Dale Healey. February 2010. Dale Healey DC. Canadian. Chiropractor. Massage Therapy Education experience. University of Minnesota PhD student. Dean, School of Massage Therapy at Northwestern Health Sciences University. ID: 709124
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Presentations text content in Hospital-Based Massage Therapy
Slide1
Hospital-Based Massage Therapy
Dale Healey
February 2010
Slide2
Dale Healey DCCanadian
Chiropractor
Massage Therapy Education experience
University of Minnesota PhD student
Dean, School of Massage Therapy at Northwestern Health Sciences University
Serve on Best Practices Committee of the MTF
Serve as COMTA site team evaluator
Slide3
Northwestern Health Sciences University
Located in Bloomington, Minnesota outside of Minneapolis
Began as Chiropractic College in 1941
School of Massage Therapy and Minnesota College of Acupuncture and Oriental Medicine added in 2000
Strong focus on integration of CAM services within CAM as well as with the allopathic community.
Mission: The mission of Northwestern Health Sciences University is to advance and promote natural approaches to health through education, research, clinical services and community involvement.
Slide4
The Vision of Northwestern Health Sciences University
Our vision is to be the University of Choice for natural and integrative health care. We promote conservative health care approaches that focus on the whole person. We provide leadership to develop collaborative and integrative health care models, support clinical
research, prepare students for successful careers, encourage lifelong learning and service to
our community.
Slide5
Objectives for this session
Define HBMT – understanding what it is and what it is not
Articulate trends surrounding MT in the hospital environment
Discuss benefits of massage therapy to the hospital patient
List steps involved in creating a HBMT training program including hospital training partnerships
Identify challenges involved in participating in HBMT
Develop strategies to overcome those challenges.
Slide6
What is Hospital-Based Massage Therapy?
Hospital-Based Massage Therapy is Massage Therapy that is based in a hospital setting
Put another way: Massage Therapy that takes place in a hospital setting
Massage Therapy that happens in a hospital.
HBMT is defined ONLY by its location (simple definition).
Focus of Hospital-Based Massage Class is on competencies associated with working in the hospital environment.
Slide7
These are not your typical massage therapy practice clients
Massage Therapy Clinic
Clients
Relatively Healthy
Contraindications are rare
Hospital
Patients
Often very sick and perhaps dying
Contraindications are common
Slide8
These is not your typical massage therapy practice setting
Massage therapy clinic setting
Dim or at least controllable lighting
Massage table
Private, controlled environment
Scheduling: regular, predicable
Hospital
Bright lighting – may or may be controllable
Hospital Bed
Interruptions common
Schedule random and even chaotic
Slide9
Hospital Based Massage Therapy Practice is NOT for all of your students!
Unpredictable and volatile environment
Strong interpersonal skills essential
Personal sense of resilience required
In many ways the environment is opposite to the environments students are looking for
Consider a 2 phase approach for a HBMT program
Slide10
What Hospital-Based Massage Therapy is Not
Not a “Pathology” Class
Not “Medical Massage”
A massage “technique”
Hospital is a highly clinical environment but there is not a strong clinical focus required of massage therapists in the hospital.
At least for now, the emphasis in most hospital settings is on massage therapy affecting the areas we are best known for and for which there is the most evidence (i.e. reduction in stress, anxiety, general pain and depressive symptoms).
Slide11
Historical Considerations
Dr. Johann Mezger – 1839-1909
A physician credited with bringing massage to the scientific community.
Presented massage to fellow physicians as a form of medical treatment and physical rehabilitation.
Popularity in the medical community grew and early research bolstered support for the emerging field.
Slide12
Nursing and Massage Therapy
Massage was part of the curriculum for nurses since the mid 1800’s
Physical therapists used massage therapy as treatment for certain medical conditions
Nurses used it mostly for comfort.
Were perhaps unaware of the physiological benefits
Slide13
American Journal of Nursing
Helen Bartlett was an Instructor in Massage at Johns Hopkins Hospital Training School for Nurses.
“
Mechano
-therapy, in exact definition massage and medical gymnastics, is a method of healing existent in some form during all history. In approximately the last decade it has undergone radical revision, and through a perhaps exceptionally slow evolution has reached a definite status. It is, in brief, a department of the science of medicine, circumscribed, indeed, but of distinct and acknowledged value. The practice of
mechano
-therapy, no longer, as in earlier struggles for recognition, performed of necessity by the physician himself, is controlled now by him, but assigned to an assistant.”
Bartlett, Helen Conkling, The Teaching of Massage to Pupils in Hospital Training-Schools,
The American Journal of Nursing
, Vol. 1, No. 10 (Jul., 1901), pp. 718-721
Slide14
American Journal of Nursing
“There continues, of course, much general ignorance and distrust of a therapeutic measure for long almost given over to quackery, and the present work, certainly in America, of both teachers and practitioners, is in many ways still that of a pioneer”
3 qualifications for massage specialists:
“A good touch in massage”
“Sufficient theoretical knowledge to detect abnormal conditions and to distinguish between serious and less serious symptoms.”
“An infinite fund of resources which can only be the result of individual experiences; essential alike for normal changes and the emergencies of practice.”
Bartlett, Helen Conkling, The Teaching of Massage to Pupils in Hospital Training-Schools,
The American Journal of Nursing
, Vol. 1, No. 10 (Jul., 1901), pp. 718-721
Slide15
American Journal of Nursing
Helene
Biermann
, RN was an instructor of massage therapy at the Graduate Training School at the German Hospital, New York
“Massage should never be given except on a physician’s orders. When employed as a treatment after injuries and diseases, it should be in the hands of a person who not only possesses the necessary technical skill acquired by painstaking toil in massage, but who has also a thorough knowledge of the movement cure, and understands the nature and course of the disease as well.”
Biermann
, Helene;
Notes on Massage,
The American Journal of Nursing
, Vol. 7, No. 7 (Apr., 1907), pp. 534-538
Slide16
American Journal of Nursing
“The result [of massage] is usually delightful, sedative and tonic. During massage treatment most patients are in a state of repose. Generally those who relax to their treatment enjoy it and feel gloriously indifferent, and needless apprehensions are dispelled. But without the sympathetic touch the [massage therapist] may fail to cause these desirable results and produce, instead, quite opposite effects. The sympathetic touch is inborn and cannot be taught nor explained. It can be improved, but it cannot be acquired if it is not there. It is a mystery.”
Churchill, Anna Quincy,
Massage, Its Physiological Effects
The American Journal of Nursing
, Vol. 15, No. 8 (May, 1915), pp. 635-640
Slide17
What Happened???
4 main factors to blame
Increase in patient load due to nursing shortages
The requirement for additional documentation by governmental regulators
New methods of billing demanded by insurance carriers
The growth of medical technology and drugs over hands-on methods of care.
MacDonald, Gayle (2005),
Massage for the Hospital Patient and Medically Frail Client
. Baltimore: Lippincott Williams and Wilkins
Slide18
But the pendulum is swinging back
There is a recognition of the high-tech, specialized, fragmented nature of care in the hospital and that hands-on human touch can provide a sense of wholeness.
Skyrocketing healthcare costs, including pharmaceuticals and hospitalization have folks scrambling and more open to looking to CAM as a part of the solution.
