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Please Note the Following:

This certification program is 33 CEUs in its entirety and requires all the courses listed below for completion. The 3 courses on Safety and Ethics are in addition to the Core Six-Module Bundle, and need to be purchased separately. Follow the links below.

Course Description:

Acupuncture Therapies for Inpatient and Hospital-based Care

This Certificate Course provides a total of 33 CEUs/PDAs. The paragraph below summarizes the course’s 6 Modules co-taught by Arya and Claudia. In addition, 3 Modules in professional standards for safety and ethics are required for the full course completion certificate to be issued (links just below).

This Course supports the development and expansion of acupuncture therapy for inpatient and hospital-based care. Many acupuncturists are interested in hospital work, but unsure where to start. Others may be contacted by patients, doctors or even hospital administrators who are genuinely interested in bringing acupuncture therapy to inpatients, but lack critical information about what is needed to make that happen, administratively and logistically as it relates to acupuncture practice. Many acupuncturists are interested in hospital work, but unsure where to start. Others may be contacted by patients, doctors or even hospital administrators who are genuinely interested in bringing acupuncture therapy to inpatients, but lack critical administrative and logistical information as it relates to acupuncture practice.

This is an exciting time for hospital-based acupuncture. The largest US hospital accreditation body, the Joint Commission, is drafting new a pain mandate that requires hospitals to ‘promote access’ to nonpharmacologic therapies as options in the treatment of pain. Acupuncture therapy leads nonpharmacologic therapies in evidence for reducing acute pain with opioid sparing and in reducing anxiety, nausea and vomiting, insomnia, depression, constipation as well as opioid side effects; benefits that can be seen in a single treatment without the need for additional multiple medications. The Modules of this course systematically support acupuncturists who are new to hospital care, as well as those seeking to better understand the context of their work or expand their service. Essential areas include: preparation for meeting with administrators to generate program proposals; communications with hospitals about Policies and Procedures; Credentialing and Privileging of licensed acupuncturists; becoming familiar with hospital structure and culture including unique Departmental logistics; current best evidence of acupuncture therapy’s benefits and how to present that evidence to hospital departments; offering financial models and options for program sustainability; and finally, ‘A Day in the Life’ – straight talk about the work life of an acupuncturist doing inpatient care. All Modules have supportive documents and/or templates. This course distils a combined 30 years of practical, administrative and supervisory experience for Arya and Claudia, spent advancing acupuncture therapy for inpatient and hospital-based settings. Join them in making this a national movement!

Module One: Building Essential Infrastructure: Policy & Procedures, Credentialing, Privileges, Supervision [5 PDA]

Description:

This class introduces the main organizational documents that must be in place for an acupuncturist to practice in a hospital system. The Policies & Procedures (P&P) is a document approved by the hospital’s highest executives/boards and/or at the department level. It details all aspects of how acupuncture therapy is to be delivered at the institution globally, or if limited to a particular department. A P&P generally describes the terms of credentialing and privileging for practitioners, referred to as licensed independent practitioners (LIP) by the Joint Commission. Credentialing is the process by which institutions establish that a new practitioner is qualified for a position and can be trusted; and what quality benchmarks they must meet to remain on staff. Privileges determine what the provider can do at the institution, which is described in a state’s scope of practice. Medical supervision or oversight is a key element of hospital-based practice, how it is delineated and evaluated is organization-specific. Particular issues regarding informed consent for inpatients are discussed. Handouts include real world templates for P&P, Credentialing and Privileging of acupuncturists, job description and evaluation, and scope of practice.

Learning Goals:

  • Learn what is credentialing, how to promote an appropriate credentialing policy
  • Learn what is privileging and how to promote appropriate privileging policy
  • Learn what is a scope of practice and where scope is detailed in a hospital
  • Learn what is supervision and what is oversight.
  • Learn what is meant by hospital-wide board approved ‘Policy & Procedures'
  • What is meant by department specific ‘Clinical Service’?
  • Learn how to strategize in the creation and or improvement of hospital documents

Module Two: Hospital Structure & Culture: Understanding the Hospital System [4 PDA]

Description:

In this class, students will be introduced to the three main power structures that drive workflow as well as administrative and clinical decision-making in a hospital. These are: institutional accreditation, including different types of standards that hospitals must meet; internal chains of command including executive/administrative, medical and nursing; and the evidence-based guidelines for clinical practice which guide inpatient care across disciplines. ‘Systems-based practice’ denotes how one’s own clinical care relates to the hospital system for a given patient. This is a competency required for all physicians and other hospital-based health care providers including LIPs. Class handouts include: background reading on key points of evidence-based practice and systems-based practice; illustrations and explanations of hospital command structures; and how a hospital guides staff to survive accreditation visits by The Joint Commission (TJC) and Department of Health (DOH).

