress the formation of a positive workplace spirit that enhances personal meaning and purpose and a connection between the healthcare system and its people.
Over the past eight years, IMESO has offered programs and services to thousands of employees. These educational, research and consultation programs support a spiritual culture where human and spiritual commitments are renewed and practiced. IMESO, thus, offers a major component in the healing process that is sometimes lost in the complex technologically sophisticated world of healthcare service of today. It reminds all that healing is wholistic in nature and includes the union of the body, mind, and spirit. IMESO is the gateway to this union which includes attention to the important values and virtues involved in the connection between healer and patient and in all the interaction in the workplace also known as reciprocal healing.
The founder and Vice President of IMESO is Rev. Anthony J. De Conciliis, C.S.C., a member of the Congregation of Holy Cross based at Notre Dame, Indiana. His background includes administrative and academic positions in higher education and extensive clinical experience. Most recently, he was the C.E.O. and President of the University of Holy Cross. He has held positions as Vice President and Dean of Academic Affairs at two academic institutions, Vice President and Dean of Student Affairs, Director of Counseling Services and Associate Professor of Psychology. He holds a professional doctorate in pastoral care (D.Min.) and an academic doctorate (Ph.D.) in pastoral counseling as well as master’s degrees in theology and Counseling. Presently he holds the title of Vice President of IMESO and Adjunct Associate Professor at the University of Queensland.
The goal of the founders of Ochsner Health System was to create a wholistic culture for the provision of medical services. Considering this goal, over the last eight years, IMESO has gained a reputation for inspired service leading toward a spiritual culture in the life of medicine at Ochsner.
The worth and contributions of a program are best assessed in narrative form by those who experience it. The word testimony means testaments, evidences, witnesses, proofs, demonstrations, verifications, indicators, and affidavits. In support of this grant proposal, we offer some of the testimonies attributed to The Institute of Medicine, Education, and Spirituality at Ochsner from a wide range of Ochsner employees. The responses were based on one question: “What does IMESO’s presence and services add to my personal and professional workplace life and to Ochsner as a whole?” The following are only a few of the many responses that were submitted to IMESO.
A Senior Physician said…
“IMESO has prompted me to deepen my own sense of spirituality and help to extend the same reflective and cognitive experience to my colleagues. It is THE reason I am here at Ochsner enjoying my daily practice. It is quite apparent to me that spirituality is not the same as religion; neither is it the same as an organization’s values. They complement each other. The photo of our 5 founders is a powerful example of ‘why’ we should hold fast as we continue to grow our corporate practice, and we must. IMESO emphasizes that developing our own spirituality; deliberately practicing the virtues of courage, justice, temperance, transcendence, and wisdom engages the world around us we serve our fellow man.”
An Operations Vice President said…
“IMESO has refocused us on the need to take care of not only the physical ailments of our patients but also the healing of mind and spirit. IMESO also does a great job keeping us focused on the minds and spirits of our caregivers who serve the needs of the Gulf Coast.”
A Senior Nurse (CNO) Leader said….
"IMESO has reminded me as a nurse leader that there is more to the patient than their diagnosis. I have a renewed sense of purpose in my role as a leader of nurses to ensure wholistic support and care, which is greater than just their diagnosis.”
A Member of the Safety Team said…
“IMESO has awakened an introspective approach, encouraging us to remember why we were drawn to a career in healthcare. It seeks to help us find the spirit and purpose that we may have lost along the way. IMESO leads us to better self-care and fulfillment.”
A Physician Leader said…
“By teaching students and residents to consider virtues as they practice medicine, IMESO gives those learners an advantage at the start of their careers. They will likely be better equipped to find balance and contentment in their stressful lives. For me, the fact that IMESO exists shows that we value the well-being of our people. I am a wholehearted supporter.”
An Attorney said...
“IMESO is a reminder that we are spiritual creatures learning to live in a physical world; that we can integrate our faith into our work and remain true to our deepest values.”
An Executive Vice President said….
“It has been our privilege to teach and to mentor future doctors. We have taught them the principles of biomedical and clinical sciences- we have given them the opportunity to pursue research – we have taught them the principles of safety - we have also attempted to strengthen their inherent values and virtues through something special called IMESO. Through IMESO virtue and value educational programs, students have been reminded of the human spirit – theirs and their patients”.
A Senior Administrative (CEO) Leader said….