Awareness of CAM and openness to it growing – NCCAM, NARCCIM, CAHCIM
CAM education included in medical school training
Slide19
General Employment and Economic Trends in Health Care and the Hospital Environment
Slide20
Total Prescription Drug Spending, 1980 – 2007(1)
Source: Centers for Medicare & Medicaid Services, Office of the Actuary. Data released January 6, 2009.
(1)
CMS completed a benchmark revision in 2006, introducing changes in methods, definitions and source data that are applied to the entire time series (back to 1960). For more information on this revision, see http://www.cms.hhs.gov/NationalHealthExpendData/downloads/benchmark.pdf.
(2)
Expressed in 1980 dollars; adjusted using the overall Consumer Price Index for All Urban Consumers.
Slide21
National Health Expenditures
(1)
,
1980 – 2018
(2)
Source: Centers for Medicare & Medicaid Services, Office of the Actuary. Data released February 23, 2009.
(1)
Years 2008 – 2018 are projections.
(2)
CMS completed a benchmark revision in 2006, introducing changes in methods, definitions and source data that are applied to the entire time series (back to 1960). For more information on this revision, see http://www.cms.hhs.gov/NationalHealthExpendData/downloads/benchmark.pdf.
Slide22
National Supply and Demand Projections for RNs,2000 – 2020
Source: National Center For Health Workforce Analysis, Bureau of Health Professions, Health Resources and Services Administration. (2004).
What Is Behind HRSA’s Projected Supply, Demand, and Shortage of Registered Nurses?
Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2007, for community hospitals.
Slide24
Hospital Employment vs. Employment in Other Industries, 2008
(1)
Source: Department of Labor, Bureau of Labor Statistics, Current Employment Statistics (CES) Survey, customized tables. Data released 2009.
Link: http://www.bls.gov/ces.
(1)
2008 figures reflect annual projections.
Slide25
Average Weekly Earnings of Workers, Hospitals
(1)
vs. All Service-providing Industries, 1990 – 2007
Source: Department of Labor, Bureau of Labor Statistics, Current Employment Statistics (CES) Survey, customized tables. Data released 2009.
Link: http://www.bls.gov/ces.
(1)
Includes physicians employed by hospitals.
Slide26
Percent Change in Employment Hospital vs. All Industries, 06 – 08
Source: Department of Labor, Bureau of Labor Statistics. Link: http://www.bls.gov/bls/employment.htm
.
2006
2008
2007
Slide27
American Hospital Asssociation
President and CEO
Rich
Umbdenstock
:
“Complementary and alternative medicine has shown great promise in supporting and stimulating healing," said. "It's one of the many tools hospitals look to as they continue to create optimal healing environments for the patients they serve."
Slide28
Trends Related to Massage Therapists in Health Care and Hospital Environments
Slide29
Current Trends - “What”
Sept. 2008 report in Health Forum – An affiliate of the American Hospital Association found:
A growing proportion of hospitals are responding to patient demand and integrating complementary and alternative medicine (CAM) services with conventional services
In 2007, more than 37% of hospitals offered one or more CAM therapies, up from 7.7% in 1998
The survey found that massage therapy is the top CAM service provided on an outpatient basis and is the second most popular service behind pet therapy in an inpatient setting.
Slide30Slide31Slide32Slide33
Current Trends – “Why”
When asked primary rationale:
Patient demand 84%
Clinical effectiveness 67%
Reflects organizational mission 57%
Attract new patients 40%
Physician’s request 40%
Slide34Slide35
Reasons Hospitals want to add MT
Patients are demanding it
Competition for patients.
Clinical outcomes
Ultimate goal of reducing costs – pharmaceuticals and length of stay.
It’s OK to be viewed as a “perk” at first – just need to get in the door.
Slide36
Current Trends – “Why”
Reasons for massage in an hospital environment:
Pain management 66%
Massage for cancer patients 57%
Pregnancy massage 55%
Part of physical therapy 53%
For mobility/movement training 45%
Palliative care 41%
Slide37Slide38
“Effects of Massage in Acute and Critical Care”
Discussion of a systematic review of 22 articles examining the effect of massage on relaxation, comfort, and sleep.
Most consistent effect: reduction in anxiety.
8/10 studies reported that massage significantly decreased anxiety or perception of tension.
7/10 studies found that massage produced physiologic relaxation, as indicated by significant changes in the expected direction in one or more physiologic indicators.
In the 3 studies in which the effect of massage on discomfort was investigated, it was found to be effective in reducing pain.
Richards, Kathy Culpepper RN, PhD et al,
AACN Clinical Issues: Advanced Practice in Acute & Critical Care: February 2000 - Volume 11 - Issue 1 - pp 77-96
Slide39
Current Trends – “Who”
Support for initiating CAM programs:
Administration 53%
Nursing 23%
Physicians 22%
Board 3%
Slide40Slide41
Relationship with Medical Staff
Critical to long term success of the program
Need “champions”
Referrals can be an indication of the quality of the relationships
Slide42Slide43Slide44
Current Trends – “How”
Criteria Hospitals Used to Select CAM Therapies:
Patient Demand 79%
Evidence Based 72%
Practitioner Availability 62%
Market Research 27%
Other 15%
Slide45Slide46Slide47
According to the Bureau of Labor Statistics….
“Employment for massage therapists is expected to increase 20 percent from 2006 to 2016, faster than average for all occupations.”
“Massage therapy’s growing acceptance as a medical tool, particularly by the medical provider and insurance industries, will have the greatest impact on new job growth for massage therapists.”
Fastest growing employment opportunity is in health care settings
Slide48
According to the AMTA 2009 industry report, the number of massage therapists reporting practicing in a health care setting increased from 10% in 2005 to 25% in 2009.
Slide49
The Baby Boomer Effect
According to a study by the American Hospital Association
“When I’m 64 – How Boomers Will Change Health Care”:
“The wave of aging Baby Boomers will reshape the health care system forever. There will be more people enjoying their later years, but they’ll be managing more chronic conditions and therefore utilizing more health care services. By 2030: The over 65 population will nearly double as a result of the aging Boomers. More than six of every 10 Boomers will be managing more than one chronic condition.”
“When I’m 64: How Boomers Will Change Health Care”, American Hospital Association Report, Washington, DC, May 2007
Slide50
The Baby Boomer Effect
The convergence of four key factors drives how Boomers will impact U.S. health care:
There are significantly more of them and, as they age, they will require more health care services than any other generation of Americans.
The prevalence of chronic diseases is increasing among Boomers.
They have different needs and expectations than past generations.
More medical services and technologies are available to them than ever before.
“When I’m 64: How Boomers Will Change Health Care”, American Hospital Association Report, Washington, DC, May 2007
Slide51
By 2030 Hospital Admissions of Boomers will more than double…
Slide52
Leading to a majority of hospital patients being over 65
Slide53
The Baby Boomer Effect
“Going Beyond the Medical Model of Care:
Finally, hospitals are undertaking initiatives to offer the more personalized care, comfort, service and convenience that Boomers have come to expect. From accommodating family caregivers and reducing sound, to complementary and alternative medicine programs (including massage and acupuncture) and a broad range of fitness programs, the focus is on wellness not simply restoring health.”
