Trials and tribulations on the road to implementing integrative medicine in a hospital setting

Coulter, Ian D.; Hilton, Lara; Ryan, Gery W.; Ellison, Marcia A.; Rhodes, Hilary J.

doi:10.5172/hesr.451.17.4.368

Cited by 20 publications

(13 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Rather, communication, and thus collaboration are stunted by the four challenges (e.g., challenges to credibility, legitimacy, and unification). Previous research reveals that the practice of collaboration is not working well in medical settings and that many challenges exist in the efforts to facilitate integration (Coulter et al, 2008;Kaptchuk & Miller, 2005;Mizrachi, Shuval, & Gross, 2005;Wiese, Oster, & Pincombe, 2010). Our results build upon these findings, and more research is needed to understand what steps can be taken to facilitate collaboration between hospital administrators and clinicians because of their greatly divergent priorities.…”

Section: Theoretical and Practical Implicationssupporting

confidence: 77%

“…The process of blending these differing communication perspectives in order to benefit a patient has rarely been researched. More often, research reveals that biomedical clinicians do not accept IM, and that "multiple communication failures" require negotiation at multiple levels by a variety of stakeholders (Cohen, 2004;Coulter, Hilton, Ryan, Ellison, & Rhodes, 2008). Interestingly, some health care systems advertise and market IM to their patients but fail to take the needed steps to ensure IM is supported and integrated within the system .…”

Section: Teamwork and Collaborationmentioning

confidence: 95%

See 1 more Smart Citation

Challenging integration: clinicians’ perspectives of communicating collaboration in a center for integrative medicine

Geist-Martin

Bollinger

Wiechert³

et al. 2015

Health Communication

View full text Add to dashboard Cite

A shift has occurred in the provision of health care to include a focus not just on biology and disease but also on the whole person, preventative care, and an array of healing modalities based on systems of beliefs and values not typically included within biomedical practice. This approach to health care, termed integrative medicine (IM), blends biomedicine with a broader understanding of patients and their illnesses, including elements of mind, body, and spirit that may be contributing to an ailment. While the use of integrative medicine has increased and centers for integrative medicine have proliferated within conventional health care organizations, distinct tensions arise from this amalgamation. The tensions between IM and biomedical clinicians often center on their differing training and philosophies, as well as on a larger system of health care that privileges biomedicine. As a result, this research is designed to explore the challenges IM clinicians face in collaborating with conventional practitioners to provide patient care. Analysis of interviews with 14 clinicians at one center for integrative medicine revealed four specific challenges they face in their attempt to co-practice IM with conventional medicine. The four challenges include (a) challenges to collaboration, (b) challenges to legitimacy, (c) challenges to consistency, and (d) challenges to unification. Future research should investigate the ways in which these challenges can be addressed so that collaboration throughout the system is facilitated. The professional training of clinicians, the structuring and institutionalization of integrative medicine, and enhanced systems for communicating patient information all play a significant role in this transformation.

show abstract

Section: Theoretical and Practical Implicationssupporting

confidence: 77%

Section: Teamwork and Collaborationmentioning

confidence: 95%

Challenging integration: clinicians’ perspectives of communicating collaboration in a center for integrative medicine

Geist-Martin

Bollinger

Wiechert³

et al. 2015

Health Communication

View full text Add to dashboard Cite

show abstract

“…Research in adult contexts has also noted the importance of key decisionmakers in implementing IM programs. 45 This suggests the importance of stakeholder engagement in the future of CIM dissemination and implementation.…”

Section: Limitationsmentioning

confidence: 99%

Employing Evidence in Evaluating Complementary Therapies: Findings from an Ethnography of Integrative Pain Management at a Large Urban Pediatric Hospital

Roth

Highfield

Cuccaro

et al. 2019

The Journal of Alternative and Complementary Medicine

View full text Add to dashboard Cite

Background: Complementary and Integrative Medicine (CIM) shows positive clinical benefit with minimal side effects, yet, challenges to effective integration of CIM providers in biomedical health care settings remain. This study aimed to better understand the role evidence played in the process of integration of complementary therapies into a large urban pediatric hospital from the perspective of patients, caregivers, providers, and administrators through applied medical ethnography. Methods: An ethnography was conducted over the course of 6 months in a large urban pediatric hospital in the Southern United States. At the time, the hospital was piloting an integrative medicine (IM) pain consult service. Purposive sampling was used to select providers, patients, administrators, and caregivers to follow as they engaged with both the preexisting pain service and pilot IM pain services. Field observation and interviews were conducted with 34 participants. Thematic content analysis was used to analyze field notes, interview transcripts, and documents collected. Findings: Analysis of the data revealed five themes regarding the role of evidence in the process of integration: Anecdotal Evidence and Personal Experience Effecting CIM Use, Open to Trying Whatever Works, Resistance to the Unfamiliar, Patients and Parents Trusting Doctors as Experts, and Importance of Scientific Evidence to Biomedicine. All themes address the role of evidence in relationship to acceptance of complementary therapies and correspond with three thought processes: critical thinking, relying on others for evidence, and reactionary thinking. Conclusion: Both scientific and anecdotal evidence informed CIM use in this context. Biomedical environments seeking to integrate CIM into pain treatment regimens will need to engage all relevant stakeholders in building education, clinical training, and research programs that are critically informed about the context and evidence for CIM.

show abstract

“…Previous research on IM in hospital settings described the development and operational elements of inpatient IM programs [ 7 – 10 ] or focused on nursing, administrative, or physician perspectives [ 11 , 12 ]. For instance, the authors of one study highlighted the views and experiences of administrators regarding the development and ultimate failure of an IM center [ 7 ]. Other studies have obtained IM practitioner perspectives in the context of primary care and research settings [ 13 – 17 ].…”

Section: Introductionmentioning

confidence: 99%

Practitioner Perspectives on Delivering Integrative Medicine in a Large, Acute Care Hospital

Nate

Griffin

Christianson

et al. 2015

Evidence-Based Complementary and Alternative Medicine

View full text Add to dashboard Cite

Background. We describe the process and challenges of delivering integrative medicine (IM) at a large, acute care hospital, from the perspectives of IM practitioners. To date, minimal literature that addresses the delivery of IM care in an inpatient setting from this perspective exists. Methods. Fifteen IM practitioners were interviewed about their experience delivering IM services at Abbott Northwestern Hospital (ANW), a 630-bed tertiary care hospital. Themes were drawn from codes developed through analysis of the data. Results. Analysis of interview transcripts highlighted challenges of ensuring efficient use of IM practitioner resources across a large hospital, the IM practitioner role in affecting patient experiences, and the ways practitioners navigated differences in IM and conventional medicine cultures in an inpatient setting. Conclusions. IM practitioners favorably viewed their role in patient care, but this work existed within the context of challenges related to balancing supply and demand for services and to integrating an IM program into the established culture of a large hospital. Hospitals planning IM programs should carefully assess the supply and demand dynamics of offering IM in a hospital, advocate for the unique IM practitioner role in patient care, and actively support integration of conventional and complementary approaches.

show abstract

Trials and tribulations on the road to implementing integrative medicine in a hospital setting

Cited by 20 publications

References 2 publications

Challenging integration: clinicians’ perspectives of communicating collaboration in a center for integrative medicine

Challenging integration: clinicians’ perspectives of communicating collaboration in a center for integrative medicine

Employing Evidence in Evaluating Complementary Therapies: Findings from an Ethnography of Integrative Pain Management at a Large Urban Pediatric Hospital

Practitioner Perspectives on Delivering Integrative Medicine in a Large, Acute Care Hospital

Contact Info

Product

Resources

About