Learning Goals:

  • Learn the context of hospital structure and institutional accreditation
  • Understand administrative, medical and nursing chains of command in typical teaching and non-teaching hospitals.
  • Understand the importance of evidence-based medicine as a force that shapes clinical decision-making in the hospital.
  • Understand what is meant by ‘systems-based practice’, why it is important, and how to operate as an acupuncturist within a medical team.
  • Become aware of unwritten rules that may not be immediately apparent

Module Three: Departmental Logistics [4 PDA]

Description:

This class discusses acupuncture service logistics, highlighting what is consistent throughout the hospital and what might be unique depending on specific hospital Departments. What are the procedures for referral, consultation, permission to treat, consenting and charting? Safe and effective treatment must mesh well with the department's work flow; how does work flow differ depending on floor or Department? We discuss acupuncture consult and treatment provided in Surgery, Orthopedic surgery, Family Medicine, Internal Medicine, Labor and Delivery, Pediatrics, Obstetrics, Oncology, Pain and Palliative, Hospice and Rehab care. Sessions for patients who are referred, permitted, consented and ‘ready to treat’ must be coordinated with nursing and work of other therapists. Considerations are detailed for work in specific departments, and for setting up service in a new department. Whether a new or sustained service, an acupuncturist does more than treat; we ‘represent and recruit’. This Module identifies areas appropriate for an ‘elevator pitch ’of evidence that is detailed in Module 4. Professional logistics and interactions described from an operational point of view in this Module are illustrated in a more personal way in Module 6: A Day in the Life: Preparation and Pacing for Inpatient Care’

Learning Goals:

  • Become aware of what is involved in setting up new service in a Department and or how to sustain and advance existing service
  • Familiarize participants with similarities of practice across hospital department
  • Familiarize participant with Departmental distinctions and their impact on workflow, patient need, chains of care and responsibility, and how to ‘fit’.
  • Learn how to build relationships and coordinate care with physicians, nurse managers, nursing and other therapists in diverse services e.g. surgery, orthopedic surgery, family medicine, internal medicine, labor/delivery, obstetrics, oncology, pain, palliative, hospice care, pediatrics, rehab, emergency, psychiatry
  • Generate a consult flyer with contact information
  • Identify key elements of a basic SOAP note for inpatient care
  • Identify important inpatient guidelines re: capacity to consent, INR, platelets count etc.
  • Understand how to brainstorm potential areas of research: what is the lay of the land? Affiliating with existing researchers who understand the process.

Module Four: Presenting Evidence to Hospital Staff [4 PDA]

Description:

This class teaches key skills for effective and well-received presentations of the research evidence for acupuncture therapies directly applicable in the hospital setting. First is the recognition that different audiences have unique needs, though with some overlap. Much like a treatment can be shaped to an individual patient’s needs, so too a talk can be shaped to the specific interests of administrators, physician teams, nurses, the public, or mixed audiences. Focus is on the most important evidence honed to a specific type of talk and attention span, from full lecture to elevator pitch. This PowerPoint will contain the current evidence on acupuncture therapy for inpatient care and can be incorporated into a participant’s own presentation. Handouts containing citations will be provided as well as publicly available full text articles.

Learning Goals:

  • How to plan a talk of the appropriate size and scope for the duration and audience
  • Become familiar with the medical database
  • Learn how to read PubMed, keep current on literature for a specific topic
  • Identify the most potent types of articles
  • Select an appropriate pre-made PowerPoint format or create one using a template
  • Generate appropriate talking points for an audience and incorporate appropriate research to support those talking points
  • Capture and retain the audience’s interest formally through shared mission of patient care and informally by responding to personal interest and curiosity
  • Understand how to develop a fluent ‘elevator pitch’ for acupuncture effectiveness in diverse areas

Module Five: Program Development and Financial Sustainability [2 PDA]

Description:

This class introduces financial considerations and the main funding options for setting up and running an acupuncture program. Financial models are presented that are currently used in programs around the country. Models include philanthropy, billed consultation or fee-for-service, postgraduate education and partnership with acupuncture schools. Advantages and disadvantages of each model are considered along with discussions of how they can be combined, and tips for identifying the institutional conditions conducive to success. Where an institution is interested in adding acupuncture service but has not yet decided on a model, discussion focuses on how to think about sustainable business options.

