Friday, December 28, 2018

December 2018 Research Thursdays Summary

key words:  research literacy, funding and grants, sharing related research in the field, research in integrative health

The December Research Roundup

Review of the "Research and Metrics Thursdays" theme from the public Facebook Page and newsletter

  1. Mindfulness program for the management of chronic pain, a article, What Mindfulness for Opioid Addiction Looks Like
  2. Evidence-based Acupuncture.  Research summaries and EBA Connect program.
  3. Research Funding Opportunity--NCCIH and NIH funding if you work in pain management or addiction, especially the field of opioid addiction.  Check out the new (12.10.2018) funding announcements related to the NIH HEAL initiative. Learn more about the HEAL initiative at this webpage.  If you have heard me talk about the National Pain Strategy document the past couple years, HEAL builds upon parts of the work laid out in that very large federal public document.

Recommended Studies to Read (started this in the summer and fall newsletters)

  • December
  • November
  • October
    • From the Mayo Clinic, St. Mary's and Methodist hospitals, a prospective study of integrative medicine services in an inpatient setting.  
      • 87% of the integrative medicine services were massage therapy performed by an NCBTMB certified massage therapist and 9% were acupuncture services by an LAc.  
      • Both services were found to statistically significantly decrease pain level post-treatment.  
      • Over 1/3 of the hospitalized patients fell asleep during treatment, which researchers found fascinating as future research potential since good quality sleep/rest helps decrease need for medications (whether it is meds to induce sleep or meds to decrease pain because lack of sleep increases pain and other symptoms), and significantly improves outcomes in an environment (inpatient hospital space) that is not naturally conducive to rest.  
      • source/citation:  Stephanie D. Clark, Brent A. Bauer, Sairey Vitek, Susanne M. Cutshall.  Effect of Integrative Medicine Services on Pain for Hospitalized Patients at an Academic Health Center.  Explore: The Journal of Science and Healing. 2018. 
  • September--see the newsletter, under "Metrics and Research Thursday" for full list.
Recommended Studies to Read in Older Newsletters
  • August 2018 newsletter
    • Metrics:  Don't underestimate the simplicity and usefulness of patient satisfaction surveys as one of your clinic's metrics
      • "We found that hospitals' patient satisfaction scores are useful signals of quality, which surprised me to some extent," said Joseph Doyle, an economist at M.I.T. and one of the studies authors.  
      • "Hospitals with more satisfied patients have lower mortality rates, as well as lower readmission rates."  New York Times article. 2017.07.24  
      • Original study is a working paper, Evaluating Measures of Hospital Quality by Joseph Doyle, John Graves, and Jonathan Gruber.  National Bureau of Economic Research (NBER), working paper no.23166, issued in February 2017.  
    • Research and delivery method practicality for teaching self-care basic breathing and meditation techniques:  email and mobile app.  
      • This study targeted oncology clinicians, who have a high burn-out rate.  What delivery method (tool) allows ease-of-access and may increase participant compliance for studying a self-care therapy?  possibly email and/or mobile apps.  More research needed.  
      • Carie Heeter and Rebecca Lehto.  Meditation App Benefits Hospice and Palliative Care Clinicians.  Oncology Nursing News.  July 31, 2018.  
  • July 2018 Newsletter
  • May 2018 Newsletter

For more on the topic of research

  • follow the tag/label in this blog for "research literacy"

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The December Self-Care Saturdays: inspiration for your home self-care practices

key words:  self-care, practitioner resilience, wellness, mindfulness practices; mindful cup of tea, mindfulness learning with kids, "forest bathing"--nature the outdoors and your health, dealing with holiday stress

The December Self-Care Roundup

Some inspiration from the Self-Care Saturdays theme over at our public Facebook Page

The Mindful Cup of Tea
  • Practice mindfulness or "being-in-the-present-moment" with a warm cuppa.  My kids do this well with their hot chocolate lately--down to watching the marshmallows melt.  

