Thursday, May 31, 2018

Research Summary Reviews for the Community, the Outline

keywords:  research literacy, sharing wisdom, community volunteer project, hospital-based practice, integrative health, integrative medicine
www.thehospitalhandbook.com
Have you come across published research related to hospital-based practice and East Asian Medicine that you would love to share with the community?

So far, we have found the most useful way to share this information is to write a guest blogpost, using the outline below.

This is a great volunteer opportunity for
  • practitioners in the hospital-based practice field who want to contribute to building this community resource and highlight their favorite work (it is okay, and even encouraged, to highlight your own clinic's or facility's work)
  • doctoral students in the field who want to continue practicing their research literacy skills
  • master's students in the field who want to hone their research literacy skills--please check in with the project leader to approve your article choice before launching into a review.
  • practitioners in private practice who want to dust off their research literacy skills and connect to the community
Please contact Megan via the website contact page or the Facebook public page with the note "would like to volunteer to write a research review guest post" if you are interested.


Why this format?
These summaries seem to be the most compatible way to share research in our field on a format everyone can reach (not just Facebook) to a group that is very busy and could use summaries to peruse before diving in head-first to read the whole article plus have access to a way to do some basic audiovisual review of concepts assumed in the research paper--usually biomedical or pharmacology concepts, but can also be specific TCM or physical medicine (fascia research) or psych/mind-body concepts.

Here is the current outline for writing a research summary guest post to share with the community:
  1. Key words (research review, type of study, specific related keywords)
  2. Acronyms used
  3. Introduction (introduce subject, its relevance to the hospital practice audience, relevance to the EAMP in private practice)
  4. Journal citation (use APA or AMA format)
  5. Link to article or article abstract
  6. Type of research (see the research pyramid for reference.  common categories are:  literature review/synopsis, systematic lit review, RCT, comparative effectiveness trial, case study, cohort study, and expert opinion)
  7. Category of research (mechanisms of action, comparing clinical treatment options for a condition, pilot study, etc)
  8. Succinct summary of information in the article
  9. Author's interpretation (what is your take on the article?  how is it relevant to you, your work, hospital practice, or other L.Ac.s/colleagues?)
  10. Audiovisual references to review basics (links to audiovisual references to explain basic concepts presented in the paper; YouTube links are preferred for their compatibility, and Vimeo and Slideshare are usually compatible, too.)
  11. Author bio (name, a little about where you practice or study, and contact info or website)

Examples of this on the blog so far:

Related References and Resources
Please contact Megan via the website contact page or the Facebook public page with the note "would like to volunteer to write a research review guest post" if you are interested.
www.thehospitalhandbook.com

Monday, May 28, 2018

Mission: Make Integrative Medicine Accessible to Patients in Hospitals

key words:  hospitals, veterans, military family, memorial day resources, blue star families, gold star families, acupuncture for veterans and military families, integrative medicine for veterans and military families, integrative medicine accessible to military special needs network and EFMP families, philanthropy

Originally published Monday, May 29th, 2017

www.thehospitalhandbook.com


Memorial weekend is here; when, as a society we remember those who have given their lives in service to our country.  This long weekend may we remember the fallen as we support the living.

As a military family with several Blue Stars, my mission has been to help make accessible non-drug, non-surgery options (acupuncture, massage, chiropractic, etc) for health and wellness to servicemembers, veterans, and their families.  Having acupuncture (which is part of East Asian Medicine) and other non-drug, non-surgery options available in medicine centers and hospital facilities to complement conventional care will help shorten inpatient stay length, decrease pain, improve function, and decrease overall health care costs.

www.thehospitalhandbook.com


This mission has taken several forms over the past decade or so.


Most recently this has been in building a set of resources, called The Hospital Practice Handbook Project, to make it easier for facilities and their hospital administrators to hire acupuncturists into their systems and thus have Integrative Medicine (IM) professionals on staff.

www.thehospitalhandbook.com
For patients to have access to integrative medicine, you need to hire IM practitioners into the facility.


Why?  Because, I found that one of the major barriers to getting access to IM is getting IM professionals hired into the system.  People have best access to care when it is delivered in places they are already going, whether it is a mobile wellness clinic at the community center or the VFW or the local medical facility.  

In particular, servicemembers and their families have best access and greatest potential for team care coordination when it is available in their facility (MTF).  The next-best is having it covered by TriCare out-in-town by trained and qualified providers.