“Health Care Response:
Innovative new approaches to meeting patient needs reflect a broader care focus that encompasses acute-care needs and enhances the overall patient experience.”
“When I’m 64: How Boomers Will Change Health Care”, American Hospital Association Report, Washington, DC, May 2007
Slide54
The Baby Boomer Effect
“
Seventy percent of Boomers have used some form of complementary or alternative medicine. The most popular treatments include massage therapy, chiropractic services and other types of body treatments. Complementary and alternative medicine is being used equally to treat specific health conditions and to improve overall wellness.”
“
Health Care Implication:
Aging Boomers with higher expectations of service will demand more innovative, personalized health care programs that cater to their needs.”
“When I’m 64: How Boomers Will Change Health Care”, American Hospital Association Report, Washington, DC, May 2007
Slide55
Costs and Payment
Slide56Slide57Slide58Slide59
Planning55% of hospitals offering CAM services do NOT have CAM as part of their overall strategic plan.
Only 30% of hospitals offering CAM services have a strategic plan for their CAM program.
Is this a good thing or a bad thing?
Slide60Slide61Slide62
Steps to Starting a HBMT Program
Needs Assessment
Resource Assessment
Build the relationships
Design the Curriculum
Launch!
Slide63
1. Needs Assessment
Does a HBMT course fit with our mission and goals?
Will the course satisfy a local market need?
What are there potential employment opportunities for graduates?
Is there interest among students?
Slide64
2. Resource Assessment
What costs will be associated with starting and sustaining the program?
Legal review
Human resource needs (administration and faculty)
Time
What resources are available to cover those costs?
Tuition
Grants
Hospital contribution
Do we have qualified faculty to teach the course?
Do we have buy in from all constituents – faculty, administration, hospital, etc.
Hospital partner
Slide65
3. Build the relationships
Importance cannot be underestimated.
More than gift baskets
Slide66Slide67
3. Build the relationships
Importance cannot be underestimated.
More than gift baskets
Relationships with:
Hospital administration
Onsite supervisors
Faculty
Create the Clinical Experience Agreement
Details responsibilities of both parties
Criminal background checks
Immunization requirements
Insurance requirements
Slide68
4. Design the Curriculum
Course Description and Educational Objectives – be sure they fit with your program objectives
Textbook
Lesson Plans with teaching methods and learning activities
Assessment tools and methods
Slide69
I. Educational Objectives
Perform appropriate massage techniques for comfort care on
diverse patient populations.
Obtain information from patient's charts and record documentation of session.
Interact comfortably with hospital staff.
Describe common medical devices and procedures.
Apply appropriate massage pressure, avoid applicable site restrictions, and use appropriate positioning for patients according to their specific medical condition.
Describe appropriate boundaries for both therapist‑patient and therapist‑ hospital staff interactions.
Apply appropriate infection control practices with all massage encounters in the hospital.
Understand common medical conditions and symptoms and how they relate to the massage session.
Discuss hospital research involving massage therapy.
Demonstrate correct body mechanics.
Slide70
Educational Objectives
Students
will be able to:
demonstrate effective verbal, non verbal and written communication skills with other health care professionals and patients.
demonstrate a working knowledge of
George Institute policies
and procedures applicable to a massage therapy extern.
demonstrate sensitivity to the cultural practices of all individuals, institution protocol and diverse communities/populations
.
design an effective massage protocol in a hospital setting with consideration for the following .
common pathology and contraindications
patient interview and treatment plan
precautions
adaptations in environment (body mechanics , music, space, lighting)
Slide71
II. The Textbook
“Massage for the Hospital Patient and Medically Frail Client” by Gayle MacDonald
“This is an essential resource for learning massage in the acute care setting. As the need for massage in hospitals has grown, many massage therapists and massage students are developing their skills in this environment to broaden their practice and meet market demand.”
“The text explores pressure adjustments, site restrictions, and positioning needs for hospital patients and medically frail clients. An easy-to-use conceptual format covers common medical devices and procedures, standard precautions, the relationship between pharmaceuticals and massage, charting, and collecting patient data. Illustrations demonstrate body mechanics, draping, room preparation, and more.”
Slide72Slide73
Contents
The revival of hospital massage
Reviewing the research
Adapting to hospital culture
Infection control practices
Pressure, site, and position – a clinical framework
Common reasons for hospitalization or medical treatment
Common conditions and symptoms
Common medical devices and procedures
Medications
Referrals, orders, and intake
The massage session
Documentation
Notice very limited on the “techniques” or “pathology”
Slide74
III. Lesson
Plans with teaching methods and learning
activities
Didactic Portion
At least a portion should take place at the hospital.
Plenty of role playing
Include roles for hospital staff that the students will interact with.
Emphasis on communication, documentation, safety issues, emotional issues (i.e. reactions to serious illness and death)
Clinical Portion
Well defined roles for both student and supervisor
Include observation expectations
Scheduling
Who is the supervisor?
Slide75
IV. Assessment Tools and Methods
Journaling
Technical component
Emotional component
Observation rubric
Group presentation
Evidence Informed Practice assignments
Slide76
Quotes from past student journals:
“The second patient that I saw with Molly was a women in her early 50’s who had just been diagnosed with Lung Cancer the day before. Molly and I read in her chart that the patient had said “well I guess I’m just here to die”. When we stopped in the patient looked very depressed and withdrawn. It was a very sad situation to see. The patient did not want any services from us.”
Slide77
“I would have to say that the highlight of my day was spending the last hour with Kim the music therapist. We saw an 81 year old woman who was dying. I gave the patient a foot massage while Kim played her guitar and sang songs for her. The patient would request a song and she would sing along with Kim. She looked so incredibly happy and so grateful that we were there with her. She was the sweetest woman, you just wanted to reach over and give her a big hug.”
Slide78
“It is so different giving massage to patients in the hospital vs. what I am learning in school. I think it is very satisfying to do this type of massage and to see what a difference I can make for someone in such a short amount of time.”
Slide79
Consider limiting enrollment
May be necessary
Application
Interview
faculty recommendation
Helps to ensure student quality
Slide80
The Application Process
Application with 3 questions:
1. What about this externship program prompted you to apply for it?
2. What goals do you have for yourself by participating in this externship opportunity?
3. What experience do you have working in a hospital (or similar fast paced health care environment)?
Slide81
Faculty Recommendation
Based on your interaction with the student, please provide your opinion regarding the student’s likelihood for success in this environment.
Please comment on the student’s communication skills? In your opinion, would they be able to communicate effectively in this environment?
Working in a hospital environment requires the ability to work effectively with all kinds of personalities. For example, there may be very emotional patients, perhaps irritable, impersonal hospital staff, etc. Please comment on the student’s interpersonal skills in dealing with various personality types.
Please comment on this student’s attendance and tardy record
.
Slide82
Faculty Recommendation
Overall I:
do not recommend this student for an externship position.
recommend this student for an externship position with some reservations.
recommend this student for an externship position.
give a high recommendation of this student for an externship position with no reservations.
Slide83
The Interview
Looking for:
Student dedication
Reasons for wanting to do the externship
Ability to manage emotions and emotional situations
Emotional maturity
Slide84
Feedback from our Hospital Partners
In a traditional hospital environment, who would be the best person to approach about setting up a partnership?