“We have worked hard to infuse the thoughts and concepts of IMESO at our hospital. This has helped ensure that the board and leadership team are in alignment in supporting the programs and services that most support the patient and our employees.”
A Chief Operating Officer said…
“IMESO has taught me about spirituality and what it means to be a spiritual leader and how to develop as a leader by challenging myself to develop and grow spiritually. I would like to think that this has improved my effectiveness as a leader.”
A Project Manager said…
“Simply put, IMESO represents an untapped and key tool for Ochsner to meet its chief goals including patient loyalty, employee/leader/physician engagement, clinical outcomes and yes, financial metrics.”
A Social Worker said…
“Spirituality in healthcare is a filter through which patients—in their respective personal and unique ways—find physical and emotional well-being. It gives patients a sense of purpose in life and transcends their physical state, especially during times of illness and healing. IMESO supports the development of spirituality in the healthcare workplace.”
An Attorney said…
“Spirituality involves striving to ‘know oneself’ and to recognize the serene dignity and the immense responsibility of bearing within a divine spark. Bringing this knowledge into the healthcare environment as ‘workplace spirituality’ cultivates peace, compassion, and understanding toward fellow employees and patients, and provides a platform for employees to rise above the inevitable workplace challenge.”
A Nursing Administrator said…
“Healthcare is complicated, and the science is massaged by the art of caring. IMESO’s presence at Ochsner allows for colleagues to navigate the challenges that arise as they connect their personal mission to Ochsner's goals. I have personally enjoyed the connections that IMESO offers as the function of the institute truly begins by connecting those who are passionate about improving care. In addition, IMESO has been an integral part of our Nursing Residency Program and has expanded the minds of new nurses who are on a journey to professionally develop and commit to a vocation of nursing others.”
An Executive Officer said…
“IMESO has put meaning and purpose in what we do as a compassionate, healing health system. In my experience, IMESO has served as the conscience and soul of Ochsner Health System. IMESO helps to answer the question, ‘Why do I do this for a living?’ which we all ask at times.”
A Specialist in Medicine said….
“Spirituality is the competency acquired and matured throughout a medical education process which forms the foundation for compassionate and caring connections made between the healthcare provider and the patient. Without it, no real healing of heart, mind, or soul can occur. IMESO reminds us of this important spirit necessary to the practice of medicine.”
A Senior Physician said…
“IMESO has given me the opportunity to improve my professional life since I am able to reflect on what I do. Reflection is defined ‘as serious thought or consideration’. Thus, having IMESO reminding me that our patients are the focus of our daily activities (through reflection) and how much do we help them it has allowed refocusing my mind to patient care and therefore a better doctor. At the end it has given me more professional satisfaction.”
A Physician Administrator said…
“I have heard several stories on the positive impact of IMESO in our organization. I interview physician candidates. In reviewing the background of these candidates, I have identified several individuals who have training/educational experience/interest in theology or evidence of involvement with spirituality in their medical training. In each of these cases, I describe IMESO as an example of Ochsner’s unique dedication to patient care at all levels. The response from these candidates is always extremely positive, and they are most impressed with our innovation in this program. I have introduced several of these physicians to IMESO, and I understand they are excited to participate.”
A Researcher said…
“Values and virtues are essential for a satisfying and meaningful personal existence. These values include a sense of humanity, a commitment to courageous behavior, an ongoing consideration of justice, a continuous desire to expand knowledge, a respect for wisdom, the practice of personal and professional prudence, and the understanding and perception of spirituality. IMESO reminds all at Ochsner Health System of these important aspects in healthcare.”
A Physician Chairperson said…
“In the fall of 2013 our departmental retreat invited IMESO to facilitate a learning discussion regarding virtues in the daily practice of patient care. This exercise helped us to gain a much-needed deeper appreciation for the talents that every member of our clinical team provided on a day-to-day basis. Suddenly, everyone better recognized what our phone people and front office staff really do daily to facilitate patient throughput. The doctors better understood the roles of our middle-level providers and the members of our allied healthcare team. A recent pulse survey revealed that the bar has been moved considerably…as from 30% to over 80% engagement across the entire departmental team.”
A Security Officer said…
“IMESO has been a true inspiration for our team and given us an idea of what our focus should be; not only to serve, heal, lead, educate and innovate but to develop our staff morally, ethically and even spiritually so they may learn how to serve and understand others and, ultimately, serve and understand themselves.”