Patients have the best access and greatest potential for team care coordination when IM (including acupuncture) is available in their usual health care facility.
 
www.thehospitalhandbook.com
The Hospital Practice Handbook Project resource is for all hospital-based practice IM practitioners, whether you work in a civilian, DoD, or VA facility.  These resources are general and collaborative.  They are not facility-specific.  They are profession-specific; specific to Integrative Medicine professionals, with emphasis on East Asian Medicine professionals.

Contribute to the work of building this stepping-stone resource over the barriers into health care facilities at the Hospital Practice Handbook Project website.


*Blue Stars—each blue star represents one family member serving in the military.  A blue star banner or flag can have up to 5 stars.  If a servicemember dies, a smaller gold star is placed on top of the blue star.


For a Quick List of My Favorite Veteran and Military Family Non-Profit Organizations to Donate to this Memorial Weekend

See this blogpost on the De-Stress Vets blog.  These are nonprofits that support veterans, active duty military, and their families.

--Megan


Friday, May 25, 2018

My Current Favorite Health-Related Audio or Audio-Visual Resources

Wondering where I come up ideas for the Lunchtime Listens?  Well, they come from a variety of sources that I read or listen to, or newsletters I subscribe to.

For a list of the Lunchtime Listen recommendations to date:  go to the Lunchtime Listen page.

If you are looking for recommendations such as podcasts on health-related topics, these are my current favorites:

ReachMD:   --you can subscribe for free and some shows are designated for continuing education credit

Samueli Institute's On Human Flourishing--this podcast has sunsetted, but the back episodes are full of good interviews

Duke University's Integrative Medicine Leadership Program--they have put out some good webinars on topics that get more in-depth coverage in their curriculum.  Several of these webinars have made it to our Lunchtime Listen list.

Healthy Seminars, founded by Lorne Brown for CEU/PDA courses in the field of functional medicine, integrative medicine, and East Asian Medicine (and the overlap).  Online courses and in-person CEU events and the occasional free webinar. This was formerly called Pro-d Seminars.

TED Radio Hour--they have some episodes that are health-related.  Provides perspective

Oprah's SuperSoul Sunday podcast--the focus is on interviews with people who have written a book and experienced or led a major spiritual or health & spiritual shift.  Only a few are healthcare professionals like Deepak Chopra.  Pick the ones that draw you in.

What are your favorite health-related resources for listening to?  
(podcasts, webinars, audiobooks, etc.)
Please let me know in the comments!

Related Resources
The Philanthropic Movement of Integrative Medicine into Mainstream Medicine
Mindfulness
Reflective Readings
Health and Wellness with Kids
Want to see more?  This resource is put together by volunteers and we welcome contributions and sponsorships of all amounts through our website to help maintain and grow this resource.  
You can support via a cup of coffee or sponsoring a Project and share this resource with your colleagues.
Thank you!!

Tuesday, May 22, 2018

Shadow Physicians, #7 of the "How to Get Your Foot in the Door of Hospital Practice" Series


keywords:  hospital practice, prospective hospital-practice integrative health practitioners, students of East Asian Medicine (acupuncture), integrative health students, shadowing health care practitioners, clinical observation, preparing for hospital practice, shadowing in hospital practice setting, shadowing hospital-based providers, what to do before you start clinical work, biomedical clinical care, biomedicine, shadowing physicians, biomedical clinical observation, Project ECHO™


This is the seventh in the blogpost series answering the question:
"How do I get my foot in the door of hospital practice?"
Want to pre-order a pdf of this entire blogpost series?  Order here.

If you are interested in following this work, subscribe to the email newsletter and like/follow the public Facebook page.

Quick overview
Acronyms and Definitions
Shadow = a unique and very old tradition of clinical observation, often short-term.  Not the same as an internship.
EAM = East Asian Medicine.  Broad term that includes Traditional Chinese Medicine (TCM) and related disciplines.
EAMP, and L.Ac. = terms for a practitioner who has completed an ACAOM-accredited master's or doctorate program and has a current state license.  EAMP = East Asian Medicine Practitioner.  L.Ac. = Licensed Acupuncturist.  L.Ac. is the most common state license title in the U.S.
MD = medical doctor, physician
PCMH = patient-centered medical home
PCM = primary care manager, depending on state scope of practice, may be an MD, DO, ND, ARNP, PA, or DC.
DO = osteopathic physician
ND = naturopathic physician
ARNP = advanced practice nurse practitioner
PA = physician assistant
DC = chiropractic physician


I began shadowing physicians as an undergraduate student and recommend every practitioner do this from time to time. 