Breathe Like a Bear by Kira Willey
  • This is my family's 2018 favorite and the book is based on her songs.  I recommend getting the matching songs; most of them are part of her Mindful Moments for Kids music compilation.  More at this blogpost.  If you follow an Amazon affiliate link from our blogpost and buy within a few hours, a few pennies of your purchase go to the Project.  However, if you want to support the Project the best and most direct way is through our website. Thank you.

Have you heard about "forest bathing" or want to read more about the health benefits of spending time outdoors?
Check out these recommendations...🙂🏞🧗‍♀️🛶🚲🏔🎣☕️
Nature, the Outdoors, and Your Health on our Gift Ideas page, just below the "outdoor fun" section:

  • Forest Bathing:  how trees can help you find health and happiness
  • Shinrin Yoku:  The Japanese Art of Forest Bathing
  • The Nature Fix: why nature makes us happier, healthier, and more creative by Florence Williams
  • Blue Mind:  the surprising science that shows how being near, in, on, or under water can make you happier, healthier, more connected and better at what you do by Wallace J. Nichols
  • The Lost Art of Reading Nature's Signs:  use outdoor clues to find your way, predict the weather, locate water, track animals--and other forgotten skills of natural navigation by Tristan Gooley

Self-care check are you doing today with the holiday stress?  Challenged to stay grounded? (12.21.2018)

  • Take a moment while you are reading this and breathe several belly breaths (diaphragmatic breathing) and stretch.
  • It's the longest night of the year tonight.  Great time to be quiet in the evenings and enjoy the starlight or the bright winter moon (if you have minimal cloud cover).  Please share a photo of your night sky when you take time to go outdoors this weekend.  For all of you in stormy weather conditions, stay safe and maybe share a pic of your warm mug of cocoa cheer.
  • Related articles:  mindful cuppa, short daily practices to manage overwhelm, and tips for dealing with holiday stress from

Move Your Body!
"Remember how amazing you felt the last time you hit the gym or took a hike in the woods?  How clear and calm you felt after your last yoga class?  Exercise can settle your mind.  It can make you feel refreshed from head to toe.  It helps to dissolve tension in places you may not have realized were tense.  You want to remember this feeling.  The next time you exercise, pause for a few minutes afterward.  Sit down or lie down to fully savor the post-exercise glow....The state of your body reflects the state of your mind.  A good walk clears away the mental cobwebs."  Read more at Winter Got You Down? article on

Get Outside and Move! 
This 6-month study found that exercise (walking or bicycling) for 30 minutes 3x/week improved your brain's function.  For the study group, about age 65 - 90+, 6 months of exercise at this rate lowered the "brain age" by 9 years.
My takeaways:
  • Not moving/sedentary lifestyle is not good for your brain
  • You can reverse the effects of a sedentary lifestyle by moving, at least 30 minutes at a time.  Every day if possible.
  • With all the data now on health benefits of being outdoors and in nature, for that extra health boost:  do your movement time...
    • Outdoors--better if it is a green area (assuming no smog or other air pollution warnings for your area that day), or woods or near a large body of water (lake, sea)
    • Do some gardening every week--working with healthy soil is good for our brains, too
  • Read more about this study at ReachMD or CNN.
You can read more about the health benefits of time spend outdoors in the book, Nature Fix. You can follow the link to the Amazon store for this book in paperback or audiobook at our gift ideas page under "outdoor fun and health benefits of nature".

Be proactive this holiday season to combat loneliness and help others do the same
"Be proactive this holiday season to combat loneliness or to help others do the same.  Map out a plan before you find yourself feeling fully disconnected and isolated.  By anticipating feelings of loneliness--either your own or of someone else (even a stranger)--you'll be better equipped to face them." If your mind is stuck in dark rut, call for free help at the national hotline:  1-800-273-8255.

