Quality Improvement Project

Quality Improvement is a Hallmark of Institutional Integrity at AOMA.

The Quality Improvement Project (QIP) provides an opportunity for students to develop an awareness of and responsiveness to the healthcare system within which they practice, conduct a self-analysis of practice to identify professional strengths and weaknesses, and develop a program of life-long self-directed learning to remediate weaknesses and further develop strengths.

In the first professional doctoral course, RQ0145 DAcOM Portfolio and Practice-Based Learning, students working alone or on teams will run a need analysis and create a quality improvement project (QIP). Upon acceptance, students will implement their QIP and report on its outcomes.

Biomedical Physical Assessment Education and Integration for Acupuncturists (Summer 2017)

Purpose

Biomedical education is a requirement for acupuncture licensure in many states. At AOMA, Master of Acupuncture and Oriental Medicine (MAcOM) students take two biomedical physical assessment (PA) classes before starting their clinical internship where they are expected to use it regularly during patient intake. However, in practice, acupuncture students are not using PA consistently and when they are asked to do so, have variability inconfidence and competence. This QIP is a needs analysis inquiry into why students are not consistently integrating PA into their clinical internship and what change in educational practices could facilitate optimal integration. Additional questions posed include: Why is PA used by acupuncturists? Why is PA important and will it change the course of acupuncture treatment chosen? How is the PA curriculum determined and are the tests required for licensure standardized from class to clinical internship?

Needs Analysis

Students are not using PA consistently in clinical internship and therefore are unlikely to use it in professional practice. 

Surveys and interviews are needed to find out why skills being learned in didactic courses are not being applied practically in clinical internship. Does it reflect a gap in MAcOM PA education and subsequent practical incompetence, a lack of confidence, a belief system that PA is not necessary for acupuncture practice, or some other phenomenon? A systematic inquiry into the current state of PA education in the MAcOM and the PA practices of Licensed Acupuncturist (L.Ac.) faculty members and professional clinicians on the AOMA campus is executed in this QIP. The end goal is to determine whether or not PA education at AOMA should be reviewed and improved with adjustments to PA tests, educational video intervention and additional PA classes.

Target Audience/Group

  • AOMA Academic Departments and leadership who are responsible for curriculum review
  • AOMA students and alumni

Description of Intervention

  • Peripheral Nervous System (PNS) physical assessment instructional video
  • Survey of PA1 and PA2 students covering class content and educational study methods
  • IRB approved survey of AOMA faculty and professional clinic L. Ac.’s covering their belief concerning and use of PA in acupuncture practice

End Product to Fill Needs/Gaps

Intended end goals include:

  1. A PA educational video that is accessible to students and alumni.
  2. An Impact on PA curriculum changes at AOMA.

Method(s) of Sharing End Product

  1. Youtube channel: https://www.youtube.com/watch?v=sxcwnUAogDg&t=118s
  2. Meeting with Biomed department heads, faculty, and director of MAcOM at AOMA.

Conclusions

PA is an important part of Acupuncture education and practice, however it is not being consistently integrated into clinical practice by AOMA students or faculty. Not all LAc's believe PA is necessary. Possible curriculum changes could include: i) a paired down list of PA tests in PA1 and PA2, ii) a standardization of content covered in these classes regardless of faculty to reduce confusion, iii) an additional class (PA3) that MAcOM students will take after starting clinical internship that repeats PA tests and integrates biomedical PA into acupuncture practice, and iv) an increase in exposure to PA at AOMA through videos and additional PA review sessions in Clinic Theater 2 and mandatory quarterly intern meetings.

Future endeavors could include a series of CEU classes teaching practical application of PA tests to Acupuncture treatment plans. Most importantly, this QIP concludes that PA is important in the practice of acupuncture and can inform acupuncture treatment plans.

Download the Full Plan [PDF]

AOMA at the VHA Austin Outpatient Clinic Documentation Quality Improvement Plan (Summer 2017)

Purpose, Intent of QIP 

The goal of this quality improvement plan (QIP) is to make the appointment and onboarding process for AOMA students working at the Veterans Health Administration (VHA) as efficient and as stress-free as possible by capturing the appointment process and daily operations in an easy to assimilate format. 