Shadow a physician who is in a discipline you are interested in learning more about or an area you specialize in. 

If you are studying pediatric acupuncture, spend time shadowing a pediatrician or family practice physician.  This helps you understand their process and lets you see the pediatric physical exam done by an expert.  Also, shadowing someone who specializes in a specific physical exam set is a great time to fine-tune some of your physical exam skills.  
Remember, you don’t know what you don’t know. 

Remember, you don't know what you don't know. --Trail Pack toolkit item #5 = humility 
www.thehospitalhandbook.com

Shadowing like this also helps you develop contacts and communication.   If you are respectful and it
turns out you get along well with the provider you shadow, it could also be a good source of referrals for your work.  This kind of referral is great because you have first-hand experience understanding this provider’s process and, for the provider, you are a real face, not just a name.

Shadowing improves your biomedicine language communication skills and can help you create positive connections.

Consider shadowing providers that are referring to you.  For example, if you work at a pain specialty clinic and notice that a large number of your referrals are coming from neurology, make a point to contact that provider or provider's office, at least to say thank you.  If shadowing doesn't work with either of your schedules, maybe you can attend the next presentation or grand rounds that provider is giving in-house. Or invite him/her to the next workshop or presentation you are doing.


How often do you shadow? 
This varies by the practitioner you are shadowing.  You learn more if you can shadow on a consistent basis.  However, some practitioners are only able to accommodate one shadow a week or one shadow a month. 

You must work out with your practitioner what works best for both of you.  If the shadow time is extra awkward, it is probably time to stop and look for another practitioner or another facility to do your shadow.





www.thehospitalhandbook.com


Travelling for a Special Opportunity to Shadow
If you have traveled out of town for a special shadowing trip, you are likely doing an intense shadow already planned by you and the provider.  

For example, you traveled 100 miles to Seattle Big Hospital and Outpatient Clinic to shadow Provider Ann.  You will be in town for two days.  Ann would like you to shadow her at the outpatient clinic 0700-1100, an ECHO® call with your sack lunch, and then to inpatient rounds until 1500.  On day 2, Ann wants you to shadow her 0700-1500, a full out-patient clinic day.

For more about Shadowing, please Review these in this Series


Stay tuned for the next post, The Volunteering Adventure.


copyright Megan Kingsley Gale.  all rights reserved.
Do not reproduce without author's written permission


Review the other posts in this series


Want to pre-order a pdf of this entire blogpost series?  Order here.


Today's resource recommendations

Was this blogpost useful or interesting to you?
 You can buy me a coffee while I blog at a coffee shop ($3-$5) or 
support operating costs for a day $20.

If you want to support one of the Projects, like the Webinar Series, or sponsor a newsletter, contact me via the website

Thank you!


Do you want to follow our work at the Hospital Handbook Project?  Just sign up for the newsletter on the website, subscribe to the blog, and like our Facebook page.


Check out our new Metrics short course on how to successfully use and chart a pain scale in your patient-centered clinical work.  100% of the proceeds from this course
help to support the Hospital Handbook Project work.  Thank you.

Thursday, May 10, 2018

Are you a New Hospital Employee? Shadow Your Team Before Starting Patient Care, #6 of the Foot-in-the-Door series

keywords:  hospital practice, prospective hospital-practice integrative health practitioners, students of East Asian Medicine (acupuncture), integrative health students, shadowing health care practitioners, preparing for hospital practice, shadowing in hospital practice setting, shadowing hospital-based providers, Team Work, shadowing your clinic team, what to do before you start clinical work



This is the sixth in the blogpost series answering the question:
"How do I get my foot in the door of hospital practice?"
Want to pre-order a pdf of this entire blogpost series?  Order here.

If you are interested in following this work, subscribe to the email newsletter and like/follow the public Facebook page.

Quick overview
Acronyms and Definitions
Shadowa unique and very old tradition of clinical observation, often short-term.  Not the same as an internship.
EAM = East Asian Medicine.  Broad term that includes Traditional Chinese Medicine (TCM) and related disciplines.
EAMP, and L.Ac. = terms for a practitioner who has completed an ACAOM-accredited master's or doctorate program and has a current state license.  EAMP = East Asian Medicine Practitioner.  L.Ac. = Licensed Acupuncturist.  L.Ac. is the most common state license title in the U.S.
MD = medical doctor, physician


As a new employee, Shadow Your Team before you start Clinical Work

Megan taking a walk around the swan pond
 at Madigan Army Medical Center.