Related blogposts
November Self-care Saturdays Roundup

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Wednesday, December 26, 2018

December Leadership and Workplace Mondays Roundup

keywords:  leadership, workplace, workplace culture, being an employee, mentorship and mentor relationships, mindfulness and leadership

Inspiration for Employees and their Leaders 

Review of the "Leadership and Workplace Mondays" theme from the public HHP Facebook Page, December 2018

"Finding the Space to Lead", a article:
"A mindful leader embodies leadership presence by cultivating focus, clarity, creativity, and compassion in the service of others....You can learn to lead with excellence by cultivating your innate capabilities to focus on what is important, to see more clearly what is presenting itself, to foster greater creativity, and to embody compassion....These choices often lead to a win-win-win scenario:  good for the organization, good for the employees, and good for the community."  
"It is also true, though, that these tumultuous times can offer great opportunity and ample possibilities for innovation, as the world becomes smaller and we begin to see the potential to meet the complexities of the day in ways that are truly creative, productive, and compassionate.  It's a time to take leadership, and to redefine what it means to lead with excellence."  
"Just as a pebble thrown into a still pond can create ripples spreading throughout the whole of the pond, so too can the cultivation of leadership presence go far beyond the effect it has on us alone."  
"Taking note of the qualities exhibited by leaders we admire can help all of us pinpoint how to become better leaders ourselves."

Why Kindness Matters at Work, an article from Wharton.
"If we see the impact that mindfulness has on safety and on outcomes for patients in reducing health care errors, how can we not start...looking at this as real way that we can improve the quality of work?"

We don't do leadership; we are leaders from the Garrison Institute

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Related blogposts on Leadership

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Monday, December 17, 2018

Find Your Trail Guides: The Directory of Hospital-based Learning Opportunities for Acupuncturists

This will also be published on the website blog--just getting through some tech learning curve with the website blog.  :)

Last updated:  09.25.2019
The Hospital-practice Handbook Project’s Directory of Hospital-based Learning Opportunities for Acupuncturists
Full explanation at this blogpost

Go to this Link to add your resource to the directory

Background and Introduction
This directory came out of feedback from the “How do I get my Foot in the Door of Hospital Practice” blogpost series that posted spring and summer 2018. The 3 main stepping stones in that series are: nonclinical volunteer work, shadowing, and cultivating mentor-relationships. The series was re-written into a booklet, Get Your Foot in the Door: First Steps for the Acupuncturist or Integrative Health Student Interested in Hospital-Based Practice; go to this page to order it and here to order the companion workbook that walks you through the exercises laid out in the booklet.

If you are a new hospital employee, I recommend you sign up for the upcoming (summer or fall 2019) audiovisual resource "Basics of Being An Employee in a Healthcare System".

Learn more about what qualifies as an entry for the directory in this post. Go to this Link to add your resource to the directory.

Facility or Program
What is available?
Contact Information
Acupuncture Program at Advocate Aurora Health System
Learn more about the program in this post.

Greater Milwaukee area, Wisconsin
Shadowing opportunities
Point of contact: 
Dr. John Burns

University Hospitals, Connor Integrative Health Program

Cleveland, Ohio
Virtual mentorship
Christine Kaiser

Evidence-based Acupuncture
More information at this webpage
Volunteer work
Mel Hopper Koppleman
Volunteer, research literacy, biomedical communication

What is available?
Contact information
Claudia Citkovitz’s program at NYU Langone Hospital-Brooklyn
Brooklyn, NY
Continuing education courses on inpatient care

Clinical intensives (3-4 days) in stroke/rehab, labor & delivery, more

Clinical observation, offered weekly

Long-term mentorship opportunities for inpatient work
Claudia Citkovitz
CEU, online, onsite, inpatient, shadow/clinic observation, mentoring,

If you find the information in this blog or its website useful, you can keep this work going by:

Thursday, December 13, 2018

Lunchtime Listen: FDA Roadmap on Patient Reported Outcome Measures

key terms:  for program managers, developing research study designs, designing patient-centered metrics for your clinical practice
updated 7.24.2019

Who this Lunchtime Listen recommendation may benefit:
  • any of you working in metrics for your clinic, as a clinician or as a program manager
  • clinicians who want to understand more about patient-reported outcomes and patient-centered metrics
  • if you are interested in health policy and how metrics and health policy collide

What this Lunchtime Listen is:  the National Health Council's webinar series on the "FDA Roadmap" as it relates to growing and developing patient-centered metrics for your clinic or program.  NHC is recommending clinical settings get ahead in creating these before federal mandates require this metrics to be in place.  Depending on your program, your mission, your patient demographic and needs, and your resources, these metrics may take years to develop and implement.