An Ochsner Medical Student said…
“IMESO provides a guiding light in this tumultuous and rapidly changing healthcare environment. As systems demand more productivity and value, IMESO reminds us that humanism and virtue remain the most important aspects of high-quality healthcare provision.”
These testimonies support the need for an institute like IMESO which fosters a spiritual culture in the workplace.
Education for Spirit and Culture
Education is central to IMESO’s activities. Educational programs and services are available to all employees and, especially for, physicians, administrative staff, medical students, residents, and fellows. The aim of each of these programs is to integrate healing of the mind, body, and spirit of caregivers so that they in turn can offer holistic or integrative care to all they serve. IMESO’s educational programs and services provide a culture that recognizes and dignifies the spiritual nature of people and medicine. See Mission and Vision statement above. As a way of connecting the mission, values, and virtues, IMESO uses a teaching tool which is pictured below.
Below are brief descriptions of some of the many programs and services that IMESO sponsors for employees.
Essays on Palliative Care: Each week a new essay will be offered for consideration by physicians at Ochsner Medical. To follow the series, go to the Education tab each week for further information. In the weeks to come:
- Palliative Care Introduction: The Nature of Palliative Care
- Providers as Leaders in Palliative Care
- Non-hospice and Hospice Palliate Care
- Grief and Palliative Care
- Goals of Care: The Bridge to Hospice
- The Components of Care
- Medical Student Course on Character and Medicine
Character in Medicine Course for Medical and Resident Students.
This is a seven-week course for Queensland/Ochsner medical students entails the application of virtues and character strengths to build character and decrease stress and burnout. For more information contact IMESO.
Why Teach Virtues in Healthcare Environment?
- Guidance: It provides tried and true guidelines to make moral decisions in interpersonal situations with patients and colleagues
- Common Language: It provides a common language in professional and personal life.
- Excellence: It provides marks of excellence in medicine
- Habit Development: It provides the basis for habit development
- Integration: It provides a mindful and not mechanical process for treatment and relationship development.
- Character: It offers the mindful development of character.
- Self-awareness: It requires self-awareness and the motivation to act in a virtuous manner – to do good for others.
- Goodness: The result of character development is a greater awareness of altruism.
- Way of Being: Virtue in medicine as it becomes ingrained promotes a natural way of being and becomes a role model for others.
- Internal Harmony: Virtue that is practiced produces internal harmony and well-being. This is an integration between cognition and emotion, freedom and adherence to ideals both individual and communal.
- Moral Lifestyle: A virtue framework develops an individuated moral style.
- Virtue Traits and Behavior: A virtuous physician embodies virtue traits and uses them to care for others.
Administration and Leadership Courses: Managers and Directors
This course is a three-week, credit bearing, course for all managers. It is based on the integration of character strengths to insure satisfied employees and well-being. This course can be adapted for all administrators so that a common language of virtues can be used throughout the System, especially the mission and values at Ochsner.
NEW: Spirituality is made concrete in the workplace by teaching values and virtues as a framework for the profession of medicine and healthcare in general. IMESO programs all contain some aspect of value and virtue. For example, the staff of IMESO has taken the mission words of Ochsner and have correlated mission, value and virtue words to create a spirituality of purpose. So, for example, we heal with compassion based on the virtue of humanity; we lead with integrity based on the virtue of courage, and we serve with the patient-first based on the virtue of transcendence.
NEW: Essay on Spirituality and Religion Relationship Explained: So many are confused whether there is a potential a relationship between religion and spirituality. The short essay presents one possible way of understanding the relationship.
Research for Spirit and Culture
NEW: Grand Rounds Series: Spirituality Understood Anew with Assessment. A Grand Rounds Series: On February 28, 2019 a Grand Rounds on Spirituality as a Psychological Construct: Its Value for the Helping Professions was presented by a nationally known personality psychologist, Dr. Ralph Piedmont. Dr. Piedmont received his Ph.D. in Personality Psychology from Boston University. Dr. Piedmont is the President of the Center for Professional Studies. His current research interests focus on the measurement of Spiritual Transcendence, a construct that represents a broad, nondenominational, motivational measure of spirituality. Dr. Piedmont is extensively published in the scientific literature and is on the editorial boards for Measurement and Evaluation in Counseling and Development, Assessment, and Journal of Personality Assessment. He was the founding editor of the new APA journal, Psychology of Religion and Spirituality. If you wish to view the video, please contact IMESO.
