ABSTRACT
Robotic-assisted surgery (RAS) presents unique teamwork challenges for perioperative team members, including anesthesia professionals. The purpose of this study was to explore anesthesiologists' and nurse anesthetists' teamwork experiences during RAS using an exploratory qualitative study design involving individual semistructured interviews. Study participants expressed that teamwork during RAS is both positive and challenging, and the start-up phase is the most demanding phase of RAS in terms of teamwork. Anesthesia professionals believe that both technical and nontechnical skills are necessary to provide excellent patient care and maintain patient safety during RAS. Furthermore, they believe that a more concentrated focus on nontechnical skills than is traditional is an essential component of teamwork.
Subject(s)
Anesthesia Department, Hospital/statistics & numerical data , Patient Care Team/standards , Perception , Robotic Surgical Procedures/psychology , Anesthesia Department, Hospital/organization & administration , Clinical Competence/standards , Clinical Competence/statistics & numerical data , Humans , Norway , Patient Care Team/statistics & numerical data , Qualitative Research , Robotic Surgical Procedures/methods , Robotic Surgical Procedures/statistics & numerical dataABSTRACT
BACKGROUND: The demand for integrative medicine care is increasing rapidly among patient consumers, yet the integrative medicine model is not the norm in clinical practice, nor is this approach a focus in traditional medical schools. Furthermore, patient well-being and satisfaction outcomes within an integrative care model are not common in the literature. OBJECTIVES: The purpose of this paper is to offer a summary of a model of integrative medicine patient care and its evaluation and outcomes from the University of Michigan Integrative Medicine Clinic. METHODS: Using three tools to evaluate patient outcomes and satisfaction, statistically significant outcomes were noted. The SF-12 showed positive change in the physical component score, the Holistic Health Questionnaire showed improvements in all of the subscales of body, mind, and spirit, and a unique Integrative Medicine Patient Satisfaction Tool suggested high satisfaction with an integrative approach to care. CONCLUSIONS: Findings, limitations, and implications are discussed.
Subject(s)
Complementary Therapies/organization & administration , Delivery of Health Care, Integrated/organization & administration , Health Knowledge, Attitudes, Practice , Patient Acceptance of Health Care/statistics & numerical data , Patient Education as Topic/organization & administration , Patient Satisfaction/statistics & numerical data , Adult , Aged , Attitude to Health , Female , Holistic Health , Humans , Male , Michigan/epidemiology , Middle Aged , Models, Organizational , Program Evaluation , Quality Assurance, Health Care , Total Quality Management/organization & administration , Universities/organization & administrationABSTRACT
CONTEXT: Massage is the most common complementary and alternative medicine (CAM) therapy used in hospitals in the United States. As such, it is often the first CAM therapy to be integrated with conventional medicine. However, few academic medical centers have a written standard policy to guide this integration. This lack of standard policy may impede institutions from offering massage therapy as a clinical service, and may put health care professionals and institutions at risk through a failure to clearly address criteria for practice credentials or malpractice liability. OBJECTIVE: To create a clinical policy for therapeutic massage that may be used as a template for development of policy in academic health centers. RESULTS: We present a clinical policy for therapeutic massage, developed by the University of Michigan Health System, that defines therapeutic massage, provides guidelines for the credentialing and professional conduct of massage therapists, lists indications and contraindications for therapeutic massage, and addresses malpractice in accordance with the specific culture and needs of academic health centers. This policy was created by health care professionals after review of existing evidence and consideration of national criteria for massage therapy. This policy is intended to be used as a template for the development of a standard policy for therapeutic massage by health system administrators, medical directors, and massage professionals, to support the integration of therapeutic massage within their institutions. CONCLUSIONS: With minor modifications of this policy by individual institutions, adoption of this policy may facilitate the thoughtful integration of this CAM therapy into academic health care settings, meeting the unique requirements of academic health care institutions while serving the needs of patients.
Subject(s)
Delivery of Health Care, Integrated/organization & administration , Health Care Reform , Massage/organization & administration , Practice Guidelines as Topic/standards , Practice Patterns, Physicians'/organization & administration , Program Development , Academic Medical Centers/organization & administration , Humans , Michigan , Organizational Policy , Quality Assurance, Health Care/organization & administrationSubject(s)
Diet , Feeding Behavior , Food , Holistic Health , Nutrition Policy , Dietary Carbohydrates/administration & dosage , Dietary Fats/administration & dosage , Dietary Fiber/administration & dosage , Dietary Supplements , Edible Grain , Fruit , Health Knowledge, Attitudes, Practice , Nutritional Requirements , United States , VegetablesABSTRACT
Acupuncture as a therapeutic modality offers multiple applications. Its effectiveness coupled with its general acceptance by conventional health care professionals makes it one of the first complementary and alternative medicine (CAM) modalities to be incorporated in an integrative approach to care. However, few centers that offer acupuncture have written standard policies to regulate its use. This lack of standard policies may impede provision of quality care, serve as a barrier to cross-institutional data collection and clinical application of that data, and may put health care professionals and institutions at risk when credentialing or malpractice liability has not been clearly addressed. Here we present a policy for acupuncture, created by a diverse group of health care professionals at the University of Michigan Health System. It may function as a generalizable template for standard policy development by institutions incorporating acupuncture.