National Health Council Webinar Series Patient-reported Outcome Measures
November 2018 – July 2019


Clinical Outcome Assessments Webinar Series with National Health Council (NHC)
National health policy is adopting more aspects of patient-centered paradigm.  Part of this paradigm is using patient-reported outcome measures. In fact, the Food and Drug Administration (FDA) released guidance documents on clinical outcome assessment for 2019.  
This webinar series by the NHC is intended to help clinicians and clinical programs and researchers better understand these ideas and this paradigm and discuss a little about what implementation looks like.  The overall take-away I had from this was to start now because implementation of clinic-wide or system-wide metrics appropriately can take years, not weeks nor months...years.

November 2018 webinar:  Patient-Reported Outcomes and Patient-Centered Outcomes 
"Nov. 7, 2018.  In patient-centered research and care, we focus on the outcomes most important to patients.  Often, patients tell us that what is most important to them is how they feel and how well they function in their everyday lives.  These outcomes are referred to in research as patient-reported outcomes or PROs.  So, what is the difference between a patient-centered outcome and a patient-reported outcome?  Are they the same?  The answer is:  No, they are not the same!  In this webinar, presented by Dr. Eleanor Perfetto, you will learn about the difference between patient-centered outcomes and patient-reported outcomes, and whey we need patient-centered PROs in research and care."  Learn more at website listed above.

Video of the presentation:

December 2018 webinar
"FDA's Roadmap to Patient-Focused Outcome Measurement in Clinical Trials"
Dec. 7th, 2018 webinar
summary:  "in patient-centered research and care we focus on the outcomes most import to patients.  Often, patients tell us that what is most important to them is how they feel and how well they function in their everyday lives.  To capture data on these outcomes in clinical trials, measures must first be developed.  This webinar introduces participants to a document, the Roadmap, developed by the Clinical Outcome Assessment (COA) team at the Food and Drug Administration.  The Roadmap helps researchers develop tools that measure outcomes that matter most to patients."

Video of the presentation:

January 17th, 2019
"Clinical Outcome Assessment Webinar Series:  Untangling the Terms:  Endpoints, Items, Outcomes, PROs, PROMS, PRO-PMs" with Ashley Slagle, MS, PhD

The presenter will be defining and providing examples of the following terms used in the past 2 webinars which are important to understand to be able to comprehend the FDA Roadmap about the new clinical outcome guidelines.  Terms to include:  endpoints, items, outcomes, PRO, PROM, and PRO-PM.

Why is this topic important?
"In 2019, the [FDA] will release two new draft guidance documents on COAs [clinical outcome measures].  COA-related terminology can be confusing.  This webinar will provide a primer to help prepared to participate in COA-related research and policy development."

video of the presentation:

February 20th, 2019
Successful Clinical Outcome Assessmements (COAs):  It all starts with the "concept of interest" and "context of use" with T. Rosie Love, MPH, of the Maryland School of Pharmacy, Department of Pharmaceutical Health Services Research.
concept of interest = what you are trying to measure.  examples: functional change; change in range of motion; change in inflammation markers; change in symptoms, etc.
context of use = (see presentation).  examples: adults with chronic back pain age 35-60; adults with inflammatory bowel disease age 18 - 28; adults post-knee surgery 2-8 weeks post-surgery
content validity = are you measuring what matters?  are you measuring what patients care about?
Video of the presentation (36 minutes):

March 20th, 2019
What Do We Mean by Validation of a Measure? Presented by Dr. Eleanor Perfetto, Executive Vice President, Strategic Initiatives, at the National Health Council
Video of the presentation (29 minutes):

