A source of information for Hospital-practice Acupuncturists and their Hospital Sponsors. This blog is part of the Hospital Handbook project which also includes social network sites to start or continue topic discussion.
Goals: to share collective wisdom of hospital practice
to create community
to encourage each other
to improve our knowledge and practice standards together
keywords: leadership, workplace, workplace culture, being an employee, teamwork and team communication
Inspiration for Employees and their Leaders
Review of the "Leadership and Workplace Mondays" theme from the public HHP Facebook Page, February 2019
"To scale daring leadership and build courage in teams and organizations we have to cultivate a culture in which brave work, tough conversations, and whole hearts are the expectation. And, probably more importantly, armor is not necessary or rewarded."
"If we want people to fully show up, to bring their whole selves, including their unarmored whole hearts, so that we can innovate, solve problems, and serve people, we have to be vigilant about creating a culture in which people feel safe, seen, heard and respected."
"Daring leaders must care for and be connected to the people they lead. Care and connection are irreducible requirements for whole-hearted, productive relationships between leaders and team members."
How to build a dream team in 5 steps--an interesting read on building a dream team with links to a free access lecture on the topic from LinkedIn learning.
How to have a productive conversation--how to talk with your manager/hospital admin about additional training, expanding a program, funding, or time. The LinkedIn Learning article and video give 5 steps for a productive conversation:
keywords: self-care, practitioner resilience, wellness, mindfulness practices, movement (walking, tai chi, qi gong), spending time outdoors, nutrition for health, the quadruple aim research paper
The February Self-Care Roundup
Some inspiration from the Self-Care Saturdays theme over at our public Facebook Page
Taking time for self-care in your day and week, from a few minutes here to 30 minutes to several hours at a time, are drops of water into your resilience bucket. A full resilience bucket makes it easier to weather the storms of life and work. A half-full or empty bucket provides little defense or support when the storms hit and make it easy to get swept away or feel like you are drowning. Fill your bucket, minutes or seconds at a time. Make regular drops or cups of self-care into your bucket part of your daily and weekly routine (habits) to keep it closer to full. Consider the following categories of self-care when you are filling your bucket:
Movement: any movement from walking, hiking, dancing, tai chi, bicycling, swimming, or other forms of active movement and exercise
Mindset/inspiration and reflective reading: any activity that encourages you to slow down and self-reflect. Forms this may take include journaling, qi gong/nei gong (inner-work qi gong), several types of mindfulness practice, reading poetry, some forms of prayer.
Spending time outdoors in nature: going outside into fresh air and "green space" whether it is your backyard lawn, working in the garden, the local town park, pond, or creek, time at the beach, the botanic garden/arboretum/conservatory, doing chores at your friend's farm, or a trip to a state park or national park/federal lands.
Breathwork: practice basic diaphragmatic breathing. It can be a simple breathing exercise, like the one below. Or maybe your breathwork self-care practice takes the form of any of the following: yoga, mindfulness meditation, qi gong, or tai chi
Nutrition/Food as fuel: everything in moderation. talk with your health care provider before making any major changes to your food intake (diet), especially if you have a chronic health care condition.
Time "having fun", socializing, connecting to your community.
Self-care practice could include more than one of these categories in just one activity
Depending on what you do for your self-care, it likely fits into more than just one of these categories, or it could. For example, practicing Tai chi outdoors is "movement", "outdoor", and "breathwork". Stretching exercises at your desk could be "movement". Or, if you add a breathwork exercise to it, it could be both "movement" and "breathwork".
Ideas from the Self-Care Saturdays theme on the public Facebook Page from February
The Research--the Quadruple Aim study
"quadruple aim" added the 4th component to the well-known "triple aim". What is the 4th component? clinician well-being and resilience. The triple aim doesn't work when the system is burning out clinicians. Adding the 4th aim, focus on a healthy workplace environment for clinicians, provides a compass for implementing the ideals of the triple aim. Read more in the research paper.
Nourishment/Food
Ready for some healthy warming winter soup? Try out this carrot ginger soup recipe from practitioner Amy Jo Accardi of Flourish Boston.