If a school were to approach you about getting their students into the hospital to do clinical rotations, what would like to hear from them?
What questions would you have for the school?
In your opinion, what would be the most important initial steps a school could take to form a partnership with their local hospital?
Anything else you think I should share with schools considering a HBMT program?
Slide85
In a traditional hospital environment, who would be the best person to approach about setting up a partnership?
“Typically this would run through a nursing department or ancillary service department and education department. Most hospital run their student clinical (
non‑physician
) through their general education
departments with nursing leadership taking the management responsibility as patient care.”
Lori Knutson, Director of the Penny George Institute for Health and Healing, Abbott Northwestern Hospital
Slide86
In a traditional hospital environment, who would be the best person to approach about setting up a partnership?
“I would approach the person responsible for alternative and integrative approaches to health care. In the event you do not know the name of the person, contact the hospital person responsible for students and/or contracts or the central education or nursing department.”
Katie Becker, Learning Specialist
,
University of Minnesota Medical Center, Fairview
Slide87
In a traditional hospital environment, who would be the best person to approach about setting up a partnership?
“I think approaching the manager of the complementary therapies department/integrative medicine area would be the best place to start. Usually this person works closely with their VP or director and has oversight of the budget and can visualize how this partnership would best work with their staff's schedules and the patients they work with.”
Renee
Sauter
– Complementary Therapies - Regions Hospital
Slide88
In a traditional hospital environment, who would be the best person to approach about setting up a partnership?
“If there is a school associated with the hospital you would start there otherwise other educational departments. It is always good to have a connection to clinical care though that has an interest in massage to help provide support.”
Susanne M.Cutshall, R.N., C.N.S. Mayo Clinic, Rochester, MN
Slide89
If a school were to approach you about getting their students into the hospital to do clinical rotations, what would like to hear from them?
“Vision, Mission of the school itself and then the intention/goals for why they want to partner. Are they an accredited school and by whom, overview of the student body from an academic perspective, student conduct requirements from the school, what is school leaderships expectations and responsibilities, how will success be measured, forms of communication for both students and the site and leadership between sites.”
Lori Knutson, Director of the Penny George Institute for Health and Healing, Abbott Northwestern Hospital
Slide90
If a school were to approach you about getting their students into the hospital to do clinical rotations, what would like to hear from them?
“The specific student objectives, the timeline ‑ when to start, how many hours total, how many students, will an instructor be on site.”
Katie Becker, Learning Specialist
,
University of Minnesota Medical Center, Fairview
Slide91
If a school were to approach you about getting their students into the hospital to do clinical rotations, what would like to hear from them?
“I would like to hear that they are willing to provide/partner in providing supervision of their students, that they train their students in specifics for "patient care" (similar to your hospital based course), and have a strong emphasis on professionalism and timeliness.”
If a school were to approach you about getting their students into the hospital to do clinical rotations, what would like to hear from them?
“I would like to hear about the content of the program (if there is any hospital based education), how many hours the student are required to have, who would provide supervision, how would the student be referred.
What would be required for evaluation of the experience.”
Susanne M.Cutshall, R.N., C.N.S. Mayo Clinic, Rochester, MN
Slide93
What questions would you have for the school?
“The initial question for someone like me is whether the school will sign a student affiliation agreement and agree to non‑negotiable language such as requiring student background checks, requiring various immunizations and vaccinations for the students providing care, liability and malpractice insurance, etc.”
Katie Becker, Learning Specialist
,
University of Minnesota Medical Center, Fairview
Slide94
What questions would you have for the school?
“In addition, I'd ask why are they interested in partnering with us? What kind of vision do they have for their program? What kind of standards are their students held to? (Do they want to know about attendance, performance, etc.) Then there are the basic questions of how are their students prepared for the hospital environment? Do they have their immunizations, etc.”
In your opinion, what would be the most important initial steps a school could take to form a partnership with their local hospital?
“Be prepared to discuss how this partnership will benefit the hospital (short term ‑ ability to provide services to patients, long term ‑ prepared massage therapist for the hospital environment) Demonstrate passion for hospital‑based massage and know the evidence for practice.”
Lori Knutson, Director of the Penny George Institute for Health and Healing, Abbott Northwestern Hospital
Slide96
In your opinion, what would be the most important initial steps a school could take to form a partnership with their local hospital?
“The University Program Director should approach the hospital initially. I believe how you and Carol and Lyn worked together was the right approach. I would use that as the best practice.”
Katie Becker, Learning Specialist
,
University of Minnesota Medical Center, Fairview
Slide97
In your opinion, what would be the most important initial steps a school could take to form a partnership with their local hospital?
“My experience between partnering with NWHSU and another local school could not have been any different! So, I think things that stand out to me are.. A) Going out to the hospital to meet face to face ‑ talk about the school and why a partnership would be a win/win for both. B)Show off the professionalism of their massage program!! There is nothing worse than working with a school and the students end up not showing, are unprofessional, are not held accountable, etc. Students need to be prepared that they are going into a professional environment, working with professionals and vulnerable adults ‑ hence, they are a representative of their school. (NWHSU students have been fantastic!!) Those would be the 2 biggest things that come to mind for me.”
Renee
Sauter
– Complementary Therapies - Regions Hospital
Slide98
In your opinion, what would be the most important initial steps a school could take to form a partnership with their local hospital?
“Provide information on the programs and highlight programs that have been successful at other facilities. Talk with an Integrative Medicine program leadership at the facility to identify programs or areas of
interest.”
Susanne M.Cutshall, R.N., C.N.S. Mayo Clinic, Rochester, MN
Slide99
Anything else you think I should share with schools considering a HBMT program?
“Will having your students benefit both parties? - remembering that the patient is our prime concern. Hope this helps”
Katie Becker, Learning Specialist
,
University of Minnesota Medical Center, Fairview
Slide100
Anything else you think I should share with schools considering a HBMT program?
“I said this above, but I believe it's a win/win for both businesses. Schools considering this type of partnership make their students stand out in the field I would guess. There aren't a ton of opportunities for students to gain this type of hands on experience ‑ working with patients (in a lot of pain, are in "fragile" states, and they see everything from
post‑op
patients to end of life issues.) My guess would be this would make them well prepared to deal with any type of patient population. Esp. in this economy, students (and schools) would want any advantage they can get to be competitive.”
Slide101
Anything else you think I should share with schools considering a HBMT program?
“It's also important for the hospital to have a main contact for the school ‑ who can they go to with questions, direction, etc. if needed? I think in our case, it's very helpful to have Jeff and Megan here supervising students here on their shifts in addition to working at NWHSU ‑ they are very familiar with the school, expectations, etc. My guess is it also sends a message to the students that their success is a priority ‑ so much so, that they have their own professionals based in the hospital when able.”
Slide102
Anything else you think I should share with schools considering a HBMT program?
“Hmm...those are the thoughts I have right now and that have stood out to me ‑ sorry if some of them (or all of them!) seem like no‑brainers. Please let me know if you have other questions ‑ I'm happy to try and take a stab at them.”
Renee Sauter – Complementary Therapies - Regions Hospital
Slide103
Anything else you think I should share with schools considering a HBMT program?
“I think it would be important to focus on safety in the hospital environment, positioning in the hospital, infection control, confidentiality issues and working with the health care team.