April 18th, 2019
The 6th in the Clinical Outcome Assessment series from the National Health Council,
Measuring Patient Experiences:  Distinguishing Between Patient-Reported Outcomes and Patient Preferences with Pauline McNulty and Bennett Levitan of Johnson & Johnson.
This webinar covers the differences between patient-reported outcomes (PROs) and patient preferences.  "Patient-reported outcomes or PROs provide insights on how patients feel and function in their everyday lives. Patient preferences, on the other hand, reflect what patients choose when presented with different options (e.g., treatment attributes, desired outcomes)."
Video recording of the presentation (60 minutes):

May 14th, 2019
"Lessons Learned from a Patient Group's Experience Developing a PRO" with Dory Kranz, President and CEO of the National Alopecia Areata Foundation. This session presents a case study of the process of a patient advocacy group as they develop a patient reported outcome (PRO). 
Video recording of the presentation: 

June 10th, 2019
"What is the Difference Between Health-Related Quality of Life (HRQoL) and Patient-Reported Outcomes" with Laurie Burke, MPH, Founder of the LORA Group, LLC

Video recording of the presentation: 

July 15th, 2019
"Core Outcome Sets" with Donna Messner, President and CEO at the Center for Medical Technology Policy

Video recording of the presentation:

For more about the National Health Council's FDA Roadmap Series, go to their website.

Monday, December 10, 2018

Acupuncturists Working in the Emergency Department at the Aurora Health System of Wisconsin: A Success Story

key phrases:  interview, acupuncture programs, acupuncture for acute pain, acupuncture in the ER, examples of incorporating acupuncture into healthcare systems and hospitals

Who:  John Burns, DPT, MSOM, Manager of Acupuncture at Aurora Health Care, Milwaukee, Wisconsin

Organization:  Advocate Aurora Health Care
Location:  Milwaukee, Wisconsin and surrounding suburbs
What:  Providing services in 11 oncology clinics, 7 OP clinics, 1 ED, 2 IP

Dr. Burns with his poster at the AIHM conference. #AIHM18
photo credit Megan Gale

Quick Outline

  1. Introduction
  2. The Study
  3. The Program
  4. References

Wouldn’t it be great, as a patient, to have access in your local emergency room (ER) to non-pharm therapy option for relief of your strong pain, nausea, or GI symptoms, especially if you have adverse reactions to some medications?  Wouldn’t it be useful, as a provider in the Emergency Department (ED), if you had the ability to refer to a non-pharm therapy within your ED to help ease common ED presenting symptoms of pain, anxiety, stress, and nausea?

I met John Burns, DPT, MSOM, at the Academy of Integrative Health and Medicine (AIHM) conference #AIHM18 in San Diego in September where he was presenting his ED work at Advocate Aurora Health Care of Milwaukee, Wisconsin, in a poster session.  His study looked at the practicality of offering acupuncture services in the ED of a Wisconsin hospital. And, with enthusiasm, I watched him receive first place in the poster session for his team’s work!

Dr. Burns has a doctorate degree in physical therapy and a master of science degree in oriental medicine from Midwest College of Oriental Medicine, Racine, Wisconsin.  For the past 4 years Dr. Burns has been the manager of the acupuncture services program at Aurora Health Care, Sinai Hospital.  During a lunch break at the AIHM conference, I interviewed Dr. Burns about his ED study from the poster, and about the Aurora Acupuncture program.

Part 2:  The Study
More about the AIHM Research Poster Submission
Site of the study presented in the poster:  Emergency Department, Aurora West Allis Medical Center, West Allis, WI. 

What was Dr. Burns’ inspiration for the project? 
With a smile, Dr. Burns notes it was the research study on acupuncture into the ED setting of the Allina Health system of Minnesota by Adam Reinstein and Jeff Dusek that inspired him. The Allina ED study was published in 2017 in the peer-reviewed scientific journal, Pain Medicine[1].

