title: Studying optimal healing environments: challenges and proposals.
abstract: The concept of optimal healing environments has strong face validity, but it is difficult to operationalize the complexity of the human dimensions that comprise the process of healing. Only rigorous evidence can justify the tremendous resources necessary to create optimal healing environments. This article outlines the current challenges of studying optimal healing environments from a clinical epidemiology perspective and discusses the major potential obstacles to include human resources, relationship-centered care competencies, dysfunctional educational and health care systems, research competencies, credibility, dispersed and unfocused current evidence base, and the actual logistical methodological difficulties. The concept of optimal healing environments is a paradigm shift in the delivery and study of medical care, and such an initiative will likely take decades to transition. However, there are feasible activities that can currently be undertaken to expedite this transition, chief of which is establishing a coalition of influential societies to forge an agenda on several fronts. Research activities presently should focus on validating and simplifying measurement tools for healing-related outcomes constructs, expanding the versatility and use of qualitative methods, as well as synthesizing research evidence to help clarify the current evidence base and the future research agenda.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA. Patrick.Omalley@na.amedd.army.mil
authors.forename: Patrick G
authors.initials: PG
authors.lastname: O'Malley
mesh_terms: D002908:Chronic Disease / Q000628:therapy*; D000529:Complementary Therapies / Q000458:organization & administration*; D006694:Holistic Health; D006801:Humans; D017146:Models, Organizational; D010347:Patient Care Planning / Q000458:organization & administration*; D010353:Patient Education as Topic / Q000458:organization & administration; D018802:Patient-Centered Care / Q000458:organization & administration*; D010818:Practice Patterns, Physicians' / Q000458:organization & administration; D011787:Quality of Health Care / Q000458:organization & administration; D012107:Research Design; D014481:United States