Needs Analysis, Gaps, Reason for QIP 

Before and when AOMA students started treating at the VHA Austin outpatient clinic, there were several unique challenges. Those problems included a tedious student and supervisor application process. It also included treating a unique patient population, working in a US government agency, using an electronic medical record system, and dealing with specific patient outcomes. In addition, students have been unable to come up to speed quickly due to a lack of written standard protocols. Thus, there was a need for a written clinical operations document. 

Target Audience/Group 

The target audience for this QIP are AOMA students, AOMA supervisors, AOMA administration, VHA supervisors, and VHA management. 

Description of Intervention, Solution, End Product to Fill Needs/Gaps 

The result of this QIP are two documents. The first document clearly and concisely outlines the VHA WOC appointment process. The second document describes the policies and procedures for daily operations at the VHA Austin outpatient clinic. These reports will be presented to the target audience. Based on the feedback from the target audience, the two papers will be amended. This process should continue until the documents are relatively stable and can be presented in an orientation. 

Method(s) of Sharing End Product with Targeted Audience 

The VHA application process document will be provided to the AOMA VHA point of contact for review. The VHA daily operations manual will be emailed to all stakeholders. The VHA daily operations manual will also be presented in a printed format at the Austin outpatient clinic for review and feedback. 

Summary, Conclusions 

After two revisions, the VHA application process document appears to be stable. After five revisions, the VHA daily operations manual is still undergoing major and minor changes. The hope is that the VHA daily operations manual will be stable in six months as policies and procedures are finalized between AOMA and the VHA.

Note: End Product Private

AOMA is unable to publicly share the process documents produced by this DAcOM graduate. However, if another ACAOM-accredited graduate school has an affiliation agreement with a VA in their area to provide clinical services, we will request permission to share these documents privately.

The Acupuncturist's Guide to Insurance Credentialing (Fall 2017)

Purpose, Intent of QIP

The purpose and intent for this quality improvement project is to better help new acupuncturist understand the interworking of the insurance credentialing process.  

Needs Analysis, Gaps, Reason for QIP

When new acupuncturists first enter the workforce obtaining new patients can be challenging. Accepting insurance can be an effective way of obtaining new patients. Many new acupuncturists shy away from accepting insurance because of the daunting process of getting in network and then the follow up work for payment. This quality improvement project has been set in place to bridge the gap between new acupuncturist and insurance companies.

Target Audience/Group

  • New Licensed acupuncturist

Description of Intervention, Solution, End Product to Fill Needs/Gaps

The intervention will be a lecture in powerpoint form, explaining the pros and cons of accepting insurance. There will also be a step by step process of what you need, and who you will need to contact. This end product will help new acupuncturists feel more comfortable with the credentialing process should they want to take insurance in the future.

Method(s) of Sharing End Product with Targeted Audience

New and/or prospective acupuncturist were given a survey prior to the powerpoint presentation. Participants were asked five questions regarding their interest, knowledge, and understanding of the credentialing process. The powerpoint presentation was given, learner were able to ask questions and make comments about the presentation. An Identical survey was given to analyze the effectiveness of the presentation.  

Summary and Conclusions

2 of the 12 respondents were interested in taking insurance prior to the lesson, 4 were interested after the lesson. 10 of the 12 respondents were not confident in the credentialing process prior to the lesson, after the lesson 8 out of the 12 respondents were more confident. Overall, this survey leads us to believe that our presentation is helpful for learners to feel more confident in the process, however it did not change the overall interest in accepting insurance dramatically.

Download the Full Plan [PDF]

AOM Business Best Practices (Fall 2017)

Purpose, Intent of QIP

The intent of the QIP is to develop a resource for recent graduates of Oriental medicine programs to improve their odds of being successful upon graduation. 