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Presentations text content in Hospital-Based Massage Therapy
Hospital-Based Massage Therapy
Dale Healey
February 2010
Slide2Dale Healey DCCanadian
Chiropractor
Massage Therapy Education experience
University of Minnesota PhD student
Dean, School of Massage Therapy at Northwestern Health Sciences University
Serve on Best Practices Committee of the MTF
Serve as COMTA site team evaluator
Slide3Northwestern Health Sciences University
Located in Bloomington, Minnesota outside of Minneapolis
Began as Chiropractic College in 1941
School of Massage Therapy and Minnesota College of Acupuncture and Oriental Medicine added in 2000
Strong focus on integration of CAM services within CAM as well as with the allopathic community.
Mission: The mission of Northwestern Health Sciences University is to advance and promote natural approaches to health through education, research, clinical services and community involvement.
Slide4The Vision of Northwestern Health Sciences University
Our vision is to be the University of Choice for natural and integrative health care. We promote conservative health care approaches that focus on the whole person. We provide leadership to develop collaborative and integrative health care models, support clinical
research, prepare students for successful careers, encourage lifelong learning and service to
our community.
Slide5Objectives for this session
Define HBMT – understanding what it is and what it is not
Articulate trends surrounding MT in the hospital environment
Discuss benefits of massage therapy to the hospital patient
List steps involved in creating a HBMT training program including hospital training partnerships
Identify challenges involved in participating in HBMT
Develop strategies to overcome those challenges.
Slide6What is Hospital-Based Massage Therapy?
Hospital-Based Massage Therapy is Massage Therapy that is based in a hospital setting
Put another way: Massage Therapy that takes place in a hospital setting
Massage Therapy that happens in a hospital.
HBMT is defined ONLY by its location (simple definition).
Focus of Hospital-Based Massage Class is on competencies associated with working in the hospital environment.
Slide7These are not your typical massage therapy practice clients
Massage Therapy Clinic
Clients
Relatively Healthy
Contraindications are rare
Hospital
Patients
Often very sick and perhaps dying
Contraindications are common
Slide8These is not your typical massage therapy practice setting
Massage therapy clinic setting
Dim or at least controllable lighting
Massage table
Private, controlled environment
Scheduling: regular, predicable
Hospital
Bright lighting – may or may be controllable
Hospital Bed
Interruptions common
Schedule random and even chaotic
Slide9Hospital Based Massage Therapy Practice is NOT for all of your students!
Unpredictable and volatile environment
Strong interpersonal skills essential
Personal sense of resilience required
In many ways the environment is opposite to the environments students are looking for
Consider a 2 phase approach for a HBMT program
Slide10What Hospital-Based Massage Therapy is Not
Not a “Pathology” Class
Not “Medical Massage”
A massage “technique”
Hospital is a highly clinical environment but there is not a strong clinical focus required of massage therapists in the hospital.
At least for now, the emphasis in most hospital settings is on massage therapy affecting the areas we are best known for and for which there is the most evidence (i.e. reduction in stress, anxiety, general pain and depressive symptoms).
Slide11Historical Considerations
Dr. Johann Mezger – 1839-1909
A physician credited with bringing massage to the scientific community.
Presented massage to fellow physicians as a form of medical treatment and physical rehabilitation.
Popularity in the medical community grew and early research bolstered support for the emerging field.
Slide12Nursing and Massage Therapy
Massage was part of the curriculum for nurses since the mid 1800’s
Physical therapists used massage therapy as treatment for certain medical conditions
Nurses used it mostly for comfort.
Were perhaps unaware of the physiological benefits
Slide13American Journal of Nursing
Helen Bartlett was an Instructor in Massage at Johns Hopkins Hospital Training School for Nurses.
“
Mechano
-therapy, in exact definition massage and medical gymnastics, is a method of healing existent in some form during all history. In approximately the last decade it has undergone radical revision, and through a perhaps exceptionally slow evolution has reached a definite status. It is, in brief, a department of the science of medicine, circumscribed, indeed, but of distinct and acknowledged value. The practice of
mechano
-therapy, no longer, as in earlier struggles for recognition, performed of necessity by the physician himself, is controlled now by him, but assigned to an assistant.”
Bartlett, Helen Conkling, The Teaching of Massage to Pupils in Hospital Training-Schools,
The American Journal of Nursing
, Vol. 1, No. 10 (Jul., 1901), pp. 718-721
Slide14American Journal of Nursing
“There continues, of course, much general ignorance and distrust of a therapeutic measure for long almost given over to quackery, and the present work, certainly in America, of both teachers and practitioners, is in many ways still that of a pioneer”
3 qualifications for massage specialists:
“A good touch in massage”
“Sufficient theoretical knowledge to detect abnormal conditions and to distinguish between serious and less serious symptoms.”
“An infinite fund of resources which can only be the result of individual experiences; essential alike for normal changes and the emergencies of practice.”
Bartlett, Helen Conkling, The Teaching of Massage to Pupils in Hospital Training-Schools,
The American Journal of Nursing
, Vol. 1, No. 10 (Jul., 1901), pp. 718-721
Slide15American Journal of Nursing
Helene
Biermann
, RN was an instructor of massage therapy at the Graduate Training School at the German Hospital, New York
“Massage should never be given except on a physician’s orders. When employed as a treatment after injuries and diseases, it should be in the hands of a person who not only possesses the necessary technical skill acquired by painstaking toil in massage, but who has also a thorough knowledge of the movement cure, and understands the nature and course of the disease as well.”
Biermann
, Helene;
Notes on Massage,
The American Journal of Nursing
, Vol. 7, No. 7 (Apr., 1907), pp. 534-538
Slide16American Journal of Nursing
“The result [of massage] is usually delightful, sedative and tonic. During massage treatment most patients are in a state of repose. Generally those who relax to their treatment enjoy it and feel gloriously indifferent, and needless apprehensions are dispelled. But without the sympathetic touch the [massage therapist] may fail to cause these desirable results and produce, instead, quite opposite effects. The sympathetic touch is inborn and cannot be taught nor explained. It can be improved, but it cannot be acquired if it is not there. It is a mystery.”
Churchill, Anna Quincy,
Massage, Its Physiological Effects
The American Journal of Nursing
, Vol. 15, No. 8 (May, 1915), pp. 635-640
Slide17What Happened???
4 main factors to blame
Increase in patient load due to nursing shortages
The requirement for additional documentation by governmental regulators
New methods of billing demanded by insurance carriers
The growth of medical technology and drugs over hands-on methods of care.
MacDonald, Gayle (2005),
Massage for the Hospital Patient and Medically Frail Client
. Baltimore: Lippincott Williams and Wilkins
Slide18But the pendulum is swinging back
There is a recognition of the high-tech, specialized, fragmented nature of care in the hospital and that hands-on human touch can provide a sense of wholeness.
Skyrocketing healthcare costs, including pharmaceuticals and hospitalization have folks scrambling and more open to looking to CAM as a part of the solution.
Awareness of CAM and openness to it growing – NCCAM, NARCCIM, CAHCIM
CAM education included in medical school training
Slide19General Employment and Economic Trends in Health Care and the Hospital Environment
Slide20Total Prescription Drug Spending, 1980 – 2007(1)
Source: Centers for Medicare & Medicaid Services, Office of the Actuary. Data released January 6, 2009.