For new hospital employees, while your paperwork is being processed and you are in that limbo zone where you are hired but can’t treat patients until all the boxes are checked, this is the ideal time to shadow everyone in the department you work in.  Everyone.

Because, once you start treating patients, getting time for this is next to impossible.  Shadowing everyone in your department, whether it is a couple hours or a whole day, gets you the best insight into what your colleagues are doing. 

Shadowing everyone in your department gets you the best insight into what your colleagues are doing and how your clinic functions.  From this information, you will be able to better understand how your skills are a best fit, not just for the clinic's mission, but for your specific team.

This helps you better understand where your skills will best mesh with theirs and gives you more common ground and experience to draw from when making inter-departmental recommendations or learning how all the pieces of the engine fit and work together. 

This understanding, no matter how rudimentary (since you are still a new employee) is invaluable and this shadowing opportunity, unfortunately, is nearly impossible time-wise once you are treating a full schedule of patients.

Shadowing your clinic team helps you learn how all the pieces of the engine fit and work together.

For example, at the IPMC, I shadowed the clinical pharmacist, the pain physician, the chiropractor, the physical therapist, the occupational therapist, the health psychologist, the yoga therapist, and the supply sergeant.

This experience helped me understand the framework of the referral system both within the outpatient clinic I worked in and the pre-program prep the patients went through before entering the full interdisciplinary therapy program.

It helped me see how what I was doing was synergizing with the other practitioners’ work.  This, combined with the occasional lunch chat, helped me better understand not just the unique discipline of each of my colleagues, but the way he or she specifically practiced it.

Shadowing helped me see how my skill set could best synergize with the specific skill sets of my clinic team members.

This helped us all worked better as a team.  And, when practitioners do good team work, the following benefit:  patients and their families, practitioners on the team, and the department administration (scheduling, positive outcome measures, through-put, happy patients and families).


Stay tuned for the next post, Shadowing Physicians.


copyright Megan Kingsley Gale.  all rights reserved.
Do not reproduce without author's written permission


Review the previous posts in this series
  1. Basic education and licensing requirements before applying for hospital-practice work
  2. Benefits of shadowing healthcare practitioners
  3. Pack Your Trail Bag--tools you need for the journey and how to develop stepping stones
  4. Find Your Trail Guide--the importance of having hospital-based practice mentors and an introduction to the stepping stones of shadowing/clinical observation and hospital-based volunteer work
  5. What to Expect on Your Shadow Day  

Want to pre-order a pdf of this entire blogpost series?  Order here.


Today's resource recommendations

Was this blogpost useful or interesting to you?
 You can buy me a coffee while I blog at a coffee shop ($3-$5) or 
support operating costs for a day $20.

If you want to support one of the Projects, like the Webinar Series, or sponsor a newsletter, contact me via the website

Thank you!


Do you want to follow our work at the Hospital Handbook Project?  Just sign up for the newsletter on the website, subscribe to the blog, and like our Facebook page.


Check out our new Metrics short course on how to successfully use and chart a pain scale in your patient-centered clinical work.

Thursday, May 3, 2018

What to Expect on Your Shadow Day: Foot-in-the-Door post #5

keywords:  hospital practice, prospective hospital-practice integrative health practitioners, students of East Asian Medicine (acupuncture), integrative health students, shadowing health care practitioners, preparing for hospital practice, shadowing in hospital practice setting, shadowing hospital-based providers, the tradition of clinical observation


This is the fifth in the blogpost series answering the question:
"How do I get my foot in the door of hospital practice?"
Want to pre-order a pdf of this entire blogpost series?  Order here.

If you are interested in following this work, please subscribe to the email newsletter and the public Facebook page.

Quick overview
Acronyms and Definitions
Shadow = a unique and very old tradition of clinical observation, often short-term.  Not the same as an internship.
EAM = East Asian Medicine.  Broad term that includes Traditional Chinese Medicine (TCM) and related disciplines.
EAMP, and L.Ac. = terms for a practitioner who has completed an ACAOM-accredited master's or doctorate program and has a current state license.  EAMP = East Asian Medicine Practitioner.  L.Ac. = Licensed Acupuncturist.  L.Ac. is the most common state license title in the U.S.
MD = medical doctor, physician
PHI = protected health information
Patient Privacy Laws = laws that protect patient privacy.  There is U.S. federal law and then, usually, more specific or detailed laws at the state level that add on to the federal law.
HIPAA = U.S. federal law on health information privacy, accountability, and accessibility.  It is the Health Insurance Portability and Accountability Act (HIPAA).  For more information, go to this post.
Minimum Necessary = Usually refers to the "minimum necessary standard", a standard within the HIPAA Law.  Refers to restricting communication about PHI to the minimum need-to-know elements.  

