Project to Enhance Research Literacy (PERL) - Achieving Competency in Evidence Informed Practice: A Resource Guide for Educators

EP7. Discuss the value of evidence informed risk management planning and risk management behavior. 

Overview 

Providers need to explain the potential benefits, risks, and interactions of the modalities they use to health care colleagues, patients, and care givers. This includes discussing the research evidence that lowers the risk to the patient and provides value to care. This competency focuses on utilizing research evidence to support effective communication of your profession's indications and contraindications. 

Goal- Utilize research evidence to support effective communication of your profession's indications and contraindications.  

Learning Objectives

  • Define risk management planning in the context of integrative healthcare.
  • List common practices for your field to mitigate risks to the patient.
  • Explain cautions and contraindications within your discipline.
  • Summarize research supporting potential efficacy and/or safety of your discipline.
  • Discuss areas of potential adverse interactions with other modalities.

Resources

Gilmour, J., Harrison, C., Asadi, L., Cohen, M. H., & Vohra, S. (2011). Hospitals and complementary and alternative medicine: managing responsibilities, risk, and potential liability. Pediatrics, 128(Supplement 4), S193-S199. This publication summarizes the risk and liability concerns surrounding the incorporation of integrative care into conventional medical hospital settings.

American Society for Risk Management has several freely available white papers through their website. These resources provide insight into conventional medical approaches to mitigate risks to the patient and reduce liability.

The U.S. Department of Health and Human Services, Health Resources Services Administration (HRSA) offers several resources, including a freely downloadable risk management plan.

National Chiropractic Mutual Insurance Company (NCMIC) provides multiple risk management resources as well as suggestions to minimize clinical risks.

Basic Risk Management for Massage Therapists available from Associated Bodywork & Massage Professionals (ABMP).

Micozzi, M. S. (2006). The practice of integrative medicine: A legal and operational guide. Springer Publishing Company. ISBN-13: 978-0826103079. This book (for purchase) reviews key issues in interprofessional care environments both for individuals as well as institutions including liability risks.

Cohen, M. H., Hrbek, A., Davis, R. B., Schachter, S. C., & Eisenberg, D. M. (2005). Emerging credentialing practices, malpractice liability policies, and guidelines governing complementary and alternative medical practices and dietary supplement recommendations: a descriptive study of 19 integrative health care centers in the United States. Archives of Internal Medicine, 165(3), 289-295. This paper outlines a pilot study to examine policies (including risk management) at integrative care centers located within hospital settings.

Classroom Activity 

Split the class into small groups and assign a current article highlighting the benefits, or risks, of your professional services. Each group reviews the article and formulates a script/argument to support your services based on the information in the article. During class, each small group could present their argument to the entire class for discussion.

Vignette

Sara would like to grow her practice, and provide a service to her community, by seeing patients at her local hospital. She arranged to meet with hospital administrators to pitch a proposal that would bring her integrative care to the hospitals patients. While the administrators were impressed with Sara's passion and operational details in her proposal, they had several questions about the research behind the clinical benefits and risks for their patients. Sara confidently reviewed several recent research studies highlighting the risks and benefits of her clinical approaches for the most common conditions that the hospital treats.