Hospital-Based Massage Therapy

AMTA Schools Summit Meeting St. Pete Beach

Hospital-Based Massage TherapyDale HealeyFebruary 2010Dale Healey DCCanadianChiropractorMassage Therapy Education experienceUniversity of Minnesota PhD studentDean, School of Massage Therapy at Northwestern Health Sciences UniversityServe on Best Practices Committee of the MTFServe as COMTA site team evaluator

2Northwestern Health Sciences UniversityLocated in Bloomington, Minnesota outside of MinneapolisBegan as Chiropractic College in 1941School of Massage Therapy and Minnesota College of Acupuncture and Oriental Medicine added in 2000Strong 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.Please come and see us in September hosting a tour on Sunday breakfast reception and tour of Penny George Institute3The Vision of Northwestern Health Sciences UniversityOur 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 clinicalresearch, prepare students for successful careers, encourage lifelong learning and service toour community.Objectives for this sessionDefine HBMT understanding what it is and what it is notArticulate trends surrounding MT in the hospital environmentDiscuss benefits of massage therapy to the hospital patientList steps involved in creating a HBMT training program including hospital training partnershipsIdentify challenges involved in participating in HBMTDevelop strategies to overcome those challenges.What is Hospital-Based Massage Therapy?Hospital-Based Massage Therapy is Massage Therapy that is based in a hospital settingPut another way: Massage Therapy that takes place in a hospital settingMassage 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.Im trying to emphasize the point that HBMT is defined by its location nothing else. If it were a technique, I certainly would not be qualified to be giving this presentation.6These are not your typical massage therapy practice clientsMassage Therapy ClinicClientsRelatively HealthyContraindications are rareHospital

PatientsOften very sick and perhaps dyingContraindications are commonThese is not your typical massage therapy practice settingMassage therapy clinic settingDim or at least controllable lightingMassage tablePrivate, controlled environmentScheduling: regular, predicableHospital

Bright lighting may or may be controllableHospital BedInterruptions commonSchedule random and even chaoticHospital Based Massage Therapy Practice is NOT for all of your students!Unpredictable and volatile environmentStrong interpersonal skills essentialPersonal sense of resilience requiredIn many ways the environment is opposite to the environments students are looking forConsider a 2 phase approach for a HBMT programWhat Hospital-Based Massage Therapy is NotNot a Pathology ClassNot Medical MassageA massage techniqueHospital 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).Historical ConsiderationsDr. Johann Mezger 1839-1909A 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.

Any good historian or prognosticator worth his/her salt will tell you that one of the best indicators of the future is the past. The value of understanding our history comes in its ability to show us the future.11Nursing and Massage TherapyMassage was part of the curriculum for nurses since the mid 1800sPhysical therapists used massage therapy as treatment for certain medical conditions Nurses used it mostly for comfort.Were perhaps unaware of the physiological benefits

Pat Ben12American Journal of NursingHelen 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. 718-721American Journal of NursingThere 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 massageSufficient 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. 718-721American Journal of NursingHelene 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 physicians 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

American Journal of NursingThe 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

What Happened???4 main factors to blame

Increase in patient load due to nursing shortagesThe requirement for additional documentation by governmental regulatorsNew methods of billing demanded by insurance carriersThe 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 WilkinsBut the pendulum is swinging backThere 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, CAHCIMCAM education included in medical school training

CAHCIM Consortium of Academic Health Centers for Integrative Medicine 44 highly esteemed academic medical centersNARCCIM North American Research Conference on Complementary and Integrative MedicineNational Center for Complementary and Alternative MedicineOur healthcare system is like the patient who comes to us as a last resort.

18General Employment and Economic Trends in Health Care and the Hospital EnvironmentTotal 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.20Ironically drugs chased Mts out now their escalating costs are one of the reasons Mt is coming backNational 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.