Breathwork is the conscious control of your breath. "Belly breathing" is practicing diaphragmatic breathing. This type of breathing induces the "rest and digest" phases of our nervous system, the parasympathetic response. This is an important practice because, in our modern world, we are often going about our day rushing, in a full or partial sympathetic (fight or flight) state.
Practice (self-care):
Take a few moments to check in our breathing. One hand over your heart, one over your belly. Practice belly breathing (where your belly hand moves more with each breath than your heart hand does).
Breathe in for a count of 5 and out for a count of 7. Repeat 20 times.
If you want, you can watch one of these videos while you practice:
You can read more about the health benefits of spending time 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". It is packed with scientific study references!
key words: self-care, practitioner resilience, wellness, mindfulness practices, movement (walking, tai chi, qi gong), spending time outdoors, nutrition for health
The January Self-Care Roundup
Some inspiration from the Self-Care Saturdays theme over at our public Facebook Page
Breathwork, the basics of breathing for self-care
As an east Asian medicine practitioner (acupuncturist) I have been teaching my patients diaphragmatic breathing on day one and reinforced practice throughout treatment course with related self-care homework. This breathing practice often also called "belly breathing" has been known for a long time to help us consciously switch our breathing state into the parasympathetic state (rest and digest). Because, in our modern world, most people go about their day in sympathetic state of breathing (fight or flight). Breathwork, the conscious control of your breath, is the foundation of qi gong and mindfulness practices. More recently, research has been conducted to test these age-old practices, such as this article available on PubMed. --Megan
Take a few moments to breathe. Check in on your breathing. One hand over heart,
one over your belly. Practice belly breathing. Breathe in for a count of 5 and
out for a count of 7. Repeat several times.
If you want, you can watch this 1 minute video of a sunrise over a bay of the Salish sea while you practice.
Have a wonderful day! Remember you can come back to this
breath-centering any time.
Food as Fuel, everything in moderation
Everything in moderation. Coffee is more than just caffeine. There is wisdom to consuming foods in the traditional way.
For example, a cup of warm black coffee (traditional) vs. iced, extra sugar, etc (modern).
Water is the best liquid to drink. If you drink caffeinated
beverages, you need to be drinking more water than coffee. Drink less coffee
than water. Stay hydrated. See your licensed and board-certified acupuncturist
for more specific advice. www.nccaom.org
“Two substances from coffee, acting together, may protect against
nerve cell damage and improve behavior in animal models of Parkinson’s disease
and a related disease called dementia with Lewy bodies (DLB). This is according
to a new study funded by NCCIH and conducted at the Rutgers Robert Wood Johnson
Medical School.
"The two coffee components, eicosanoyl-5-hydroxytryptamide (EHT)
and caffeine, were evaluated separately and together in mouse models of the two
diseases. Both diseases are associated with abnormal deposits of a protein
called alpha-synuclein in the brain. The two substances administered together
for 6 months, decreased the buildup of alpha-synuclein and led to better nerve
cell function, less nerve inflammation, and closer-to-normal behavior.
"These findings may help to explain the link between coffee consumption
and reduced risk of Parkinson’s disease;however, other components of coffee—a
complex mixture of more than a thousand different substances—may also be
involved."
Setting your new year resolutions--know your "why"
"Why? It’s a small word, but a mighty question, especially
when it comes to setting a New Year’s resolution.... When you get right down to
it, your why is about authenticity. And authenticity falls in lockstep with
trusting yourself. What do you need this year and why?" Go to the Chopra.com article.
Poetry
"Snow was falling,
so much like stars
filling the dark trees
that one could easily imagine
its reason for being was nothing more
than prettiness."
-Mary Oliver
The health benefits of regular movement practice, particularly practicing Tai Chi, includes improved balance and strength. More at the NY Times article, "Using Tai Chi to Build Strength".
Outdoors/Time in Nature
You can read more about the health benefits of spending time 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". I have been listening to the Nature Fix as a audiobook throughout January. It is packed with scientific study references!
Medicare, Medicaid, insurance coverage, major hospital insurance entities, federal health care coverage policy, health care policy
CMS and
acupuncture coverage for LBP
The U.S. Center for Medicare and Medicaid Services (CMS), whose coverage policies are intertwined in hospital and medical center systems, has announced a call for public comment on the topic: “acupuncture coverage for low back pain”.
