The Veterans Health Administration, National Pain Management Strategy, initiated on November 12, 1998, established Pain Management as a national priority (Lee, 2018).Veteran Administration National Pain Management Strategy provides a system-wide standard of care to reduce suffering from preventable pain. (VA Research on Pain Management, 2015). The V A established three War Related Injury and Illness Study Centers(WRIISC) nationwide, who specializes in the treatment and search of medically unexplainable conditions and symptoms and difficult to diagnose symptoms ( VA Complementary and Integrative Medicine, 2016). In addition to the Integrative Medicine, Department of Veteran Affairs requested assistance for excellence in person-centered care from Planetree Services. Planetree Organization offers a full spectrum of consulting services to support healthcare organizations at any stage of the Person-Centered Care Certification journey (certification.planetree.org, 2014) Planetree provides targeted recommendations for establishing (or strengthening) structures, processes, practices, and cultural underpinnings to ensure any person-centered improvement efforts are effective and sustainable (Planetree, 2014). The VA East Orange Hospital integrated all of those three optional specialties in patient care. Despite the availability of analgesics –particularly opioids- and national guidelines to manage pain, the incidence of postoperative pain has remained stable over the past decade. Thus acute pain associated with surgical and diagnostic procedures is a common occurrence in U.S. hospitals and remains inadequately managed for many patients (Wells, 2008). Poorly managing pain may put clinicians at risk for legal action. Current standards for pain management, such as the national standards outlined by the Joint Commission (formerly known as the Joint Commission on Accreditation of Healthcare Organizations, JCAHO), require that pain is promptly addressed and managed (Wells, 2008). Because of the Opioid Overdose and mismanagement of pain treatments, the U.S. Veterans Administration is partnering with the National Institute of Health begun a five-year, 21.7 million initiative to study the effectiveness of alternative treatment to chronic pain without worsening the opioid abuse problem (Webster, 2015). In this center for Integrated Healthcare, the East Orange VA providers are engaged in complementary integrative medicine like Visualization Guided Imagery. Guided Imagery involves the use of patient imagination to help put the body in a more relaxed state (Visualization /Guided Imagery, 2013). The alternative-therapy programs mark a dramatic departure in the treatment offered to troops who are returning from the wars in Iraq and Afghanistan and seeking relief from pain (Thibodeaux, 2014). The East Orange V A Hospital is known to be one of the most progressive V A’s nationwide in advances in clinical integrative medicine and alternative therapy research due to their establishment of a collaborative community which includes an Integrative Medicine Specialty Service, a WRIISC, and a Planetree Suite (Reed, 2017). Veterans seeking new or alternative ways to manage and improve overall health and well-being may be interested in learning about Complementary and Integrative medicine and its benefits (U.S. Department of Veterans Affairs, 2016). To have a consult with the Integrative Medicine service, the provider has to initiate a consult request. When the consult is received, the patient is scheduled for an appointment. During the consult, the patient is evaluated for his/her service needs, for medical care. The services provided may include; pain management, psychiatric evaluation, PT and mobility evaluation, rehabilitation, etc. If the patient is comfortable with their service, they can request to transfer their primary care to the Integrative Medicine Services. After the patient is seen by a provider and social worker, they make a plan of care with an RN acting as a case manager. The services are for traditional treatments and guided imagery one to one or group sessions, acupuncture, yoga as an example. Other addition activities are Zumba classes, dance studio, surfing, horseback riding, greenhouse gardening (Reed, 2017). East Orange VA Healthcare has built a multimillion-dollar spa-like complex to house their Integrative Medicine department equipped with examination rooms, patient lounges with internet access. This way the patients can access V A Healthcare System, and be able to manage their care the way they wanted. More veterans will have access to guided imagery, meditation and other powerful portable mind-body interventions because Guided Imagery has been officially placed on an Approved for use list at the VA (Naparstek, 2017)Guided imagery is already used in the Integrative Health services by the WRIISC by providers in the Psychiatric outpatient and in-service units, by nurses in some of the inpatient areas, nurses in the post-anesthesia care units, and in same day surgery Reed, 2017).
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