Needs Analysis, Gaps, Reason for QIP

The needs analysis includes the following: casual conversation with recent graduates, a formal survey through REDCAP, various articles and studies completed. One recent popularized study is the data presented in the US Department of Education report which indicates that the majority of the AOM schools in the US are failing due to the income to loan ratios during the first 3 years after graduation. 

Target Audience/Group

The target audience are students in their last year of AOM school or the first 2 years of practice.

Description of Intervention, Solution, End Product to Fill Needs/Gaps

This QIP is focused on creating best practice guidelines for new graduates of acupuncture and oriental medicine programs. These guidelines include, but are not limited to, steps to successfully start a business, strategies for establishing an effective marketing plan, and tools to aid in assessing progress of practice development. This will be a pdf or a similar format to encourage ease of distribution.

Method(s) of Sharing End Product with Targeted Audience

The end product will be in a pdf format or similar, which can be emailed, printed or posted on a website for download.

Summary, Conclusions

The AOM programs in the US provide a solid education focused on the actual practice of Chinese medicine and acupuncture. There is however, very little provided to students on how to be successful in the field once they graduate. There is much frustration surrounding this and unfortunately, many talented practitioners do not realize they are having problems until their businesses are struggling. There are minimal requirements regarding practice management for AOM schools and most students prefer not to pay for extracurricular classes, so this problem perpetuates. The goal is to provide a valuable resource which can help address this gap.

Disclosures if any

Both authors are currently DAcOM candidates at AOMA Graduate School of Integrative Medicine.  There are no conflicts of interest presented.

Download the Full Plan [PDF]

Download the eBook

A Practical Approach to Using Food in the Creation of a Healthy Lifestyle and Prevention of Disease (Fall 2017)

Purpose, Intent of QIP

The purpose of this QIP is to educate specific groups of the general public about utilizing food as a component to overall health and wellness and additionally how dietary changes can affect specific illnesses or diseases. Information will include, but not be limited to: differing types of food groups, processed versus whole foods, how to grocery shop on a budget wherever you are and with the available resources, patterns and behaviors linked with eating, along with the ability to make educated decisions on food as a component to overall health and well-being.

Needs Analysis, Gaps, Reason for QIP

Specific areas and geographic locations will be targeted based on measurements such as: SES, income, accessibility of grocery stores and farmers markets and education levels. These areas and subgroups of individuals tend to lack the skills to integrate healthy diets and regimens into their habitual lifestyles. There are many resources on the internet that teach individuals what to eat and why, but not how to practically achieve these goals. The QIP is based on the awareness of internet education and resources as well as ample research showing the correlation of a healthy diet and the reduction of specific diseases and illnesses.                  

Target Audience/Group

The intended audience is specifically geared toward individuals classified in or relating to the lower economic status description: lower income, less education, along with less access and resources to options. There is no specificity toward gender, age, physical well-being, etc. This audience will mostly be comprised of the general public meaning non-medical individuals, but is open to any individual in the public who is interested in this topic or related topics. The template for the topic will be aimed at the aforementioned population but can be applied to a wide breadth of demographics. The information will remain basic and practical to the audience, and in this regard may be viewed as introductory level information to certain groups such as medical professionals, OM practitioners, ND’s, DC’s, nutritionists, therapists, chefs, etc.

Description of Intervention, Solution, End Product to Fill Needs/Gaps

The type of intervention and solution-based training will be surrounding training materials and educational tools including but not limited to: general interaction, question-asking to audience, icebreaker; physical training materials (brochure, MakeFoodFun document, Disease cheat sheet); humor and anecdotal experience sharing; Q&A small group exercises and live cooking demonstrations. The larger goal is to provide access to other practitioners to utilize the template and spread the concept globally.

Method(s) of Sharing End Product with Targeted Audience

The presenters will use a variety of techniques generated to capture the audience’s attention and interest in the education of food and surround topics. The end product will be a series of seminars/workshops generated from a template of training materials.  