What is Shadowing?
Shadowing is the unique and very old tradition of, with pre-approval, quietly observing a professional working a typical shift/day.  In this case, shadowing is clinical observation of a health care professional.  Shadowing is usually short-term and not the same as an internship.

www.thehospitalhandbook.com

What to Expect on Your Shadow Day

So, you have connected with your hospital-practice mentors and other hospital-practice providers you are interested in following through a full or partial typical clinic day.  And, you have set a date and time to shadow this provider.

While every facility varies, here is what to expect on your first day shadowing a hospital-based healthcare practitioner/provider:

  • First, have very clear permission from the practitioner to do this.
  • The practitioner will direct you to where to park and sign in and meet them.¹
  • Dress professionally for your shadow.  
    • To review, basic professional dress for this situation is: dress pants and dress shirt, closed-toed shoes, hair pulled away from your face, and no strong smells that may trigger patient allergies (perfume, cologne, essential oils, some shampoos, lotions, and food odors).
  • Identification badge.  Many facilities require you to sign some privacy policy paperwork and wear an identification badge, even if the badge just says "visitor".  
    • Privacy paperwork will include HIPAA compliance paperwork.
  • Bring a print book to read.
  • Bring a blank notebook and pen. 
  • Then, follow closely (shadow) your practitioner.  They are responsible for you and your behavior.  Be polite and respectful.
    • Do not ask questions in front of patients.
    • Be prepared to wait.
  • Do ask questions in the appropriate space, like in the provider's office, outside of the provider-patient direct interaction.  

¹If you shadow in a federal facility located on a base, an entirely separate set of rules applies.  
Discuss with your mentor-shadow how to have access/permission to enter the base as well as permission to shadow.

Bring a book to read in case your shadow-day involves more waiting than shadowing.  It is likely you will need to leave your smart phone/cell phone in your car or locker, so don't depend on having it available for any down-time. 

Bring a blank notebook on your shadow day.
You can bring a notebook to take notes for yourself, but you cannot write anything in it that falls under the privacy laws like protected health information (PHI).  

At the end of your shadow time, double-check that you have no PHI in your notebook.  If you do, just inform your practitioner and ask where the nearest office shredder or burn bag is for those items.

Do not take such notes home with you—that would be a Privacy Law (likely also HIPAA) violation and you or your shadowed practitioner could be fined.  Violations of Privacy Law carry hefty fines.



The Waiting Place:  When the Patient Says "No"
The provider you are shadowing is required to introduce you to each patient and request patient permission/consent for you to observe.  Sometimes the patient will say "no"  to you entering the room and you will not be allowed to observe that patient-provider interaction.  Sometimes an office situation will come up that is private or confidential and you don't need to know. In that case, the provider may tell you to wait outside the room or in the provider's office.

While you are waiting, review your notes or read that book or research paper or the latest issue of Meridians you brought along.

Post-Shadow Observation Day
After shadowing, write your provider a thank you note.

Repeat the shadow (clinical observation) process regularly.  I recommend shadowing any practitioner whose work you are interested in.


Stay tuned for the next post, As a New Employee, Shadow Your Team Before You Start Clinical Work.

copyright Megan Kingsley Gale.  all rights reserved.
Do not reproduce without author's written permission


Review the previous posts in this series

  1. Basic education and licensing requirements before applying for hospital-practice work
  2. Benefits of shadowing healthcare practitioners
  3. Pack Your Trail Bag--tools you need for the journey and how to develop stepping stones
  4. Find Your Trail Guide--the importance of having in hospital-based practice mentors and introduction to the stepping stones of shadowing/clinical observation and hospital-based volunteer work

Want to pre-order a pdf of this entire blogpost series?  Order here.


Today's resource recommendations

Was this blogpost useful or interesting to you?
 You can buy me a coffee while I blog at a coffee shop ($3-$5) or 
support operating costs for a day $20.

If you want to support one of the Projects, like the Webinar Series, or sponsor a newsletter, contact me via the website

Thank you!


Do you want to follow our work at the Hospital Handbook Project?  Just sign up for the newsletter on the website, subscribe to the blog, and like our Facebook page.