New: IMESO offers courses based on the inclusion of virtue language and practice for medical students and to all members of the Ochsner community. This is an effort to bring together the mission, values and virtues of Ochsner to make it a better workplace environment. Outcomes of these workshops and courses are collecting data to measure changes in workplace spirit. For more information, contact IMESO.
Workplace Spirituality Research at Ochsner adds to the engagement and meaning profile of Ochsner’s employees. For more information on workplace spirituality, contact IMESO.
IMESO measures a spiritual culture by using survey instruments which evaluate workplace spirit, which includes meaning, values, interconnection, and inner life, and workplace attitude which includes organizational commitment, intention to stay, work satisfaction, job involvement and self- esteem at work. It has developed instruments to measure the presence and growth in virtues and behaviors that are associated with virtue in medicine which determine culture.
A variety of toolkits have been developed to provide employees with new perspectives about the workplace and the importance of a spiritual workplace. Many of these Topics include “Meaningful Work,” “Healthcare Goodness: A Spiritual Culture,” “Healthcare Mission, Values and Virtues,” “Compassionate Presence and Care: Virtue in Medicine.” For information, contact IMESO.
IMESO is regarded as a source of consultation for personal and professional concerns. The issues that are presented are usually spiritual and professional in nature. IMESO is also a source place for referrals. The staff sees this work of consultation as acts of goodness for the spiritual health of employees. Over 500 people have made use of the consultation services.
Programs and Articles
Anandarajah, G, Hight E. Spirituality and Medical Practice: Using the HOPE Questions as a Practical Tool for Spiritual Assessment. Am Fam Physician. 2001 Jan 1;63(1):81-89. http://www.aafp.org/afp/2001/0101/p81.html
A spiritual assessment as part of a medical encounter is a practical first step in incorporating consideration of a patient's spirituality into medical practice. The HOPE questions provide a formal tool that may be used in this process.
Bryan CS, Babelay AM. Building character: a model for reflective practice. Acad Med. 2009 Sep;84(9):1283-1288. doi: 10.1097/ACM.0b013e3181b6a79c.
Recent work in philosophy underscores the importance of character ethics (virtue ethics) as a complement to ethical systems based on duty or results. Recent work in psychology suggests that virtues and character strengths can be analyzed and taught. This article proposes a four-step method of reflective practice for building character that includes (1) the details of a situation; (2) the relevant virtues; (3) the relevant principles, values, and ethical frameworks; and (4) the range of acceptable courses of action.
Cloninger CR, Svrakic DM, Przybeck TR. A psychobiological model of temperament and character. Arch Gen Psychiatry. 1993 Dec;50(12):975-990. Review.
Previous research has confirmed four dimensions of temperament that are independently heritable, manifest early in life, and involve preconceptual biases in perceptual memory and habit formation. This article describes three dimensions of character that mature in adulthood and presents a psychobiological model of the structure and development of personality that accounts for dimensions of both temperament and character.
Curlin FA, Hall DE. Strangers or friends? A proposal for a new spirituality-in-medicine ethic. J Gen Intern Med. 2005 Apr;20(4):370-374.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1490093/
The authors argue that dialogue about religion between patient and physician should be approached as a form of philosophical discourse about ultimate human concerns. They further argue that such moral discourse is often essential to the patient-physician relationship.
Davidson RJ. Spirituality and medicine: science and practice. Ann Fam Med. 2008 Sep-Oct;6(5):388-389. doi: 10.1370/afm.900.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2532774/
This editorial identifies key questions about assessing a physician’s sensitivity to patient spirituality that have major implications for how healthcare clinicians are trained.
Ehman JW, Ott BB, Short TH, Ciampa RC, Hansen-Flaschen J. Do patients want physicians to inquire about their spiritual or religious beliefs if they become gravely ill? Arch Intern Med. 1999 Aug 9-23;159(15):1803-6.http://archinte.jamanetwork.com/article.aspx?articleid=1105624
The objective of this study was to determine if patients would object to the inclusion of the following question in a routine medical history: "Do you have spiritual or religious beliefs that would influence your medical decisions if you become gravely ill?" The results—based on responses from 177 ambulatory adult patients visiting a pulmonary practice at a university teaching hospital in 1997—showed that many but not all of the patients would welcome such a carefully worded inquiry about their beliefs.