(1)
CMS completed a benchmark revision in 2006, introducing changes in methods, definitions and source data that are applied to the entire time series (back to 1960). For more information on this revision, see http://www.cms.hhs.gov/NationalHealthExpendData/downloads/benchmark.pdf.
(2)
Expressed in 1980 dollars; adjusted using the overall Consumer Price Index for All Urban Consumers.
Slide21National Health Expenditures
(1)
,
1980 – 2018
(2)
Source: Centers for Medicare & Medicaid Services, Office of the Actuary. Data released February 23, 2009.
(1)
Years 2008 – 2018 are projections.
(2)
CMS completed a benchmark revision in 2006, introducing changes in methods, definitions and source data that are applied to the entire time series (back to 1960). For more information on this revision, see http://www.cms.hhs.gov/NationalHealthExpendData/downloads/benchmark.pdf.
Slide22National Supply and Demand Projections for RNs,2000 – 2020
Source: National Center For Health Workforce Analysis, Bureau of Health Professions, Health Resources and Services Administration. (2004).
What Is Behind HRSA’s Projected Supply, Demand, and Shortage of Registered Nurses?
Link: ftp://ftp.hrsa.gov/bhpr/workforce/behindshortage.pdf.
Shortage of over 1,000,000 nurses in 2020
Slide23Number of Hospital Employees, 1993 – 2007
Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2007, for community hospitals.
Slide24Hospital Employment vs. Employment in Other Industries, 2008
(1)
Source: Department of Labor, Bureau of Labor Statistics, Current Employment Statistics (CES) Survey, customized tables. Data released 2009.
Link: http://www.bls.gov/ces.
(1)
2008 figures reflect annual projections.
Slide25Average Weekly Earnings of Workers, Hospitals
(1)
vs. All Service-providing Industries, 1990 – 2007
Source: Department of Labor, Bureau of Labor Statistics, Current Employment Statistics (CES) Survey, customized tables. Data released 2009.
Link: http://www.bls.gov/ces.
(1)
Includes physicians employed by hospitals.
Slide26Percent Change in Employment Hospital vs. All Industries, 06 – 08
Source: Department of Labor, Bureau of Labor Statistics. Link: http://www.bls.gov/bls/employment.htm
.
2006
2008
2007
Slide27American Hospital Asssociation
President and CEO
Rich
Umbdenstock
:
“Complementary and alternative medicine has shown great promise in supporting and stimulating healing," said. "It's one of the many tools hospitals look to as they continue to create optimal healing environments for the patients they serve."
Slide28Trends Related to Massage Therapists in Health Care and Hospital Environments
Slide29Current Trends - “What”
Sept. 2008 report in Health Forum – An affiliate of the American Hospital Association found:
A growing proportion of hospitals are responding to patient demand and integrating complementary and alternative medicine (CAM) services with conventional services
In 2007, more than 37% of hospitals offered one or more CAM therapies, up from 7.7% in 1998
The survey found that massage therapy is the top CAM service provided on an outpatient basis and is the second most popular service behind pet therapy in an inpatient setting.
Slide30Slide31Slide32Slide33Current Trends – “Why”
When asked primary rationale:
Patient demand 84%
Clinical effectiveness 67%
Reflects organizational mission 57%
Attract new patients 40%
Physician’s request 40%
Slide34Slide35Reasons Hospitals want to add MT
Patients are demanding it
Competition for patients.
Clinical outcomes
Ultimate goal of reducing costs – pharmaceuticals and length of stay.
It’s OK to be viewed as a “perk” at first – just need to get in the door.
Slide36Current Trends – “Why”
Reasons for massage in an hospital environment:
Pain management 66%
Massage for cancer patients 57%
Pregnancy massage 55%
Part of physical therapy 53%
For mobility/movement training 45%
Palliative care 41%
Slide37Slide38“Effects of Massage in Acute and Critical Care”
Discussion of a systematic review of 22 articles examining the effect of massage on relaxation, comfort, and sleep.
Most consistent effect: reduction in anxiety.
8/10 studies reported that massage significantly decreased anxiety or perception of tension.
7/10 studies found that massage produced physiologic relaxation, as indicated by significant changes in the expected direction in one or more physiologic indicators.
In the 3 studies in which the effect of massage on discomfort was investigated, it was found to be effective in reducing pain.
Richards, Kathy Culpepper RN, PhD et al,
AACN Clinical Issues: Advanced Practice in Acute & Critical Care: February 2000 - Volume 11 - Issue 1 - pp 77-96
Slide39Current Trends – “Who”
Support for initiating CAM programs:
Administration 53%
Nursing 23%
Physicians 22%
Board 3%
Slide40Slide41Relationship with Medical Staff
Critical to long term success of the program
Need “champions”
Referrals can be an indication of the quality of the relationships
Slide42Slide43Slide44Current Trends – “How”
Criteria Hospitals Used to Select CAM Therapies:
Patient Demand 79%
Evidence Based 72%
Practitioner Availability 62%
Market Research 27%
Other 15%
Slide45Slide46Slide47According to the Bureau of Labor Statistics….
“Employment for massage therapists is expected to increase 20 percent from 2006 to 2016, faster than average for all occupations.”
“Massage therapy’s growing acceptance as a medical tool, particularly by the medical provider and insurance industries, will have the greatest impact on new job growth for massage therapists.”
Fastest growing employment opportunity is in health care settings
Slide48According to the AMTA 2009 industry report, the number of massage therapists reporting practicing in a health care setting increased from 10% in 2005 to 25% in 2009.
Slide49The Baby Boomer Effect
According to a study by the American Hospital Association
“When I’m 64 – How Boomers Will Change Health Care”:
“The wave of aging Baby Boomers will reshape the health care system forever. There will be more people enjoying their later years, but they’ll be managing more chronic conditions and therefore utilizing more health care services. By 2030: The over 65 population will nearly double as a result of the aging Boomers. More than six of every 10 Boomers will be managing more than one chronic condition.”
“When I’m 64: How Boomers Will Change Health Care”, American Hospital Association Report, Washington, DC, May 2007
Slide50The Baby Boomer Effect
The convergence of four key factors drives how Boomers will impact U.S. health care:
There are significantly more of them and, as they age, they will require more health care services than any other generation of Americans.
The prevalence of chronic diseases is increasing among Boomers.
They have different needs and expectations than past generations.
More medical services and technologies are available to them than ever before.
“When I’m 64: How Boomers Will Change Health Care”, American Hospital Association Report, Washington, DC, May 2007
Slide51By 2030 Hospital Admissions of Boomers will more than double…
Slide52Leading to a majority of hospital patients being over 65
Slide53The Baby Boomer Effect
“Going Beyond the Medical Model of Care:
Finally, hospitals are undertaking initiatives to offer the more personalized care, comfort, service and convenience that Boomers have come to expect. From accommodating family caregivers and reducing sound, to complementary and alternative medicine programs (including massage and acupuncture) and a broad range of fitness programs, the focus is on wellness not simply restoring health.”
“Health Care Response:
Innovative new approaches to meeting patient needs reflect a broader care focus that encompasses acute-care needs and enhances the overall patient experience.”
