As the number of hospitals that offer complementary and alternative medicine services continues to grow, the methods used to assess the success of their programs often seems less than adequate.
Over the years, I have queried hospitals about their programs — the modalities they offer; why they offer them; and their staffing, reimbursement and evaluation. When I ask about the metrics used to measure program success, I've found that patient satisfaction, volume and health outcomes were the most important metrics to hospitals. But more detail is needed to understand the perceptions of senior leaders regarding the value of these programs, and the literature is scarce.
Richard Gannotta, N.P., D.H.A., president of Duke Raleigh (N.C.) Hospital, conducted a study with his colleagues in 2010 that revealed some interesting information. While the study was small (comprising interviews with eight hospital leaders), and while it was specific to inpatient CAM services, it helped to shed some light on the factors identified by clinical and nonclinical directors for the success of their programs.
The interview participants were queried in three key areas:
- Clinical outcomes — has integrative medicine had an impact, and has it reduced length of stay?
- Patient satisfaction — has integrative medicine had an impact on patient satisfaction, and how does it compare with other inpatient services?
- Financial performance — does the organization expect the service to be profitable? Is it profitable? Are there plans to expand, contract or discontinue the service?
Some key themes emerged from the responses Gannotta and his colleagues gathered:
With regard to clinical outcomes, some common refrains were pain reduction, reduction in stress and anxiety, reduced use of medication, and a belief that length of stay had decreased.
With regard to patient satisfaction, respondents believed that the integrative medicine services were viewed favorably; that work culture was improved; and that the service may have raised satisfaction scores for other departments, such as medicine and surgery.
With regard to financial outcomes, programs were expected to cover expenses. There was a general perception that better clinical outcomes will improve financial performance and that these services help to attract patients and physicians, as well as help with recruiting and retaining staff.
Even though this study was small and limited only to hospital leaders' perceptions of inpatient services, the responses are consistent with the results of my national CAM survey and with what I have been hearing over the last few decades. Certainly more rigorous research needs to be done regarding length of stay, for example, or whether, in fact, patients who have a positive experience using CAM services come back and use the hospital for their other medical needs.
Hospital leaders, particularly administrators, long have been the champions and supporters of CAM. While their perceptions may be positive, it is the solid data on financial and clinical performance that will allow for program sustainability.
Sita Ananth, M.H.A., is a writer and content expert on complementary and alternative medicine based in Napa, Calif. She is also a regular contributor to H&HN Daily.