Perceptions of providers and administrators in the Veterans Health Administration regarding complementary and alternative medicine.
BACKGROUND
The integration of complementary and alternative medicine (CAM) therapies into a large organization such as the Veterans Health Administration (VHA) requires cultural change and deliberate planning to ensure feasibility and buy-in from staff and patients. At present, there is limited knowledge of VHA patient care providers' and administrators' viewpoints regarding CAM therapies and their implementation.


OBJECTIVE
Our purpose was to qualitatively examine knowledge, attitudes, perceived value and perceived barriers, and/or facilitators to CAM program implementation among VHA providers and administrators at a large VHA facility.


METHODS
We are reporting the qualitative interview portion of a mixed-methods study.


METHODS
Twenty-eight participants (patient care providers or administrators) were purposely chosen to represent a spectrum of positions and services. Participants' experience with and exposure to CAM therapies varied.


METHODS
Individual interviews were conducted using a semi-structured format and were digitally recorded, transcribed, and coded for themes.


RESULTS
Recurrent themes included: a range of knowledge about CAM; benefits for patients and staff; and factors that can be facilitators or barriers including evidence-based practice or perceived lack thereof, prevailing culture, leadership at all levels, and lack of position descriptions for CAM therapists. Participants rated massage, meditation, acupuncture, and yoga as priorities for promotion across the VHA.


CONCLUSIONS
Despite perceived challenges, providers and administrators recognized the value of CAM and potential for expansion of CAM within the VHA. Interview results could inform the process of incorporating CAM into a plan for meeting VHA Strategic Goal One of personalized, proactive, patient-driven health care across the VHA.
*VA Ann Arbor Medical Center, Ann Arbor, MI †Penny George Institute of Health and Healing, Abbott Northwestern Hospital, Minneapolis, MN.
Carol E
CE
Fletcher
Allison R
AR
Mitchinson
Erika L
EL
Trumble
Daniel B
DB
Hinshaw
Jeffery A
JA
Dusek
D001291:Attitude of Health Personnel; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D005260:Female; D006740:Hospital Administrators; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009937:Organizational Objectives; D036301:Qualitative Research; D014481:United States; D014493:United States Department of Veterans Affairs