In the healthcare reform environment it is imperative that chaplains redesign how pastoral care is conducted in ways that are more efficient and effective. One model is to screen patients to identify those who want or need pastoral care. Another model is using referrals from other healthcare staff. This article describes an attempt to combine these two models using volunteers and Basic Clinical Pastoral Education students. Under pressure of healthcare reform, healthcare providers and professionals are reassessing how they do their work. This is true of chaplaincy as well. This article is a preliminary report on one attempt at re-designing how pastoral care is conducted by a Department of Pastoral Services at a academic medical center in the East.