Integrating a Complementary Medicine Service Within a General Surgery Department: From Contemplation to Practice

Schiff, Elad; Attias, Samuel; Hen, Haim; Kreindler, Gur; Arnon, Zahi; Sroka, Gideon; Ben‐Arye, Eran

doi:10.1089/acm.2011.0564

Cited by 28 publications

(13 citation statements)

References 20 publications

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“…In addition, they were required to have multiple CM expertise (eg, tai chi and acupuncture), excellent communication skills, proven leadership initiative, didactic capability, an appreciation of conventional medicine and respect for the institutional context. Their competences were evaluated by reviewing school curricula and individual curriculum vitae, asking referees about the characteristics described above and conducting a formal interview with the directors of the CM service, CM practitioners and a clinical psychologist …”

Section: Resultsmentioning

confidence: 99%

“…In 2010, a CM service was launched at a public academic medical centre in Israel. 4 In this service, patients are referred by the medical staff to CM practitioners according to predefined indications, such as pain, anxiety, nausea and insomnia. 26 27 CM practitioners also actively survey patients for side effects, which they document in the registry.…”

Section: Study Setting and Patient Populationmentioning

confidence: 99%

“…The use of complementary medicine (CM) is increasing steadily in the Western world, with interest growing in proportion to the chronicity of illness and its burden on life . Provision of CM for hospitalised individuals has been reported mainly in the context of clinical trials, whereas the integration of CM as a service for the care of hospitalised patients has seldom been reported in the medical literature …”

Section: Introductionmentioning

confidence: 99%

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First, keep it safe: Integration of a complementary medicine service within a hospital

et al. 2018

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Summary Objectives This paper sought to explore risk/safety considerations associated with the integration of a complementary medicine (CM) service within a public academic medical centre in Israel. Methods We reviewed various sources pertaining to the CM service (interviews with CM staff, patients' electronic charts, service guidelines, correspondence with hospital administration) and conducted a thematic analysis to evaluate safety‐related incidents during the 7 years of operation. In addition, we systematically assessed the charts for reports of treatment‐associated adverse effects, which were documented in an obligatory field on treatment reports. Results After reviewing transcripts of interviews with 12 CM practitioners and with the director and vice‐director of the CM service as well as transcripts of 8560 consultations that included 7383 treatments, we categorised 3 major domains of CM safety management: (i) prevention of safety‐related incidents by appropriate selection of CM practitioners and modalities, (ii) actual adverse incidents and (iii) prevention of their recurrence using both hospital and CM service safety protocols. CM staff reported 5 categories of adverse incidents, most of which were minor. Twenty‐nine adverse incidents were documented in the 7383 treatment sessions (0.4%). Conclusions Safety management needs to be addressed both before introducing CM services in hospitals and throughout their integration. Important considerations for the safe integration of CM practices in the hospital include communication between CM and conventional practitioners, adherence to hospital safety rules, implementing a systematic approach for detecting and reporting safety‐related incidents and continuous adaptation of the CM service safety protocols.

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Section: Resultsmentioning

confidence: 99%

Section: Study Setting and Patient Populationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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First, keep it safe: Integration of a complementary medicine service within a hospital

et al. 2018

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“…Other studies of CM practitioners in hospital settings have identified that clear boundaries are often drawn around the ‘work’ of CM practitioners. Physicians may support the CM practitioners’ presence but maintain ‘jurisdictional’ control [1, 32, 33]. …”

Section: Discussionmentioning

confidence: 99%

The process of care in integrative health care settings – a qualitative study of US practices

Grant

Bensoussan

2014

BMC Complement Altern Med

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BackgroundThere is a lack of research on the organisational operations of integrative healthcare (IHC) practices. IHC is a therapeutic strategy integrating conventional and complementary medicine in a shared context to administer individualized treatment. To better understand the process of care in IHC - the way in which patients are triaged and treatment plans are constructed, interviews were conducted with integrative health care leaders and practitioners in the US.MethodsSemi-structured interviews were conducted with a pragmatic group of fourteen leaders and practitioners from nine different IHC settings. All interviews were conducted face-to-face with the exception of one phone interview. Questions focussed on understanding the “process of care” in an integrative healthcare setting. Deductive categories were formed from the aims of the study, focusing on: organisational structure, processes of care (subcategories: patient intake, treatment and charting, use of guidelines or protocols), prevalent diseases or conditions treated, and the role of research in the organisation. The similarities and differences of the ITH entities emerged from this process.ResultsOn an organisational level, conventional and CM services and therapies were co-located in all nine settings. For patients, this means there is more opportunity for ‘seamless care’. Shared information systems enabled easy communication using internal messaging or email systems, and shared patient intake information. But beyond this infrastructure alignment for integrative health care was less supported. There were no use of protocols or guidelines within any centre, no patient monitoring mechanism beyond that which occurred within one-on-one appointments. Joint planning for a patient treatment was typically ad hoc through informal mechanisms. Additional duties typically come at a direct financial cost to fee-for-service practitioners. In contrast, service delivery and the process of care within hospital inpatient services followed a more formalised structure.ConclusionsIHC is a complex, emerging field with divergent meanings and interpretations. The structures and processes of the IHC entities reported provide insight to the variable ways in which IHC manifests whilst commonly holding a similar vision. This report contributes to understanding IHC, providing evidence for future planning, implementation and evaluation to meet patient needs and demands in this area.

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“…Practitioners at the CISS provide various CM treatments to palliate common perioperative symptoms. Treatment outcomes are documented and analyzed via a rigorous registry protocol [14, 15]. Acupuncture was reported in several studies as an effective treatment for reducing postoperative pain [16], and therefore we considered it as potentially appropriate for PLSP.…”

Section: Introductionmentioning

confidence: 99%

Treating Postlaparoscopic Surgery Shoulder Pain with Acupuncture

Kreindler

Attias

Kreindler

et al. 2014

Evidence-Based Complementary and Alternative Medicine

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Objective. The purpose of this study was to examine the effect of acupuncture on postlaparoscopic shoulder pain (PLSP) which is a common side effect in patients undergoing abdominal laparoscopic surgery. Methods. Patients with moderate to severe PLSP in spite of analgesic treatment, which were referred by the medical staff to the Complementary-Integrative Surgery Service (CISS) at our institution, were provided with acupuncture treatment. The severity of PLSP and of general pain was assessed using a Visual Analogue Scale (VAS) from 0 to 10. Pain assessment was conducted prior to and two hours following acupuncture treatment. Acupuncture treatment was individualized based on traditional Chinese medicine diagnosis. Results. A total of 25 patients were evaluated during a 14-month period, from March 2011 to May 2012. A significant reduction in PLSP (mean reduction of 6.4 ± 2.3 P < 0.0001) and general pain (mean reduction 6.4 ± 2.1 P < 0.0001) were observed, and no significant side effects were reported. Conclusion. Individualized acupuncture treatments according to traditional Chinese medicine principles may improve postlaparoscopic shoulder pain and general pain when used in conjunction with conventional therapy. The primary findings of this study warrant verification in controlled studies.

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Integrating a Complementary Medicine Service Within a General Surgery Department: From Contemplation to Practice

Cited by 28 publications

References 20 publications

First, keep it safe: Integration of a complementary medicine service within a hospital

First, keep it safe: Integration of a complementary medicine service within a hospital

The process of care in integrative health care settings – a qualitative study of US practices

Treating Postlaparoscopic Surgery Shoulder Pain with Acupuncture

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