Poster Title
“Utilization of Acupuncture Services in the Emergency Department Setting:  A Quality Improvement Study” by John Burns, DPT, MSOM, Jessica J.F. Kram, MPH, Vashir Xiong, MSOM, Jeanne Stark Casadont, MSOM, Tiffany Mullen DO, Nancy Conway, MS, Dennis Baumgardner, MD
Dr. John Burns awarded first place of the
 AIHM 2018 posters.
photo credit Megan Gale
Background and Reason for this ED Pilot
Patients often present to the emergency department (ED) for pain.  Acupuncture may decrease acute pain experienced by patients seeking ED services.  Acupuncture is an evidence-based, non-pharmacologic option for pain relief and pain management[2].

Goal of the Pilot
Dr. Burns notes: “the major purpose was to determine acceptability of acupuncture in the ED as either adjunctive or optional care for patients.”  The study was the first to assess the impact of acupuncture in the ED for pain management in the Aurora Health system.  The researchers wanted to determine acceptability of the acupuncture program by the patients and the ED staff.  This was a quality improvement study.

This was a retrospective observational study of patients in the Emergency Department. 

Patients admitted to the ED were offered acupuncture treatment for their acute pain condition based on their:
·         Emergency severity index (ESI)[3]
·         Reason for visit
·         Their physician’s approval

What Electronic Health Record (EHR) program do you use?
Aurora uses EPIC for documentation.  Dr. Burns worked with IT staff to create a specific data field in the EHR to track outcomes from the acupuncturists’ progress notes. 

Measurements/Metrics Used in ED study
In the ED study, they tracked patient-reported outcomes.  The top 3 measures were:  pain, stress, and anxiety.  The symptoms were measured on the numeric rating scale (NRS), of 0-10 for each.

Striking aspects to note about the study
The demographics of the patients treated represented the demographics of the local ED.
When patients were treated by the ED acupuncturist, they received only acupuncture.  For example, some patients had less than 8 needles per acupuncturist’s discretion, and some did not retain the needles past 20 minutes due to other services needed (such as x-rays).

What are important points/take-aways from this study?
  • Acupuncture reduced acute pain.  In the study, patients who received acupuncture reported 50% pain relief (average)
  • Acupuncture reduced symptoms of nausea by about 60%
  • Acupuncture in the ED setting is feasible

Where is the Emergency Department (ED) research published?
Dr. Burns’ paper was published April 29th, 2019, in the peer-reviewed scientific journal, Journal of Patient-Centered Research and Reviews (JPCRR).  See reference section below for citations and links.

Review of Clinical Program Implications for this Study
Availability of acupuncture services in the ER increases ease of access to non-pharm pain relief. And, for someone admitted to the hospital, having acupuncture as an option in the ER and the inpatient unit may decrease the complexity of their medication panel.  It may reduce the medication panel complexity because it reduces the common symptoms of nausea, stress, anxiety, and pain without medication (non-pharm therapy).

Considerations for future studies
Dr. Burns noted: “This [study] was only a pilot program to determine if acupuncture would be accepted by ED patients and staff.  This was not a controlled study or a study that followed patients over a period to determine changes in their behavior.” 
He says, “Next plan is to repeat the study with a different demographic and provide free follow-up care.”
  • Reproduce the ED project in Milwaukee, WI, in next year with different patient demographics
  • Track whether availability of acupuncture in the ED reduces opioid prescriptions
  • Follow up with patients who receive acupuncture in the ED at an outpatient clinic.  No follow up with the patients was performed for this pilot program due to study limitations.  They found that "following discharge from the ED, less than 2% received acupuncture services within 30 days."  Assumptions about why this may be:  patient choice, lack of reimbursement, even though outpatient services were available at the West Allis site.

Part 3: Acupuncture in the Aurora System
The acupuncture program at Advocate Aurora began in 2002 with one acupuncturist.  The program now employees 11 acupuncturists, full-time and part-time, who provide care in 11 oncology clinics, 7 outpatient clinics, 2 inpatient units, and one emergency department. Acupuncturists in the program are employees of Aurora.

The acupuncture program is part of Aurora’s Department of Integrative Medicine (IM).  The IM department employs practitioners who provide the following services:  massage therapy, chiropractic care, acupuncture, aromatherapy, and mind-body exercise.  The mind-body exercise therapy program is at Aurora’s psychiatric hospital.