“When I’m 64: How Boomers Will Change Health Care”, American Hospital Association Report, Washington, DC, May 2007
Slide54The Baby Boomer Effect
“
Seventy percent of Boomers have used some form of complementary or alternative medicine. The most popular treatments include massage therapy, chiropractic services and other types of body treatments. Complementary and alternative medicine is being used equally to treat specific health conditions and to improve overall wellness.”
“
Health Care Implication:
Aging Boomers with higher expectations of service will demand more innovative, personalized health care programs that cater to their needs.”
“When I’m 64: How Boomers Will Change Health Care”, American Hospital Association Report, Washington, DC, May 2007
Slide55Costs and Payment
Slide56Slide57Slide58Slide59Planning55% of hospitals offering CAM services do NOT have CAM as part of their overall strategic plan.
Only 30% of hospitals offering CAM services have a strategic plan for their CAM program.
Is this a good thing or a bad thing?
Slide60Slide61Slide62Steps to Starting a HBMT Program
Needs Assessment
Resource Assessment
Build the relationships
Design the Curriculum
Launch!
Slide631. Needs Assessment
Does a HBMT course fit with our mission and goals?
Will the course satisfy a local market need?
What are there potential employment opportunities for graduates?
Is there interest among students?
Slide642. Resource Assessment
What costs will be associated with starting and sustaining the program?
Legal review
Human resource needs (administration and faculty)
Time
What resources are available to cover those costs?
Tuition
Grants
Hospital contribution
Do we have qualified faculty to teach the course?
Do we have buy in from all constituents – faculty, administration, hospital, etc.
Hospital partner
Slide653. Build the relationships
Importance cannot be underestimated.
More than gift baskets
Slide66Slide673. Build the relationships
Importance cannot be underestimated.
More than gift baskets
Relationships with:
Hospital administration
Onsite supervisors
Faculty
Create the Clinical Experience Agreement
Details responsibilities of both parties
Criminal background checks
Immunization requirements
Insurance requirements
Slide684. Design the Curriculum
Course Description and Educational Objectives – be sure they fit with your program objectives
Textbook
Lesson Plans with teaching methods and learning activities
Assessment tools and methods
Slide69I. Educational Objectives
Perform appropriate massage techniques for comfort care on
diverse patient populations.
Obtain information from patient's charts and record documentation of session.
Interact comfortably with hospital staff.
Describe common medical devices and procedures.
Apply appropriate massage pressure, avoid applicable site restrictions, and use appropriate positioning for patients according to their specific medical condition.
Describe appropriate boundaries for both therapist‑patient and therapist‑ hospital staff interactions.
Apply appropriate infection control practices with all massage encounters in the hospital.
Understand common medical conditions and symptoms and how they relate to the massage session.
Discuss hospital research involving massage therapy.
Demonstrate correct body mechanics.
Slide70Educational Objectives
Students
will be able to:
demonstrate effective verbal, non verbal and written communication skills with other health care professionals and patients.
demonstrate a working knowledge of
George Institute policies
and procedures applicable to a massage therapy extern.
demonstrate sensitivity to the cultural practices of all individuals, institution protocol and diverse communities/populations
.
design an effective massage protocol in a hospital setting with consideration for the following .
common pathology and contraindications
patient interview and treatment plan
precautions
adaptations in environment (body mechanics , music, space, lighting)
Slide71II. The Textbook
“Massage for the Hospital Patient and Medically Frail Client” by Gayle MacDonald
“This is an essential resource for learning massage in the acute care setting. As the need for massage in hospitals has grown, many massage therapists and massage students are developing their skills in this environment to broaden their practice and meet market demand.”
“The text explores pressure adjustments, site restrictions, and positioning needs for hospital patients and medically frail clients. An easy-to-use conceptual format covers common medical devices and procedures, standard precautions, the relationship between pharmaceuticals and massage, charting, and collecting patient data. Illustrations demonstrate body mechanics, draping, room preparation, and more.”
Slide72Slide73Contents
The revival of hospital massage
Reviewing the research
Adapting to hospital culture
Infection control practices
Pressure, site, and position – a clinical framework
Common reasons for hospitalization or medical treatment
Common conditions and symptoms
Common medical devices and procedures
Medications
Referrals, orders, and intake
The massage session
Documentation
Notice very limited on the “techniques” or “pathology”
Slide74III. Lesson
Plans with teaching methods and learning
activities
Didactic Portion
At least a portion should take place at the hospital.
Plenty of role playing
Include roles for hospital staff that the students will interact with.
Emphasis on communication, documentation, safety issues, emotional issues (i.e. reactions to serious illness and death)
Clinical Portion
Well defined roles for both student and supervisor
Include observation expectations
Scheduling
Who is the supervisor?
Slide75IV. Assessment Tools and Methods
Journaling
Technical component
Emotional component
Observation rubric
Group presentation
Evidence Informed Practice assignments
Slide76Quotes from past student journals:
“The second patient that I saw with Molly was a women in her early 50’s who had just been diagnosed with Lung Cancer the day before. Molly and I read in her chart that the patient had said “well I guess I’m just here to die”. When we stopped in the patient looked very depressed and withdrawn. It was a very sad situation to see. The patient did not want any services from us.”
Slide77“I would have to say that the highlight of my day was spending the last hour with Kim the music therapist. We saw an 81 year old woman who was dying. I gave the patient a foot massage while Kim played her guitar and sang songs for her. The patient would request a song and she would sing along with Kim. She looked so incredibly happy and so grateful that we were there with her. She was the sweetest woman, you just wanted to reach over and give her a big hug.”
Slide78“It is so different giving massage to patients in the hospital vs. what I am learning in school. I think it is very satisfying to do this type of massage and to see what a difference I can make for someone in such a short amount of time.”
Slide79Consider limiting enrollment
May be necessary
Application
Interview
faculty recommendation
Helps to ensure student quality
Slide80The Application Process
Application with 3 questions:
1. What about this externship program prompted you to apply for it?
2. What goals do you have for yourself by participating in this externship opportunity?
3. What experience do you have working in a hospital (or similar fast paced health care environment)?
Slide81Faculty Recommendation
Based on your interaction with the student, please provide your opinion regarding the student’s likelihood for success in this environment.
Please comment on the student’s communication skills? In your opinion, would they be able to communicate effectively in this environment?
Working in a hospital environment requires the ability to work effectively with all kinds of personalities. For example, there may be very emotional patients, perhaps irritable, impersonal hospital staff, etc. Please comment on the student’s interpersonal skills in dealing with various personality types.
Please comment on this student’s attendance and tardy record
.
Slide82Faculty Recommendation
Overall I:
do not recommend this student for an externship position.
recommend this student for an externship position with some reservations.
recommend this student for an externship position.
give a high recommendation of this student for an externship position with no reservations.
Slide83The Interview
Looking for:
Student dedication
Reasons for wanting to do the externship
Ability to manage emotions and emotional situations
Emotional maturity
Slide84Feedback from our Hospital Partners
In a traditional hospital environment, who would be the best person to approach about setting up a partnership?
If a school were to approach you about getting their students into the hospital to do clinical rotations, what would like to hear from them?
What questions would you have for the school?
In your opinion, what would be the most important initial steps a school could take to form a partnership with their local hospital?
Anything else you think I should share with schools considering a HBMT program?
