Referrals to integrative medicine in a tertiary hospital: findings from electronic health record data and qualitative interviews.

摘要: Objective To examine patterns of, and decision-making processes, informing referrals for inpatient access to integrative medicine (IM) services at a large, acute care hospital. Design Retrospective electronic health record review structured qualitative interviews. Setting A 630-bed tertiary hospital with an IM service available inpatients. Participants of all inpatients aged ≥18 years between July 2012 December 2014 were identified using the hospital9s record. Fifteen physicians, 15 nurses 7 administrators interviewed better understand roles perspectives in referring patients services. Results In study hospital, primary sources orthopaedic neuroscience/spine lines. While largest absolute number was made lengths stay 3 days or fewer, disproportionate total long (≥10 days), compared smaller percentage ≥10 days. Physicians more likely refer who displayed strong symptoms (eg, pain anxiety) and/or did not respond conventional therapies. predominantly nurse-initiated. built-in delay time from referral initiation delivery discouraged some patients. Conclusions Conventional providers when these are Referral influenced by patient characteristics, operational features provider perspectives. Nurses play key role process. Overcoming cultural knowledge differences is be continuing challenge providing settings.