To my knowledge, this is the first time in history the
CMS has ever announced a public comment call for anything related to coverage
of acupuncture services.Tell your hospital
sponsors and advocates.If CMS
reimbursed for acupuncture and other integrative health therapies, that would
be a major milestone.
CMS is under the U.S. Department of Health and Human
Services (HHS).HHS is an enormous
department that also contains the National Institutes of Health
(NIH) and the Agency for Healthcare Research and Quality (AHRQ)
“In response to the U.S.
opioid crisis, HHS is focused on preventing opioid use disorder and providing
more evidence-based non-pharmacologic treatment options for chronic pain. The
[AHRQ, CMS, and NIH] are collaborating in this effort.”In June 2018, AHRQ “published a systematic
review of noninvasive, nonpharmacological treatment for chronic pain.”“This review included assessment of several
nonpharmacological interventions, including exercise, acupuncture, spinal
manipulation, and multidisciplinary rehabilitation for [chronic low back pain]
CLBP. “
“The NIH recently issued a Funding Opportunity Announcement
for interested parties to apply to conduct an efficient, large-scale pragmatic
trial to evaluate the impact of, and strategies to best implement, acupuncture
treatment of older adults (65 years and older) with chronic low back pain.”
“CMS is opening this national coverage analysis (NCA) to
complete a thorough review of the evidence to determine if acupuncture for CLBP
is reasonable and necessary under the Medicare program.CMS is soliciting public comment on this
topic.We are particularly interested in
comments that include scientific evidence and discuss appropriate clinicians
and training requirements to provide acupuncture that improves health
outcomes.In addition, for commenters
recommending Coverage with Evidence Development, we are interested in comments
related to appropriate outcomes and study designs.While CMS has conducted previous national
coverage analyses on acupuncture, the scope of this current review is limited
to acupuncture for chronic low back pain.”
key words: research literacy, funding and grants, sharing related research in the field, research in integrative health
The January Research Roundup
(and funding announcements!)
Review of the "Research and Metrics Thursdays" theme from the public Facebook Page and newsletter
NCCIH and NIH Research Funding Opportunity--the HEAL Initiative
NCCIH and NIH funding if you work in pain management or addiction, especially the field of opioid addiction. 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.
The recordings from this conference are now available to
view. I added the NAM playlist for this
conference to the HH Project channel’s library.
Thank you to ACIH for announcing this information.
The NAM conference was 2 days, so the recordings playlist is
long. So far, I recommend the first
video with Dr. Cherkin.
Massage
Therapy Foundation Poster Abstract Submission deadline 1.31.2019
For those of you working with or leading massage therapists and
collecting metrics, the 2019 call for poster abstracts for the International
Massage Therapy Research Conference (IMTRC) is out:
The IMTRC is held once every 3 years. It is “an opportunity to learn the latest
research, connect with colleagues, and gain insight into best practices in
massage therapy.” And it “brings together thought leaders in the profession and
educators to discuss massage therapy innovations”
The next IMTRC conference is May 9-10, 2019 in Alexandria,
Virginia.
Massage
Therapy Foundation Research Grants for 2019—applications are now open. Submission deadline is March 1st,
2019.
“Massage Therapy Foundation Research Grants are awarded to those
conducting studies that seek to advance our understanding of specific
therapeutic applications of massage, public perceptions of and attitudes toward
massage therapy, and the role of massage therapy in health care delivery.”
Massage
Therapy Foundation Community Service Grants for 2019—applications
are now open.
Submission deadline is
April 1st, 2019
If you work with a 501c3 organization providing massage, you may
qualify. They say they take applications
from the U.S., internationally, and have a specific grant opportunity for those
providing massage therapy in northern Illinois.
Learn more about this community service grant here: http://massagetherapyfoundation.org/grants-and-contests/community-service-grants/
Massage therapy case report submissions
The Massage Therapy Foundation also accepts case reports from
practitioners for their journal publication, International Journal of Therapeutic Massage & Bodywork (IJTMB)
and runs a student case report contest.