21National Supply and Demand Projections for RNs,2000 2020Source: National Center For Health Workforce Analysis, Bureau of Health Professions, Health Resources and Services Administration. (2004). What Is Behind HRSAs 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 202022Number of Hospital Employees, 1993 2007 Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2007, for community hospitals.

23Hospital 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.24Average 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.25Percent Change in Employment Hospital vs. All Industries, 06 08Source: Department of Labor, Bureau of Labor Statistics. Link: http://www.bls.gov/bls/employment.htm.

20062008200726American Hospital Asssociation President and CEORich 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."Trends Related to Massage Therapists in Health Care and Hospital EnvironmentsCurrent Trends - WhatSept. 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 servicesIn 2007, more than 37% of hospitals offered one or more CAM therapies, up from 7.7% in 1998The 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.

Notice 2006 is missing30

Current Trends WhyWhen asked primary rationale: Patient demand 84% Clinical effectiveness 67% Reflects organizational mission 57%Attract new patients 40%Physicians request 40%

Reasons Hospitals want to add MTPatients are demanding itCompetition for patients.Clinical outcomesUltimate goal of reducing costs pharmaceuticals and length of stay.

Its OK to be viewed as a perk at first just need to get in the door.Last point is in comparison to chiros trying to get in they cant do it.35Current Trends WhyReasons 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%

Effects of Massage in Acute and Critical CareDiscussion 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 77-96American Association of Critical Care Nurses38Current Trends WhoSupport for initiating CAM programs:

Administration 53%Nursing 23%Physicians 22%Board 3%

Relationship with Medical StaffCritical to long term success of the programNeed championsReferrals can be an indication of the quality of the relationships

Current Trends HowCriteria Hospitals Used to Select CAM Therapies:

Patient Demand 79%Evidence Based 72%Practitioner Availability 62%Market Research 27%Other 15%

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 therapys 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 settingsAccording 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.

The Baby Boomer EffectAccording to a study by the American Hospital Association When Im 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 theyll 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 Im 64: How Boomers Will Change Health Care, American Hospital Association Report, Washington, DC, May 2007

The Baby Boomer EffectThe 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.


By 2030 Hospital Admissions of Boomers will more than double

Leading to a majority of hospital patients being over 65

The Baby Boomer EffectGoing 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.


The Baby Boomer EffectSeventy 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.


Costs and Payment

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?

Steps to Starting a HBMT ProgramNeeds AssessmentResource AssessmentBuild the relationshipsDesign the CurriculumLaunch!1. Needs AssessmentDoes 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?

Dont do it if it doesnt fit the mission avoid mission creep will not fly if people see you as the local spa school632. Resource AssessmentWhat costs will be associated with starting and sustaining the program?Legal reviewHuman resource needs (administration and faculty)TimeWhat resources are available to cover those costs?TuitionGrantsHospital contributionDo we have qualified faculty to teach the course?Do we have buy in from all constituents faculty, administration, hospital, etc.Hospital partner

The instructor is keyMust have the right qualifications and credentialsWho could teach this class for you?A nurse massage therapistA graduate that works in the hospital as a massage therapist or other

643. Build the relationshipsImportance cannot be underestimated.More than gift basketsReference chiro experience65

3. Build the relationshipsImportance cannot be underestimated.More than gift basketsRelationships with:Hospital administrationOnsite supervisorsFacultyCreate the Clinical Experience AgreementDetails responsibilities of both partiesCriminal background checksImmunization requirementsInsurance requirements

Reference chiro experience674. Design the CurriculumCourse Description and Educational Objectives be sure they fit with your program objectivesTextbookLesson Plans with teaching methods and learning activitiesAssessment tools and methods

I. Educational ObjectivesPerform 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 therapistpatient 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.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 planprecautionsadaptations in environment (body mechanics , music, space, lighting)

II. The TextbookMassage for the Hospital Patient and Medically Frail Client by Gayle MacDonaldThis 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.