Summary, Conclusions

Food is a topic often convoluted and misunderstood by many. It is also a format for change that can be easily reachable and affordable with the proper education and understanding. This QIP intends to create workshops/seminars based off a series of training procedures and templates focusing on the education and training of food as an important component to health and wellness and prevention of specific diseases to a general population and sub-population of low-income and/or low education in addition to lack of accessibility. The information can additionally be applied to any demographic of the public that is interested and not limited to the aforementioned demographic.

Download the Full Plan [PDF]

Download Presentation #1: 

Download Presentation #2:

Download "Whole Fresh Foods" Guide [PDF]

Download "Wallet Grocery Card" [PDF]

Download "Disease Cheat Sheet" [PDF]

A Response to the Opioid Epidemic: Integrating TCM Practitioners in American Medical Centers (Fall 2017)

Purpose, Intent of QIP

The purpose of this QIP is to inspire Traditional Chinese Medicine (TCM) practitioners and students to work in an integrative model and to assist them with tools to make this a possibility. Our intent is to develop a resource for TCM practitioners that would better prepare them to pursue integrative jobs in American hospital systems and other large medical practices. This will include a PDF document with resources as well as a video walk-through of said document.

Needs Analysis, Gaps, Reason for QIP

This project was originated by a response to the opioid epidemic in North America. The Joint Opioid Task Force and the American Society of Acupuncture started this effort by asserting acupuncture as a nonpharmacologic intervention to treat chronic pain. It then evolved to address the gap between licensed practitioners desiring to work in integrative positions and the lack of such positions in American hospitals.

Target Audience/Group

The target audience for this QIP is licensed acupuncturists and TCM practitioners. This project also ideally targets recent graduates of acupuncture school who desire to work in hospital systems and other large integrative health facilities. Another group that could benefit from this project includes hospital administrative staff looking to comply with the Joint Commission's new and revised pain assessment and management standards, effective January 1, 2018, for its accredited hospitals.

Description of Intervention, Solution, End Product to Fill Needs/Gaps

The final project will consist of a video reviewing the steps and information needed to work at an integrative practice as well a document with each resource used. This QIP can be used by students and practitioners alike to coach them into new opportunities within established clinics.

Method of Sharing End Product with Targeted Audience

This project will be gifted to AOMA as well as NCCAOM for professional development of students and practitioners.

Summary, Conclusions

By providing the tools and information through a tutorial, it is expected that more acupuncturists seek out positions in integratives spaces treating chronic pain and eventually other conditions.

Disclosures

Both authors are currently DAcOM candidates at AOMA Graduate School of Integrative Medicine. There are no conflicts of interest presented.

Watch the Presentation [Video]

Download the Appendix [PDF]

MINDFULNESS MEDITATION for Children: A How-To Guide for Teachers/Parents/Practitioners (Fall 2017)

Purpose, Intent of QIP

To create an example of a proven method of how-to teach children mindfulness meditation.

Needs Analysis                                 

Research continues to demonstrate the value of learning meditation for all people. A famous quote attributed to the Dalai Lama states “If every 8 year old in the world is taught meditation, we will eliminate violence from the world within one generation.” Although this was met with some controversy as naïve, it is a worthwhile aspiration for us all.

Target Audience/Group

The target audience for this QIP is teachers, parents, practitioners wanting to learn simple ways to teach children mindfulness meditation.

Description of Intervention/Solution/End Product to fill needs/gaps      

15 minutes once a week, meditation to a group of 2nd and 3rd graders, median age 8 was offered. The focus was on body awareness, the 5 senses, observing and witnessing the breath and thoughts. An option to choose one word of their choice as a mantra to repeat silently to themselves was offered  And a guided check in before and after each session was standard.

Method of sharing end product with targeted audience                                                              

A How-To worksheet with suggestions on how-to teach children mindfulness meditation.

Summary/Conclusions                    

The benefits of teaching children mindfulness, meditation, and self-love should not be underestimated. Studies continue to conclude that meditation has benefits such as: reduced stress, strengthens the immune system, increases concentration, helps one better deal with ADHD, depression and anxiety, improves sleep, improves tolerance to pain, lowers blood pressure, and increases happiness.

Download the Full Plan [PDF]

Download the Video Guide [MOV]

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