Integrative Pediatrics: Successful Implementation of Integrative Medicine in a German Hospital Setting—Concept and Realization
2. The Hospital Setting of St. Marien
4. First Steps
6. Results of Our Project
- “I think it is wonderful that our hospital belongs to the more progressive ones. I support CAM treatments 100%.”
- “I am VERY happy, that CAM is now being established in our hospital and I hope that nursing staff can participate in trainings and teachings.”
- “I think this area is really interesting and important, I would love to receive additional training and participate.”
CAM Services Now Offered at St. Marien
- Aromatherapy is now being used regularly on hospitalized patients as roll-on sticks and in form of wraps and poultices. One nurse successfully completed her certification as an aromatherapist.
- Acupuncture points have been taught to nurses and physicians and are now being applied in the form of pyonex press needles inserted in the acupuncture point P6 (pericard 6) to almost all children under anesthesia to prevent post-operative nausea and vomiting. Several studies have shown that P6 can be as effective as antiemetic drugs in preventing post-operative nausea and vomiting . Nurses and doctors have been trained to insert the needles and regular refresher teachings take place.
- Acupressure points are being taught to children and parents for cough, anxiety, abdominal pain, and nausea.
- Another treatment modality is foot reflexology according to Hanne Marquardt . Two indications were chosen—abdominal and lung conditions—and their treatment methods were taught to staff and parents. It is now being used regularly. A study was initiated and started in September 2016 to determine the effect of reflexology on children with these conditions.
- Yoga is being offered in the hospital now and a study was initiated and completed by our research partner in Essen, Germany, about the effect of yoga for headaches in children.
- Basic hypnotherapy methods (like “the magic glove”) were taught to physicians and nurses over the course of two weekends and are now being applied regularly.
- Wraps and poultices are used in combination with aroma oils in the Newborn Intensive Care Unit (NICU) and the pediatric wards on patients with rheumatic diseases, anxiety, fever, joint pain, sleep problems, abdominal pain, and cough, among others.
- Two doctors are now consulting on the wards on request for integrative treatment options for a variety of conditions. One of them is a certified homeopath, the other one is certified in naturopathy and TCM.
- A “handling” course for parents has been held a few times since September 2016 to enable them to touch and move their babies in a more supportive and physiologic way to help their developmental process.
- Herbal remedies are being applied and medical reference cards (detailing indications and dosage) have been designed for physicians.
- A multidisciplinary pain management team now applies CAM Methods for treating pain in children.
- Relaxation techniques of mind-body medicine are applied in the psychosomatic unit and social pediatric center.
- The institution in which methods of the CAM spectrum require establishment has to make a clear decision on the path that should be taken.
- Institutional support from the executive leader and medical director of the institution is essential. They represent the hospital and determine the overall concept of the institution. In our case, the leaders communicated well with each other about the new business concept, relayed this to their staff and put plans in place for it to be introduced by them. This enabled efficient evolution of the project and offered the prospect of sustainability.
- It is important to have back-up support within the organization, as leaders can change over time. The project becomes vulnerable if the primary protagonist leaves. At least one well-respected person, preferably a qualified physician, should take the lead in the beginning. This person does not have to be an expert in all offered CAM modalities, but must be willing to cooperate with other CAM experts so that all team members can learn from each other. In St. Marien, two physicians led the project—one in the coordinating role and the other as an integrative physician present and active in the hospital.
- It is crucial to have philanthropic support or available funds. Financial resources are often scarce and money is required for salaries, education of staff, and to generate research projects.
- To minimize resistance, it is advisable to build on the prevalent interest of the institution. Depending on the organization, it could be research or clinical applications, or education, or a combination of both. It is easier to first follow that path and strengthen it before starting new ventures. In our case, clinical applications and education of staff were where the most interest was found, followed by research. We followed that interest, used existing resources, and tapped on motivation of the staff members (identified through a questionnaire) and subsequently built the new concept from inside out to keep staff members motivated.
- It is essential to have motivated, creative colleagues working together, who can solve problems and find solutions one person can’t see.
- Networking with like-minded colleagues and institutions creates motivation and inspiration. Sharing ideas and experiences can help expand the project. In our project, three hospitals were involved and common projects were created and ideas exchanged in regular meetings with all participants. Networking with international colleagues also created inspiration and offered new ideas.
- It is important to not implement several modalities at once. To have a clear and simple treatment plan in which the patient can develop a relationship with the therapist is better that an overwhelming and expensive plan. In addition, too many new modalities can lead to an overload of the staff and therefore lead to resistance, which is not good for the project. We selected our modalities by identifying evidence-based knowledge and experience present within the hospital. Although there is a lack of evidence in the treatment of children, in accordance with other centers, we did not exclude modalities that had inadequate evidence ; instead, we evaluated efficacy by performing meta-analyses and reviews on various topics [31,32,33,34].
- Multidisciplinary meetings can help broaden one’s spectrum of knowledge and experiences within the institution.
- Research programs can be important in some institutions. Academic centers mostly want and need to add research to the project. Again, it is essential to follow the interest of the staff members and collaborate with other disciplines.
- Education is an important aspect of any facility, be it in the form of lectures for students, training and rotations for staff members, or workshops.
- Financing is a challenge in all centers. Financial plans have to be made, fundings organized, and payments by patients considered.
- Cooperation and communication with colleagues in other hospitals as well as in private practices have to be established, in order to ensure complete integration into the field. In Germany, resistance can be quite high if the hospital offers treatments that colleagues in private practices don’t. This can hinder the success of the project. A qualified physician or well-respected person has to represent the project in order to raise acceptance and reputation of the institution.
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|Art therapy||Homeopathy||Music therapy|
|Craniosacral therapy||Nutritional counseling||Yoga|
© 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Eckert, M.; Amarell, C.; Anheyer, D.; Cramer, H.; Dobos, G. Integrative Pediatrics: Successful Implementation of Integrative Medicine in a German Hospital Setting—Concept and Realization. Children 2018, 5, 122. https://doi.org/10.3390/children5090122
Eckert M, Amarell C, Anheyer D, Cramer H, Dobos G. Integrative Pediatrics: Successful Implementation of Integrative Medicine in a German Hospital Setting—Concept and Realization. Children. 2018; 5(9):122. https://doi.org/10.3390/children5090122Chicago/Turabian Style
Eckert, Marion, Catharina Amarell, Dennis Anheyer, Holger Cramer, and Gustav Dobos. 2018. "Integrative Pediatrics: Successful Implementation of Integrative Medicine in a German Hospital Setting—Concept and Realization" Children 5, no. 9: 122. https://doi.org/10.3390/children5090122