Learn more here: http://massagetherapyfoundation.org/grants-and-contests/case-report-contest/
FDA Roadmap Series with the National Health Council
The January 17th, 2019, webinar was on "Untangling the Terms: Endpoints, Items, Outcomes, PROs, PROMS, PRO-PMs" with Ashley Slagle, MS, PhD. For more about this series and to watch the latest webinar, go to the FDA Roadmap Lunchtime Listen recommendation post.
Breathwork, a foundation in Traditional Chinese Medicine practice, and a research article
Research Thursday...Breathwork
As an east Asian medicine practitioner (acupuncturist) I have been teaching my
patients diaphragmatic breathing on day one and reinforced practice throughout
treatment course with related self-care homework. This breathing practice often
also called "belly breathing" has been known for a long time to help
us consciously switch our breathing state into the parasympathetic state (rest
and digest). Because, in our modern world, most people go about their day in
sympathetic state of breathing (fight or flight). Breathwork, the conscious
control of your breath, is the foundation of qi gong and mindfulness practices.
More recently, research has been conducted to test these age-old
practices, such as this article available on PubMed. --Megan
If you enjoyed this post, subscribe to our email list for the latest updates and follow us for "research and metrics Thursdays" on the public Facebook Page.
You can support this community-wisdom-sharing work by
buying me a coffee or sponsoring a newsletter via our website. Thank you.
key concepts: improving public health through whole systems nutrition, patient-centered care, Traditional East Asian Medicine paradigm of wellness, incorporating integrative health paradigms into modern health care system practices, teaching cooking skills to improve health, teaching patients self-care, modifying determinants of health through changing individual behavior around eating & cooking..nutrition keywords: mind-body medicine, integrative health, community health and wellness, learning nutrition for health, Teaching Kitchen Collaborative (TKC), Healthy Kitchens Healthy Lives® conference TCM = Traditional Chinese Medicine NCCAOM® = National Certification Commission on Acupuncture and Oriental Medicine HKHL = Healthy Kitchens, Healthy Lives®
“If a patient has a chronic condition, first modify diet and lifestyle, then add medicine”. –paraphrase, inspired by Sun Si Miao
In East Asian Medicine, we know that, for best
long-term self-care and health maintenance, we prescribe patients foods to incorporate in their diet. Why? To
manage their conditions and support their constitution. For example, individualized
TCM nutrition consults were a self-care session I would do with my chronic pain
patients when they were interested in learning more about food as a basic support system for health. As a board-certified TCM
herbalist (NCCAOM®-board certification), it took me time to research and put
their personalized plan together. And, for a patient, modifying diet takes courage and
commitment and follow up.
There is a new resource for helping patients learn and practice cooking healthy meals coming to a neighborhood medical facility or academic center near you, the "Teaching Kitchens". Well, maybe not so new. Several of these teaching kitchens have been around for a decade, but the hope is, that with the collaborative now helping stand-alone centers connect to more resources, that the movement will grow and expand. What is this new resource for providers and patients? The Teaching Kitchen Collaborative
Twenty years ago, Dr. David Eisenberg noticed that few health professionals understood the science of nutrition and most of them knew even less on how to cook healthy meals for themselves, let alone teach such skills to their patients. So, he worked with a team (Harvard School of Public Health and the Culinary Institute of America) to create an annual conference for health care professionals to bring together physicians, dietitians, nurses, allied health professionals, hospital administrators, and culinary specialists together, the Healthy Kitchens, Healthy Lives® conference, the first of which was in 2006 [Eisenburg, JACM, July 2018],
Dr. Eisenberg was an early advocate of the integrative health paradigm and, from the enthusiasm and success of the Healthy Kitchens Healthy Lives® conference, launched The Teaching Kitchen Collaborative (TKC).
The resource-sharing collective that the TKC can be, has the potential to encourage academic health institutions to recognize that nutrition and lifestyle change is a viable part of the treatment plan.
TKC is a "data-driven, taste-driven, whole system, experiential ... transformation campaign to put food, nutrition, and lifestyle front and center, in transitioning our medical industry toward ... a health care system." [Eisenburg, JACM, July 2018]
TKC launched in 2016 by the Harvard T.H. Chan School of Public Health-Department of Nutrition and The Culinary Institute of America (CIA). The TKC "is an invitational network of over 30 organizations using teaching kitchen facilities as catalysts of enhanced personal and public health. The TKC's mission is to enable early adopters to learn about one another's facilities and educational programs, to develop best practices for reproducing and scaling emerging models, and to document the clinical, behavioral, and financial impact of teaching kitchens for a broad range of populations."
