Use of inpatient integrative therapies relies on physician and nurse collaboration

At Abbott Northwestern Hospital, staff are supportive of patients receiving integrative therapies, such as massage and acupuncture, while hospitalized, but levels of use vary depending on the patients. That was a conclusion of a National Institutes of Health funded study conducted at Abbott Northwestern Hospital, part of Allina Health, and published on July 25 in BMJ Open.

"Abbott Northwestern is a leading institution with a unique model of delivering integrative medicine services to hospitalized patients, and we hoped that describing this process qualitatively could provide valuable insight for this program and others around the country," said Jeffery Dusek, PhD, principal investigator and research director for the Integrative Health Research Center at Penny George Institute for Health and Healing, part of Allina Health.

Abbott Northwestern's integrative medicine program provides therapies such as massage, acupuncture and mind-body therapies at no cost to inpatients. As part of a four-year NIH-funded study of pain and integrative medicine in the hospital, researchers used interviews with clinical staff to better understand the referral process for integrative medicine. Physicians, nurses, and administrators were asked about their attitudes and beliefs towards integrative care, their personal experience with integrative care, and their experiences referring inpatients for integrative care at Abbott Northwestern Hospital. This study was one of the first attempts by researchers to understand referral processes for hospital-based integrative medicine.

Researchers learned that while most doctors are either supportive or neutral regarding the hospital's integrative medicine offerings, their levels of engagement range widely. Some doctors order integrative medicine for all of their patients and let the patients opt out. Others rely on nurses and mid-level providers to recommend the specific patients who should be offered these services. Nurses were found to be important decision-makers in recommending integrative medicine.

"The study highlighted some operational features of the hospital's integrative medicine program—such as the tendency for patients with long hospital stays and complex cases to be more frequently referred for integrative medicine—that raise questions about what patients in the hospital should be referred and whether we might be missing additional patients who could benefit from these services," said Kristen Griffin, MA MPH, who was the lead author of the study.