Objectives
        Objectives
   Learn the research needed prior to 
   proposing an Integrative Health Clinic.
   Understand the people to involve in the 
   planning stages.
   Learn the steps needed to establish an 
   Integrative Health Clinic and Program.
   Describe strategies to overcome the 
   challenges and organizational barriers. 
      Formative Research
      Formative Research
      Readiness for change 
      Readiness for change 
   Greatest mistake: attempting an innovative change 
    without understanding pre-conditions for success. 
   Rigorous assessment to determining the level of 
    “readiness” for change in the local market. 
   Do the research, lay the necessary groundwork before 
    proposing, designing and implementing. 
   Literature Review for evidence of effectiveness and 
    outcomes must be knowledgeable on your topic.
   Investigate change management, benchmarking, and 
    best practice.
      Formative Research
      Formative Research
      Readiness to change
      Readiness to change
   Is there commitment from institutional leaders?
   Analyze the supporters and barriers, identifying potential 
   power struggles.
    Assemble a powerful team to lead the change- steering 
   committee.
   Create and communicate a compelling vision of change-
   business plan.
   Experiences of other VA organizations with similar 
   attempts. 
   Readiness criteria that needs to be satisfied before 
   proposing.
     Timing- External Market 
     Timing- External Market 
        Analysis Research 
        Analysis Research 
    CAM use in U.S. & Veterans CAM use surveys. 
    Klemm Analysis 1999.
    White House Commission Report on CAM 2002.
    National VA CAM Therapies & Practices (HAIG-2002).
    National VA CAM Field Advisory Board
      Credentialing and privileging guidelines.
    Patient protection and affordable care act Title IV 
    (subtitle A). 
    Prevention of chronic disease, health promotion, 
    Integrative Health.
             Internal and External 
             Internal and External 
                           Support
                            Support
     1.  Administrators: Director, Chief Nurse, Chief of Staff, 
         ACNS, Chief of Services: Anesthesia, Mental Health.
     2.  Providers Known to offer CAM (VA CAM Practice 
         2002), Psychologist, Nursing, DO/MD, PT, LCSW, 
         Clergy
     3.  VA Integrative & CAM: Elizabeth.Hakas@va.gov 
     4.  VA Acupuncture: Elizabeth.Hakas@va.gov
     5.  VASLC sandra.smeeding@va.gov
     6.  VA Long Beach anfu.Hsaio@va.gov