Using the framework of corporate culture in "mergers" to support the development of a cultural basis for integrative medicine - guidance for building an integrative medicine department or service.

BACKGROUND: An increasing number of clinics offer complementary or integrative medicine services; however, clear guidance about how complementary medicine could be successfully and efficiently integrated into conventional health care settings is still lacking. Combining conventional and complementary medicine into integrative medicine can be regarded as a kind of merger. In a merger, two or more organizations - usually companies - are combined into one in order to strengthen the companies financially and strategically. The corporate culture of both merger partners has an important influence on the integration. PURPOSE: The aim of this project was to transfer the concept of corporate culture in mergers to the merging of two medical systems. METHODS: A two-step approach (literature analyses and expert consensus procedure) was used to develop practical guidance for the development of a cultural basis for integrative medicine, based on the framework of corporate culture in "mergers," which could be used to build an integrative medicine department or integrative medicine service. RESULTS: Results include recommendations for general strategic dimensions (definition of the medical model, motivation for integration, clarification of the available resources, development of the integration team, and development of a communication strategy), and recommendations to overcome cultural differences (the clinic environment, the professional language, the professional image, and the implementation of evidence-based medicine). CONCLUSION: The framework of mergers in corporate culture provides an understanding of the difficulties involved in integrative medicine projects. The specific recommendations provide a good basis for more efficient implementation.

Development of a hospital-based integrative healthcare program.

Public demand for complementary and alternative medicine (CAM) therapies, often referred to as integrative health (IH), continues to grow. Health systems are now pursing the integration of these therapies with conventional medical care. This article describes the development and evolution of 1 nursing-led model for the integration of CAM services in an inpatient setting and to provide lessons learned for nursing administrators or others interested in developing hospital-based IH programs.

Personal use of complementary and alternative medicine (CAM) by U.S. health care workers.

OBJECTIVE: To examine personal use of complementary and alternative medicine (CAM) among U.S. health care workers. DATA: Data are from the 2007 Alternative Health Supplement of the National Health Interview Survey. We examined a nationally representative sample of employed adults (n = 14,329), including a subsample employed in hospitals or ambulatory care settings (n = 1,280). STUDY DESIGN: We used multivariate logistic regression to estimate the odds of past year CAM use. PRINCIPAL FINDINGS: Health care workers are more likely than the general population to use CAM. Among health care workers, health care providers are more likely to use CAM than other occupations. CONCLUSIONS: Personal CAM use by health care workers may influence the integration of CAM with conventional health care delivery. Future research on the effects of personal CAM use by health care workers is therefore warranted.

The impact of integrative medicine on pain management in a tertiary care hospital.

BACKGROUND: Optimal inpatient pain management remains a major institutional and therapeutic challenge. Nontoxic, nonpharmacological approaches to treating pain show promise but have not been widely implemented, nor has their effectiveness been evaluated. AIMS: To evaluate the effectiveness of an inpatient integrative medicine consult service for pain management in 6 settings across an entire tertiary care hospital. DESIGN: Retrospective, observational study. SETTING: Abbott Northwestern Hospital, a 629-bed tertiary-care hospital in Minneapolis, Minn, that is part of Allina Hospitals & Clinics. PARTICIPANTS: Approximately 1837 patients hospitalized between January 1, 2008, and June 30, 2009. MEASUREMENTS: Pretreatment and posttreatment pain scores on a verbal scale of 0 to 10. RESULTS: Most patients (66%) had never previously received integrative services. Provision of integrative services had immediate and beneficial effects on pain scores. The average reduction in pain scores was 1.9 points (on a 10-point scale), and the average percentage in pain reduction was approximately 55%. CONCLUSIONS: The formal provision of inpatient integrative medicine had a significant impact on pain scores for hospitalized patients, reducing self-reported pain by more than 50%, without placing patients at increased risk of adverse effects. This was true in all 6 settings. Age, previous use of complementary therapies, and sex did not affect results. Future research must define the appropriate dose of the intervention, the duration of the relief, and the identification of patients most likely to respond to these nonpharmacological treatments. Additionally, future research using the electronic health record will allow quantification of any reduction in total costs, pain medication usage, and adverse events.