Abstract ID: 3810

Primary Topic: Clinical skills-building
Secondary Topic: Integrative medicine delivery models

Weaving Together Patient-Centered Care, Integrative Health, and Self-Care: The Whole Health Approach in Your Practice and Your Life
Adam Rindfleisch, MD, University of Wisconsin, Madison, WI, United States; Carol Bowan, MD, Baltimore VA, Baltimore, MD, United States; Henri Roca, MD; Michael Hollifield, MD; Aysha Saeed, MD; Theresa Liao, MD; Bisty Recupero, MD, , Brockton, MA, United States

Late Breaker: No

Purpose

We all agree that patient-centered, integrative, and self-care matter, but what does it look like to draw all of these elements of care into your day-to-day practice?  How do you create a personalized health plan for each of your patients in a way that is both efficient and professionally fulfilling?  

For several years, the Veterans Health Administration (VHA) National Office of Patient Centered Care and Cultural Transformation has been exploring practical implementation of a new way of offering care, using what they call the Whole Health approach.  Over 5,000 VA clinicians have received training in Whole Health, and as of October 2017, 18 different VA facilities will be implementing a Whole Health Systems model.  The purpose of this pre-conference workshop is to familiarize participants with the model, but even more importantly, to teach them how to tailor the Whole Health approach to their own specific practices.  Skill-building and experiential learning are emphasized, and multiple supportive resources will be offered.  The material from the VA's national course, "Whole Health in Your Practice," will be adapted for use by non-VA clinicians.

This experience will enlist expertise from Whole Health educators nationwide and builds on information that will be featured in Dr. Tracy Gaudet's plenary address. 

Objectives

After completing this workshop, participants will be able to:

1.  Describe the elements of Whole Health care, including the exploring Meaning/Aspirations/Purpose with patients, the Circle of Health, and the key elements of Personal Health Planning.  

2.  Co-create a personal health plan for themselves and for a partner, emphasizing core values, self-care, and complementary and integrative health approaches.

3.  Describe how their own self-care practices are relevant in this approach to care.

4.  Complete a Whole Health Assessment.

5.  Discuss research findings relating to the efficacy of Whole Health care and its various components.

6.  List at least 5 online resources where they can get additional in-depth information about Whole Health.

7.  Describe 3 ways they will incorporate Whole Health more fully into practice after returning home.

Time Frame

This 6-hour session would be divided into segments as follows, with two short breaks in the middle of the morning and afternoon sessions and a longer break over lunchtime.  Content of each of these sessions is described in detail in the "Educational Design" section:

1.  Introductions - to each other and to Whole Health concepts (30 minutes)

2.  Mindful Awareness (30 minutes) - research, experiential session, and bringing it into practice

3.  Cultivating Therapeutic Presence (30 minutes) - exploration of nonspecific variables and their clinical effects.  How can you be the most effective healer you can be?

4.  Self Care, Part I (1 hour).  Surroundings and resilience, and how they relate to your practice

5.  Self Care, Part II. (40 minutes). Eating, Activity, and Sleep and their role in a patient-centered model.  Guided movement experience.

6.  Self Care, Part III. (40 minutes).  Spirituality, Relationships, and Power of Mind are discussed, with experiential learning opportunities linked to each.  

7.  Professional Care (40 minutes).  Complementary and Integrative Health in Practice and how integration can occur in various health systems.  

8.  Implementation I (45 minutes).  Creating a Personal Health Plan

9.  Implementation II (45 minutes).  Planning how to apply what has been learned in clinical practice.

Faculty

Presenters for the 9 elements of this workshop will be as follows:

1.  Introductions - Rindfleisch

2.  Mindful Awareness - Bowman

3.  Therapeutic Presence - Roca

4.  Self Care I - Bowman, Rindfleisch

5.  Self Care II - Saeed

6.  Self Care III - Hollifield

7.  Professional Care - Roca

8.  Implementaton I - Liao

9.  Implementation II - Recupero

All faculty members will support the learning process throughout, including sitting in with various small groups during their discussions around resilience, self-care, and implementation.

Teaching/Learning Strategies

After teaching about Whole Health for the past five years, with close evaluation by Pacific Institute for Research and Evaluation, we have found that we have been most successful if we draw in several different educational approaches.  These are informed by adult education and transformative learning models:

  1.  Slides - a few slides are offered to make key points and to highlight key research.  Materials are evidence-based and directly related to learners' own experiences in their personal and practice lives.
  2.  Experiential learning - participants try the very approaches they are learning about.  This includes, in this workshop: mindfulness exercises, a movement practice (tai chi), breathing techniques, and some guided imagery as well.  
  3.  Applyingwhat you learn to yourself first.  Participants learn the Whole Health approach by moving through it themselves and co-creating their own care plans with a partner.
  4.  Skill-building.  This is not merely didactic; each person actively applieswhat he/she is learning in collaboration with a "health planning partner" as they move through the workshop.
  5.  Group discussions.  Multiple large and small group discussions allow for discussion of concepts and sharing of experiences.
  6.  Reflection and implementation.  Participants consolidate their learning by creating specific plans for how to apply it, which they share with one another.  