Program Funding and Sustainability
How do they sustain the program?
Program is sustained through philanthropic funding and cash-based service.
Outpatient acupuncture services are cash-based except for the ED study program.  The ED program is sponsored by Aurora at no charge to the patients.  The oncology clinic acupuncture program is supported through both philanthropic funding and cash-based services.

How is program success or failure measured?
The Aurora IM programs are measured with the new model of care: value-based metrics, particularly outcome-based measures.  Program success is not measured solely by RVUs or patient load.

More about what Dr. John Burns does and where he works
Dr. Burns teaches Tai Chi and Qi Gong to patients in the mental health clinic and psychiatric hospital.  This clinical care has been well-received by patients and by staff who have seen patients’ positive response to it.  Dr. Burns also does in-service presentations to the following provider types: acupuncturists, physical therapists, nurses, occupational therapists, and physicians.

Dr. Burns’ Vision for the Aurora Acupuncture program:
Dr. Burns believes acupuncture, as an integrative health paradigm, has a “patient empowering philosophy”.  His hopes to see acupuncture available in all services lines, but especially incorporated into the following services:  neurology, palliative care, and the back and spine group.  He feels the integrative medicine program will benefit when acupuncture services are covered by the following insurances:  Medicare, Medicaid, and the Aurora employee health benefits system.  He would like to bring acupuncture into the mental health clinic as part of the substance abuse treatment program. 

On being a manager of an integrative health program:
Dr. Burns has been in a management position for 4 years.  He wants his LAcs maintain work-life balance.  He understands that clinician resilience and program sustainability are inter-related.  So, he makes this a priority in his role as program manager.

What learning opportunities are available to integrative health students and practitioners interested in hospital-based practice?
Shadowing opportunities are available in his program.  The integrative health courses that teach self-care may be soon be open to the public.

Part 4: References
Contact information for Dr. Burns and the Aurora Acupuncture Program

Links to related publications on the Aurora ED Study


Related Blogposts
Videos highlighting the Aurora integrative medicine program

Tags:  #AIHM #AIHM18 #EDacupuncture

Advocate Aurora's Oncology Acupuncture and Integrative Therapies Program (update Oct 2020)
  • New* in Sept 2020, published in JACM, with information on Advocate Aurora's (Wisconsin) oncology acupuncture and massage therapy programs. "A Quality Brief of an Oncological Multisite Massage and Acupuncture Therapy Program to Improve Cancer-Related Outcomes" by Jennifer Fink, John Burns, Ana Christina Perez Moreno, Jessica J.F. Kram, Melissa Armstrong, Sara Chopp, Scott J. Maul, and Nancy Conway. The Journal of Alternative and Complementary Medicine (JACM), Sept 2020. 822-826.
  • More on the topic of oncology acupuncture programs and defining "success" at this post.

If you found this information useful, please sponsor this work via our website, whether it is a cup of coffee or a sustaining contribution.  Thank you.

[1] Adam S. Reinstein, Lauren O. Erickson, Kristen H. Griffin, Rachael L. Rivard, Christopher E. Kapsner, Michael D. Finch, Jeffery A. Dusek; Acceptability, Adaptation, and Clinical Outcomes of Acupuncture Provided in the Emergency Department: A Retrospective Pilot Study, Pain Medicine, Volume 18, Issue 1, 1 January 2017, Pages 169–178,

[2] The Consortium’s Pain Task Force White Paper. 
Tick H, Nielsen A, Pelletier KR, et al.  Evidence-Based Nonpharmacological Strategies for Comprehensive Pain Care.  The Consortium Pain Task Force White Paper.  2018.

[3] Emergency Severity Index (ESI) is a triage algorithm that measures urgency of case on a scale of 1 to 5. “1” indicates the highest degree of urgency and “5” is the lowest degree, developed by Agency for Healthcare Research and Quality (AHRQ), a division of the U.S. Department of Health and Human Services (HHS).