ContentsThe revival of hospital massageReviewing the researchAdapting to hospital cultureInfection control practicesPressure, site, and position a clinical frameworkCommon reasons for hospitalization or medical treatmentCommon conditions and symptomsCommon medical devices and proceduresMedicationsReferrals, orders, and intakeThe massage sessionDocumentation

Notice very limited on the techniques or pathology

III. Lesson Plans with teaching methods and learning activitiesDidactic PortionAt least a portion should take place at the hospital.Plenty of role playingInclude 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 PortionWell defined roles for both student and supervisorInclude observation expectationsSchedulingWho is the supervisor?

IV. Assessment Tools and MethodsJournaling Technical componentEmotional componentObservation rubricGroup presentationEvidence Informed Practice assignments

Quotes from past student journals:The second patient that I saw with Molly was a women in her early 50s 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 Im 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.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.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.

Consider limiting enrollmentMay be necessaryApplicationInterviewfaculty recommendationHelps to ensure student qualityDo not send students to hospital without training.79The Application ProcessApplication 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)?Prior experience in a hospital not always an advantage.80Faculty RecommendationBased on your interaction with the student, please provide your opinion regarding the students likelihood for success in this environment.Please comment on the students 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 students interpersonal skills in dealing with various personality types.Please comment on this students attendance and tardy record.Faculty RecommendationOverall 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.

The InterviewLooking for:

Student dedicationReasons for wanting to do the externshipAbility to manage emotions and emotional situationsEmotional maturity

Feedback from our Hospital PartnersIn 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?

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 (nonphysician) 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


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


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 HospitalIn 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, MNIf 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 HospitalIf 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.


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.

Renee Sauter Complementary TherapiesRegions Hospital

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

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 nonnegotiable language such as requiring student background checks, requiring various immunizations and vaccinations for the students providing care, liability and malpractice insurance, etc.


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.

Renee Sauter Complementary Therapies-Regions Hospital

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 hospitalbased massage and know the evidence for practice.

Lori Knutson, Director of the Penny George Institute for Health and Healing, Abbott Northwestern 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.



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


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.


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


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 postop 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.


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.


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 nobrainers. 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 HospitalAnything 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.


Thank you for your interest!!Chart10.0770.1020.1430.1580.1630.1790.1830.2650.374

Growth in the Number of Hospitals Offering CAM Services

Sheet1Growth in the Number of Hospitals Offering CAM ServicesSeries 2Series 319987.7%2.42199910.2%4.42200014.3%1.83200115.8%2.85200216.3%200317.9%200418.3%200526.5%200737.4%

Chart10.120.180.220.20.370.40.260.3100.4600.150.20.18

200520072005 and 2007 Inpatient CAM ServicesN/AN/A

Sheet120052007Series 3Acupuncture12%18%2Guided Imagery22%20%2Massage Therapy37%40%3Music/Art Therapy26%31%5Pet Therapy046%Reiki015%Relaxation Therapy20%18%

Chart10.180.350.090.210.20.240.40.540.120.250.310.180.460.10.250.30.180.27

InpatientOutpatient2007 Inpatient and Outpatient CAM Services

Sheet1InpatientOutpatientSeries 3Acupuncture18%35%2Biofeedback9%21%2Guided Imagery20%24%3Massage Therapy40%54%5Meditation12%25%Music/Art therapy31%18%Pet Therapy46%10%Therapeutic Touch25%30%Relaxation Therapy18%27%To resize chart data range, drag lower right corner of range.