Koenig HG. Religion, spirituality, and medicine: how are they related and what does it mean? Mayo Clin Proc. 2001 Dec;76(12):1189-1191.
This editorial reviews the controversy over addressing religious and/or spiritual issues within a medical setting and calls for clinical trials to examine not only the effects of spiritual interventions on health outcomes, but also to assess the effects on the patient-physician relationship, compliance with treatment, use of health services, disease outcomes, and quality of life.
McKee DD, Chappel JN. Spirituality and medical practice. J Fam Pract. 1992 Aug;35(2):201, 205-208.
This paper distinguishes between spiritual and religious issues and reviews the history of these issues in medicine as well as the growing medical literature in this area. The article also provides practical guidelines for the practicing physician.
Mueller PS, Plevak DJ, Rummans TA. Religious involvement, spirituality, and medicine: implications for clinical practice. Mayo Clin Proc. 2001 Dec;76(12):1225-1235.
This article provides a review of published studies, metaanalyses, systematic reviews, and subject reviews that examine the association between religious involvement/spirituality and physical health, mental health, health-related quality of life, and other health outcomes.
Religion among the millennials: Less religiously active than older americans, but fairly traditional in other ways. Pew Research Center. A Pew Forum on Religion & Public Life Report. 2010. http://www.pewforum.org/Age/Religion-Among-the-Millennials.aspx
This report—one of a series of studies that examine the values, attitudes, and experiences of America’s next generation—provides data on the religious affiliation, worship attendance, other religious practices, and religious attitudes and beliefs of young adults aged 18 to 29.
Salt S. Is Spirituality Good for Your Health? Cleveland Plain Dealer. Cleveland.com. April 03, 2012. http://blog.cleveland.com/healing/2012/04/is_spirituality_good_for_your.html
Religion and spirituality have often been viewed in medicine as largely irrelevant, even conflicting with care. That impression is changing according to Dr. Harold Koenig, Director of the Center for Spirituality, Theology and Health at Duke University. He has studied the links between health and spirituality for nearly 30 years.
Sevensky, RL. The Religious Foundations of Health Care: A Conceptual Approach. J Med Ethics. 1983;9:165-169. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1059326/pdf/jmedeth00010-0037.pdf
The relationship of religion and health is often misunderstood owing to a tendency to concentrate on the medical model and to ignore the wider context of health care.
Oxford Textbook of Spirituality in Healthcare by Mark R Cobb, Christina M Puchalski
This is one of the most comprehensive books on spirituality and healthcare. The relationship between spirituality and healthcare is historical, intellectual and practical, and it has now emerged as a significant field in health research, healthcare policy, and clinical practice and training. Understanding health and well-being requires addressing spiritual and existential issues, and healthcare is therefore challenged to respond to the ways spirituality is experienced and expressed in illness, suffering, healing, and loss.
The George Washington Institute for Spirituality and Health http://smhs.gwu.edu/gwish/
Center for Spirituality, Theology and Health http://www.spiritualityandhealth.duke.edu/index.php
Center for Spirituality and Healing: University of Minnesota http://www.csh.umn.edu/index.htm
Program on Medicine and Religion, University of Chicago https://pmr.uchicago.edu/
Coalition for Physician Well-Being http://forphysicianwellbeing.org/
Center for Spirituality and the Mind: University of Pennsylvania http://www.uphs.upenn.edu/news/News_Releases/apr06/CSM.htm
Medical Ethics: Ochsner Health System https://www.ochsner.org/health-resources/medical-ethics-at-ochsner
Mayo Clinic: Studies on Spirituality and Health http://www.ourjourneyofhope.com/general-resources/mayo-clinic-releases-studies-on-spirituality-and-health/
You can help IMESO serve the healthcare needs of our community.
To donate, please contact IMESO directly at IMESO@ochsner.org
or call 504.842.6941.
To learn more about different ways you can donate to Ochsner, visit our Philanthropy page.
Rev. Anthony De Conciliis, C.S.C., D. Min., Ph.D.
Vice President - IMESO: Spiritual Culture and Transformation
Institute of Medicine, Education, and Spirituality at Ochsner
Ochsner Health System
Adjunct Associate Professor
University of Queensland Medical School