Individual Teaching Kitchens include:
The Cleveland Clinic Center for Lifestyle Medicine
Maine General Health
Kaiser Permanente San Francisco Medical Center
Turner Farm with University of Cincinnati Center for Integrative Health and Wellness
University of Michigan's MHealthy
University of Minnesota's Center for Spirituality and Healing
Vanderbilt University Medical Center's Osher Center for Integrative Medicine and Center for Biomedical Ethics
The Sampson Family Branch of YMCA Greater Pittsburgh
The Teaching Kitchen Collaborative is a movement to connect teaching kitchens to each other. Because a Teaching Kitchen can, potentially, be a "catalyst of enhanced personal and public health across medical, corporate, school, and community settings.”
The TKC regularly hosts research days or other opportunities to share your program’s story, progress, and research. If you are already doing this work, the TKC seems like a great way to share what you are doing and be connected to others doing similar work. It seems like it would be a good place to support each other while changing the U.S. culture of health, wellness, and “food as grounding for health”.
Why join the TKC?
For all the reasons, watch the video below. Here are some useful quotes from the video:
from long-term research studies:
“We've learned that healthy dietary choices have a huge impact on the number of years that we live and how we feel during those years that we're alive and the teaching kitchen collaborative is a way to translate what we've learned into the… meals that people can have available and enjoy.” minute 0:11 Walter C. Willett, MD, DrPH
On benefits of being a member:
"tap into the expertise of all the other members on things like outcomes based research” minute 3:27
“It's just been fabulous hearing from all the other members, the discussions, the collaborations, and opportunities that we have going forward to work as teams and across institutions all over the country” minute 03:32
“The benefit from being part of the collaborative is [it] helps… resource good information. So, I see it as it’s not just a network of people collaborating together, but… it will … be a rich database…to access…the research... It is a network, too, so the ability to develop relationships with people around the country--for that matter around the world--is an opportunity that I think we couldn’t have gotten anywhere else.” Lori Knutson, RN minute 4.56
TKC kitchens are places/groups
“who are using kitchens as catalysts of personal and societal health enhancement. [Teaching kitchens are] the vehicle to teach people about food, nutrition, and new habits.” minute 00:31
A teaching kitchen is “a platform to really acknowledge the crucial role of nutrition and dietary information in the entire whole look at a person's lifestyle choices and wellness” minute 01:40
“[Teaching] kitchens, when used appropriately for different populations in
different settings, will change behaviors for the better…will change health
outcomes for the better…will be sustained changes."
"And ultimately we hope to prove that they
will change [lower overall population healthcare] costs either by preventing
chronic disease [or by] bringing people with chronic disease portfolios back to
a healthier state.” David Eisenberg, MD minute 4.19
“So I think the capacity for multi-site research trials around food and
mindful living and exercise and movement is enormous to be able to scale up as
opposed to a one kitchen .”[TKC has] “the capacity to reach so many more kids and families.The capacity to prevent cardiovascular
disease…prevent diabetes and hypertension…prevent the major chronic conditions
that we know are very heavily influenced by lifestyle… the capacity as a
collective group is enormous.” Sian Cotton, PhD minute 5.16
“But the goal is to show
that we can build reproducible teaching kitchens that will change our society for
the better on the individual basis and across populations.And that we will also save money while doing
that.” David Eisenberg, MD minute 5.48
The Journal of Alternative and Complementary Medicine.Volume 24, no. 7.Teaching Kitchen Collaborative Research Day Abstracts. The Estate Yountville, Napa Valley, CA, USA. February 7th, 2018
“A day of original research and innovative strategies involving teaching kitchens and their potential to positively impact behaviors, improve health outcomes, and reduce costs.”
video of the rooftop farm and how it connects to their Teaching Kitchen and the hospital's nutrition services: https://youtu.be/1bM-V_ySC_w
🥕🥗
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You can support this community-wisdom-sharing work by buying me a coffee or sponsoring a newsletter via our website. Thank you.