Chart10.040.050.140.210.330.40.40.570.670.84

Reasons Hospitals Choose to Offer CAM ServicesReasons Hospitals Choose to Offer CAM Services

Sheet1Reasons Hospitals Choose to Offer CAM ServicesSeries 2Series 3Insurance Coverage4%2.42Employer's Request5%4.42Other14%1.83Potential Cost Savings21%2.85Differentiate from Competitors33%Physician's Request40%Attract New Patients40%Reflects Organizational Mission57%Clinically Effective67%Patient Demand84%

Chart10.660.570.550.530.450.41

Reasons for Massage in a Hospital EnvironmentReasons for Massage in a Hospital Environment

Sheet1Reasons for Massage in a Hospital EnvironmentSeries 2Series 3Pain management66%2.42Massage for cancer patients57%4.42Pregnancy massage55%1.83Physical therapy53%2.85Mobility training45%Palliative care41%To resize chart data range, drag lower right corner of range.

Chart10.530.230.220.03

Support for Initiating CAM Programs

Sheet1Support for Initiating CAM ProgramsSeries 2Series 3Administration53%2.42Nursing23%4.42Physicians22%1.83Board3%2.85To resize chart data range, drag lower right corner of range.

Chart10.160.160.40.40.320.320.120.12

Program's Relationship With Medical StaffProgram's Relationship With Medical StaffPrograms Relationship With Medical Staff

Sheet1Program's Relationship With Medical StaffExcellent (high referrals)16%Good (moderate referrals)40%Mediocre (limited referrals)32%Poor (few referrals)12%To resize chart data range, drag lower right corner of range.

Chart10.160.160.40.40.320.320.120.12

Program's Relationship With Medical StaffProgram's Relationship With Medical StaffPrograms Relationship With Medical Staff

Sheet1Program's Relationship With Medical StaffExcellent (high referrals)16%Good (moderate referrals)40%Mediocre (limited referrals)32%Poor (few referrals)12%To resize chart data range, drag lower right corner of range.

Chart10.790.720.620.270.15

Criteria Hospitals Used to Select CAM Therapies

Sheet1Criteria Hospitals Used to Select CAM TherapiesSeries 2Series 3Patient Demand79%2.42Evidence Based72%4.42Practitioner Availability62%1.83Market Research27%2.85Other15%To resize chart data range, drag lower right corner of range.

Chart10.80.770.510.17

How Patients Access CAM Services

Sheet1How Patients Access CAM ServicesSeries 2Series 3Self Referral80%2.42Physician Referral77%4.42Nurse Referral51%1.83Other17%2.85To resize chart data range, drag lower right corner of range.

Chart10.10.130.20.270.25

Therapists Reporting Employment in a Health Care Environment

Sheet1Therapists Reporting Employment in a Health Care EnvironmentSeries 2Series 3200510%2.42200613%4.42200720%1.83200827%2.85200925%To resize chart data range, drag lower right corner of range.

Chart10.860.10.04

Start-up CostsHospital CAM Program Start-up Costs86%10%4%

Sheet1Start-up CostsUnder $200,00086%Between $200,000 and $500,00010%Over $500,0004%4th Qtr1.2To resize chart data range, drag lower right corner of range.

Chart10.560.240.140.06

Two YearsThree YearsOne YearNot Expected ToBreak EvenBreak Even Expectation

Sheet1Break Even ExpectationNot expected to break even56%Three years24%Two years14%One year6%To resize chart data range, drag lower right corner of range.

Chart10.150.10.110.140.20.380.390.71

How Patients Pay for CAM Services

Sheet1How Patients Pay for CAM ServicesSeries 2Series 3Other15%2.42Medicaid10%4.42Billed as part of physician care11%1.83Medicare14%2.85Workers compensation20%No Charge38%Third-party reimbursment39%Patient self-pay71%

Chart10.450.55

YESNOCAM Part of Hospital's Strategic Plan

Sheet1CAM Part of Hospital's Strategic PlanYes45%No55%3rd Qtr1.44th Qtr1.2To resize chart data range, drag lower right corner of range.

Chart10.30.7

NOYESCAM Strategic Plan

Sheet1CAM Strategic PlanYes30%No70%3rd Qtr1.44th Qtr1.2To resize chart data range, drag lower right corner of range.

Documents

Hospital-Based Massage Therapy