The Circle of Health is attached for review, as a resource that will be used during the workshop.  Note that each participant would receive a small course manual to support them as they complete various workshop exercises and activities.  Websites that will be provided as resources include the Whole Health Online Library, at http://projects.hsl.wisc.edu/SERVICE/, the link to the 250-page Whole Health Reference Manual, at http://projects.hsl.wisc.edu/SERVICE/key-resources/PDF%20Passport%20to%20Whole%20Health%20FINAL%2011-10-16.pdf, and the VA Office of Patient Centered Care site, at https://www.va.gov/patientcenteredcare/.

Outline

This 6-hour session includes the following 9 modules, with short breaks in the middle of the morning and afternoon sessions and a longer break over lunchtime.  Because faculty have taught these topics multiple times, it is possible for us to gauge timing fairly accurately for each of the 9 modules.

1.  Introductions (30 minutes) - Participant introductions, introduction Whole Heath at an individual, team, and system-wide level, with a focus on the Circle of Health and elements of Personal Health Planning.   

2.  Mindful Awareness (30 minutes) - Summary of latest research on mindfulness, with five-minute mindfulness experience and discussion of how to integrate it into daily clinical care.  Each participant will assess their own clinical practice and self-care in terms of what is going well and where they would like to make improvements using two self-assessment instruments.  Each person will complete a Personal Health Inventory.

3.  Cultivating Therapeutic Presence (30 minutes) - Experiential exercise related to reconnecting with reasons to enter a healing profession.  Summary of research related to how clinicians can be most effective for their patients/clients based on non-specific variables they bring into practice.  

4.  Self Care, Part I (1 hour).  Participants will focus on two areas - healthy surroundings (optimal healing environments) (30 minutes) and resilience/personal development (30 minutes).  They will complete an exercise related to key elements of a healing space with a small group discussion with a partner.  They will have small group discussion on what contributes to resilience.  Participants will each be assigned "health planning partners" and they will begin to do Whole Health assessments with each other, asking questions related to Surroundings and Personal Development.

5.  Self Care, Part II. (40 minutes).  Healthy lifestyle.  Self-care tips and resources related to Eating, Activity, and Sleep will be discussed.  A guided movement meditation will be offered in the middle of the time.  Participants will discuss these three aspects of self-care with their health planning partners.  

6.  Self Care, Part III. (40 minutes). Healthy connections.  Spirituality, Relationships, and Power of Mind will be discussed, with an emphasis on research related to their roles in promoting health and well being.  Participants will share their perspectives on spirituality and clinical care with their small groups.  They will practice taking a partner through a basic breathing exercise.  They will discuss these three elements of self-care with their planning partners as well.

7.  Professional Care (40 minutes).  The role of Complementary and Integrative Health in Practice will be discussed, with a focus on several of the most popular approaches used nationally.  The VA now requires that several complementary approaches be provided by all VA sites, and this unique perspective will be discussed in a large group format.  National resources to support professionals in Whole Health Practice will be shared.  Faculty will demonstrate the overall model with a participant volunteer.

8.  Implementation I (45 minutes).  Working with their same partners, participants will finish creating, with step-by-step guidance, their Personal Health Plan.

9.  Implementation II (45 minutes).  Working in small groups, participants will discuss how to apply the Whole Health model in their own practices and share their ideas with the larger group.

If the program committee feels your presentation would be better suited for a different presentation type, such as a symposium (shorter format during the main meeting), would you be willing to adapt your presentation to fit the new format?

Yes

Who is the target audience of the workshop? Are there particular skills or background that are recommended as pre-requests?

Anyone who works with patients/clients, ranging from doctors and naturopathic physicians to nurses, chiropractors, dietitians, pharmacists, psychologists, and PT's. Anyone with a practice of some kind will find the workshop relevant.

Is this workshop proposed by an organization?

No

Has the content (or substantial parts) of this workshop been previously presented or published (note: previous experience presenting the material may be considered a strength as long as continued interest is anticipated)?

Yes

Please provide Location of Presentation and/or Publication Information and date of each presentation

The content of this 6 hour workshop is built in part from course materials from the course, Whole Health in Your Practice, which will have been presented over 70 times by April 2018 to audiences of clinicians from VA facilities nationwide.  For the purposes of the International Congress, materials have been specifically re-designed to be appropriate for non-VA clinicians, including practitioners of CIH approaches.   All of the sites are linked to different VA Medical Centers.  The first site was Madison, WI in September 2013 and at the time of submission the most recent is Salisbury, NC in October of 2017.  We will gladly provide you a list of every site where this material has been taught if necessary, but other examples include VA facilities in Long Beach, Portland, Puget Sound, Salt Lake, Prescott, Muskogee, Pueblo, Sioux Falls, Minneapolis, St. Louis, Little Rock, Dallas, San Antonio, Biloxi, Nashville, Birmingham, Louisville, Detroit, Saginaw, Pittsburgh, Lyons NJ, DC, Richmond, and Orlando, to name some examples.