Learning Goals:

  • Understand what models may work for a given hospital system (teaching, community, wealthy, poor, mix)
  • Learn to identify the hospitals most likely to be able to hire on a salary, consultation or fee-for-service basis
  • Understand conditions conducive to success of a postgraduate training program and/or an acupuncture school partnership
  • How to think about a business plan where one does not yet exist

Module Six: A Day in the Life: Preparation and Pacing for Inpatient Care [4 PDA]

Description:

You have arrived! Everything is in place for a great day of work providing acupuncture therapy in an inpatient setting. What does that day look like? What kinds of patients will you see, what conditions will you treat? Acupuncture therapy is making an impact: filling gaps in care, changing patient satisfaction scores, reducing need for analgesic medication and facilitating recovery as we have seen in the five previous modules. How are the Departments different in terms of acupuncture care? While the inpatient population is more acute, and more severely ill than one sees an outpatient setting, the impact of treatment is also greater. Here is the secret: the patient presentations may be more complicated, but the acupuncture therapies you already know work very well. We discuss treating in acute care, and the skill of prioritizing treatment based on urgency or severity of symptoms that are part of complex comorbid presentations. Got your security badge, your clean lab coat, your lunch, your toolkit? Let’s head over the OB Grand rounds for coffee and a bagel and then to patient clinical rounds on orthopedic surgery.

Learning Goals:

  • Know what things you must have set up before your first day
  • Have a sense of where you want to locate for the shift
  • Anticipate most common consultation calls for acupuncturist.
  • How to find your way around departments of Surgery, Orthopedic surgery, OB, Pediatrics, Internal medicine, Family medicine, Pain &Palliative Care, Oncology, Rehab, ED etc.
  • How to rehearse various ‘elevator pitch’ responses for questions commonly asked of acupuncturists.
  • Learn how the very presence of an acupuncturists ‘recruits and represents’
  • Be familiar with practice considerations: limb precautions, lymphedema, INR, platelet counts, patient history.
  • Understand options for treating patient in their beds, or chairs near their beds
  • Understand useful approaches to treatment in acute care
  • Understand ‘rescue acupuncture’ where ‘TCM evaluation’ may not inform treatment

This Course Includes:
Acupuncture, Business
California
California: 
Category 2
NCCAOM Details
Core Knowledge, Skill, Ability: 
22.00
Texas Details
General Acupuncture: 
22.00

Arya Nielsen and Claudia Citkovitz

Arya Nielsen

Dr. Arya Nielsen is an American acupuncturist taught in the classical lineage of Dr. James Tin Yau So. She graduated in the first class of the first acupuncture college in the United States in 1977 (New England School of Acupuncture). She is a practitioner, teacher, author, and researcher and is considered the Western clinical authority on Gua sha.

Dr Nielsen is an Assistant Clinical Professor at Icahn School of Medicine at Mount Sinai in the Department of Family Medicine & Community Health and directs the Acupuncture Fellowship for Inpatient Care at Mount Sinai. Her research includes both the physiology and therapeutic effect of Gua sha, acupuncture therapies for acute care and the inpatient setting as well as research on the treatment of chronic pain in underserved populations.

Dr. Nielsen is the author of the textbook Gua Sha, A Traditional Technique for Modern Practice, (also in German, French and Italian) now in its second edition. She also filmed Gua Sha: Step-by-Step a teaching DVD. Arya teaches internationally on topics related to East Asian medicine and Integrative medicine she developed and teaches the Gua sha Certification Course with ProD Seminars (http://www.prodseminars.net/guasha) as well as courses on safe and ethical practice standards, evidence for acupuncture and traditional East Asian modalities, and inpatient hospital-based acupuncture therapy.

Dr. Nielsen is the Chair of the Policy Working Group for the Academic Consortium for Integrative Medicine & Health, the 70 plus North American member organization of academic medical centers and health systems that support utilization of evidence-based nonpharmacologic therapies as integrative medical care. Arya served on a 2014 Joint Commission Stakeholder Panel on pain that led to their clarification (2015) that nonpharmacologic therapies be included in treatment strategies.

Arya can be contacted by email at Arya.Nielsen@mountsinai.org or at her website http://www.guasha.com/.

Claudia Citkovitz, L.Ac. has led the Acupuncture Service at NYU Lutheran since 2004, supervising 12 acupuncturists who provide inpatient care and clinical instruction in the areas of neurological and orthopedic management, rehabilitation, labor and delivery, pain management. Dr. Citkovitz studied Chinese language in Beijing and acupuncture at the Pacific and Tri-State colleges in New York. An internationally known lecturer on acupuncture practice and research methodology, she lectures regularly for the American College of Traditional Chinese Medicine, the Oregon College of Oriental Medicine and the Pacific College of Oriental Medicine, the University of Westminster in London and the British Acupuncture Council. Her PhD study on acupuncture during acute stroke rehabilitation was the first conducted in the United states, as was her 2006 study of acupuncture during labor and delivery. Dr. Citkovitz is a frequent peer reviewer and Editorial Board member on journals including Acupuncture in Medicine, BMC Pregnancy and Childbirth, the Journal of Alternative and Complementary Medicine, Explore, and Meridians.

Picture of Arya Nielsen and Claudia Citkovitz