Slide85In a traditional hospital environment, who would be the best person to approach about setting up a partnership?
“Typically this would run through a nursing department or ancillary service department and education department. Most hospital run their student clinical (
non‑physician
) through their general education
departments with nursing leadership taking the management responsibility as patient care.”
Lori Knutson, Director of the Penny George Institute for Health and Healing, Abbott Northwestern Hospital
Slide86In a traditional hospital environment, who would be the best person to approach about setting up a partnership?
“I would approach the person responsible for alternative and integrative approaches to health care. In the event you do not know the name of the person, contact the hospital person responsible for students and/or contracts or the central education or nursing department.”
Katie Becker, Learning Specialist
,
University of Minnesota Medical Center, Fairview
Slide87In a traditional hospital environment, who would be the best person to approach about setting up a partnership?
“I think approaching the manager of the complementary therapies department/integrative medicine area would be the best place to start. Usually this person works closely with their VP or director and has oversight of the budget and can visualize how this partnership would best work with their staff's schedules and the patients they work with.”
Renee
Sauter
– Complementary Therapies - Regions Hospital
Slide88In a traditional hospital environment, who would be the best person to approach about setting up a partnership?
“If there is a school associated with the hospital you would start there otherwise other educational departments. It is always good to have a connection to clinical care though that has an interest in massage to help provide support.”
Susanne M.Cutshall, R.N., C.N.S. Mayo Clinic, Rochester, MN
Slide89If a school were to approach you about getting their students into the hospital to do clinical rotations, what would like to hear from them?
“Vision, Mission of the school itself and then the intention/goals for why they want to partner. Are they an accredited school and by whom, overview of the student body from an academic perspective, student conduct requirements from the school, what is school leaderships expectations and responsibilities, how will success be measured, forms of communication for both students and the site and leadership between sites.”
Lori Knutson, Director of the Penny George Institute for Health and Healing, Abbott Northwestern Hospital
Slide90If a school were to approach you about getting their students into the hospital to do clinical rotations, what would like to hear from them?
“The specific student objectives, the timeline ‑ when to start, how many hours total, how many students, will an instructor be on site.”
Katie Becker, Learning Specialist
,
University of Minnesota Medical Center, Fairview
Slide91If a school were to approach you about getting their students into the hospital to do clinical rotations, what would like to hear from them?
“I would like to hear that they are willing to provide/partner in providing supervision of their students, that they train their students in specifics for "patient care" (similar to your hospital based course), and have a strong emphasis on professionalism and timeliness.”
Renee Sauter – Complementary TherapiesRegions Hospital
Slide92If a school were to approach you about getting their students into the hospital to do clinical rotations, what would like to hear from them?
“I would like to hear about the content of the program (if there is any hospital based education), how many hours the student are required to have, who would provide supervision, how would the student be referred.
What would be required for evaluation of the experience.”
Susanne M.Cutshall, R.N., C.N.S. Mayo Clinic, Rochester, MN
Slide93What questions would you have for the school?
“The initial question for someone like me is whether the school will sign a student affiliation agreement and agree to non‑negotiable language such as requiring student background checks, requiring various immunizations and vaccinations for the students providing care, liability and malpractice insurance, etc.”
Katie Becker, Learning Specialist
,
University of Minnesota Medical Center, Fairview
Slide94What questions would you have for the school?
“In addition, I'd ask why are they interested in partnering with us? What kind of vision do they have for their program? What kind of standards are their students held to? (Do they want to know about attendance, performance, etc.) Then there are the basic questions of how are their students prepared for the hospital environment? Do they have their immunizations, etc.”
Renee Sauter – Complementary Therapies-Regions Hospital
Slide95In your opinion, what would be the most important initial steps a school could take to form a partnership with their local hospital?
“Be prepared to discuss how this partnership will benefit the hospital (short term ‑ ability to provide services to patients, long term ‑ prepared massage therapist for the hospital environment) Demonstrate passion for hospital‑based massage and know the evidence for practice.”
Lori Knutson, Director of the Penny George Institute for Health and Healing, Abbott Northwestern Hospital
Slide96In your opinion, what would be the most important initial steps a school could take to form a partnership with their local hospital?
“The University Program Director should approach the hospital initially. I believe how you and Carol and Lyn worked together was the right approach. I would use that as the best practice.”
Katie Becker, Learning Specialist
,
University of Minnesota Medical Center, Fairview
Slide97In your opinion, what would be the most important initial steps a school could take to form a partnership with their local hospital?
“My experience between partnering with NWHSU and another local school could not have been any different! So, I think things that stand out to me are.. A) Going out to the hospital to meet face to face ‑ talk about the school and why a partnership would be a win/win for both. B)Show off the professionalism of their massage program!! There is nothing worse than working with a school and the students end up not showing, are unprofessional, are not held accountable, etc. Students need to be prepared that they are going into a professional environment, working with professionals and vulnerable adults ‑ hence, they are a representative of their school. (NWHSU students have been fantastic!!) Those would be the 2 biggest things that come to mind for me.”
Renee
Sauter
– Complementary Therapies - Regions Hospital
Slide98In your opinion, what would be the most important initial steps a school could take to form a partnership with their local hospital?
“Provide information on the programs and highlight programs that have been successful at other facilities. Talk with an Integrative Medicine program leadership at the facility to identify programs or areas of
interest.”
Susanne M.Cutshall, R.N., C.N.S. Mayo Clinic, Rochester, MN
Slide99Anything else you think I should share with schools considering a HBMT program?
“Will having your students benefit both parties? - remembering that the patient is our prime concern. Hope this helps”
Katie Becker, Learning Specialist
,
University of Minnesota Medical Center, Fairview
Slide100Anything else you think I should share with schools considering a HBMT program?
“I said this above, but I believe it's a win/win for both businesses. Schools considering this type of partnership make their students stand out in the field I would guess. There aren't a ton of opportunities for students to gain this type of hands on experience ‑ working with patients (in a lot of pain, are in "fragile" states, and they see everything from
post‑op
patients to end of life issues.) My guess would be this would make them well prepared to deal with any type of patient population. Esp. in this economy, students (and schools) would want any advantage they can get to be competitive.”
Slide101Anything else you think I should share with schools considering a HBMT program?
“It's also important for the hospital to have a main contact for the school ‑ who can they go to with questions, direction, etc. if needed? I think in our case, it's very helpful to have Jeff and Megan here supervising students here on their shifts in addition to working at NWHSU ‑ they are very familiar with the school, expectations, etc. My guess is it also sends a message to the students that their success is a priority ‑ so much so, that they have their own professionals based in the hospital when able.”
Slide102Anything else you think I should share with schools considering a HBMT program?
“Hmm...those are the thoughts I have right now and that have stood out to me ‑ sorry if some of them (or all of them!) seem like no‑brainers. Please let me know if you have other questions ‑ I'm happy to try and take a stab at them.”
Renee Sauter – Complementary Therapies - Regions Hospital
Slide103Anything else you think I should share with schools considering a HBMT program?
“I think it would be important to focus on safety in the hospital environment, positioning in the hospital, infection control, confidentiality issues and working with the health care team.
”
Susanne
M.Cutshall
, R.N., C.N.S. Mayo Clinic, Rochester, MN
Slide104Thank you for your interest!!