F E AT U R E S
Initiating a Reiki or CAM Program in a Healthcare Organization-Developing a Business Plan ■
Anne Vitale, PhD, APN, AHN-BC Complementary and alternative medicine (CAM) services, such as Reiki, continue to be offered to consumers in many hospitals and other health care organizations. There is growing interest among nurses, doctors, and other health care providers for the integration of CAM therapies into traditional settings. Health care organizations are responding to this need but may not know how to start CAM programs. Starting a Reiki program in a health care setting must be envisioned in a business model approach. This article introduces nurses and other health care providers to the basic concepts of business plan development and important steps to follow when starting a Reiki or CAM program. KEY WORDS: Reiki, Reiki in hospitals, CAM programs, Reiki business plans Holist Nurs Pract 2014;28(6):376–380
INTRODUCTION We are in an environment of significant change and transformation of health care. The Patient Protection and Affordable Care Act of 2010 and the Obama Health Plan include restructured reimbursement criteria for the delivery of health care services with little known impact on funding for complementary and alternative medicine (CAM) services.1 A trend in hospitals over the last 10 years included the addition of CAM services to other offerings, such as Reiki, acupuncture, massage therapy, and others for stress reduction.2 The American Hospital Association and Samueli Institute (as cited in Goldstein and Goldstein)1 recent survey research concluded that at least 1 CAM service was offered at the 714 hospitals response hospitals, an increase of CAM services from 27% to 42% in only 5 years. Andrews2 estimates that CAM treatment fee spent by consumers is sizeable and represents about 11% of total out-of-pocket expenditures on health care in the United States.
Author Affiliation: InnerlightResearch, LLC, Toms River, NJ and Drexel University College of Nursing and Health Professions, faculty adjunct. The author has disclosed that she has no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Correspondence: Anne Vitale, PhD, APN, AHN-BC, 1708 Waterberry Ct., Toms River, NJ 8755 ([email protected]). DOI: 10.1097/HNP.0000000000000052
Hospitals continue to offer CAM services to patients, families, and staff for many reasons, including recognition that CAM therapies can be effective in certain circumstances by balancing the biofields, for example, for pain reduction and stress relief management for hospitalized patients.2–4 There is also growing consumer and health care provider demand for the integration of CAM therapies into traditional health care settings).5,6 There is emerging research about the effectiveness of Reiki and this is of growing interest to nurses, doctors, and other health care providers.4,7 There is no better time than the present to start or facilitate the development of a Reiki or other CAM program! Starting a Reiki program in a health care setting must be envisioned as a new program for the hospital or institution.8 Shi and Singh (2012) remind us that hospitals are in the business of caring for patients and families and interested in innovative programs to help fulfill their humanistic missions. Hospitals are starting to tap into consumer interest and willingness to spend money on CAM.1,8 It is important to understand that similar to other organizations, hospitals function in a business model approach and are accustomed to business plan reviews to assist in new program development decision-making.9 This article introduces nurses and other health care providers to the basic concepts of business plan development and important steps to follow when
376 Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
The Art, Science, and Business of Starting a Reiki or CAM Program
starting a Reiki or CAM program. The first step includes a fundamental exercise before business plan development, that is, to access and come to know the mission/vision of the organization.10 A well-thoughtout business plan must “speak” to the overarching goals of the organization.11 For example, how will the Reiki or CAM program assist the organization to fulfill their vision of caring for patients, families, and staff? Does the institution support a nursing theory as a guiding framework for holistic care? Remember that a CAM program can be an especially good fit for a hospital that strives to deliver holistic, caring, and healing health care environments.12
ENSURING INSTITUTIONAL CONGRUENCE It is important to network to key institutional stakeholders in the health care organization and discuss the organizational “climate” and need for a Reiki program. This is an integral step to gain health care institution support for a Reiki or CAM program. Nurses, health care providers, and lay Reiki practitioners interested in starting Reiki programs must understand how health care organizations are structured, including “chain of command” reporting lines.1 Goldsteen and Goldsteen (2013) discuss the hierarchal structures of these organizations to better understand that collaboration among key administrative, managerial, and staff personnel is needed to develop, support, and implement patient-centered care and programs. A variety of services are needed to help meet the physical, emotional, and psychosocial needs of patients and families, facing both acute and chronic health conditions.8 Health care organizations are responding to the contemporary need to offer and integrate CAM services within traditional health care services, but may not know how to go about doing so.8 This is vital information for professional nurses and physicians to understand as these providers represent the leading health care disciplines supporting Reiki use in health care environments, with holistic nurses taking the lead in conducting Reiki research.4,13
377
identified organizational stakeholders are integral to new program development. Nurses and others need to understand that the work of Morjikian and Bellack is foundational to starting a Reiki or CAM program in any setting. A comprehensive business plan can run 25 to 40 pages; however, a short version may be sufficient when proposing a Reiki program to a health care organization. Benefits of a business plan for program development include the following: (a) forecast the growing market for the program within an organization; (b) determining opportunities and risks; (c) how to get services to where they are needed; (d) a clear blueprint for program decision-making; and (e) planning to evaluate program effectiveness.14 Business plan development basic steps offered by McKeever10 and Pinson11 can be applied to your Reiki or CAM business plan and include: 1. An executive summary about the Reiki program 2. Reiki program description, that is, program type— volunteer, paid, and initial target audience 3. Vision/mission statement congruent with the organization’s vision/mission/philosophy of care, that is, to provide 4. Background information that supports why start a Reiki program (include emerging research data from the workshop delivered in understandable terms) 5. Reiki program objectives 6. Reiki practitioner educational requirements, that is, evidence of Reiki training level 7. Program management requirements (resources needed) 8. Capital/financial requirements to implement and sustain a Reiki program 9. Marketing strategies 10. Potential outcomes, that is, benefits of a Reiki program and potential risks 11. Future expansion of Reiki services A well-written and cogent business plan begins with the forecast of key questions that organizational stakeholders may ask when starting new programs. Applied from the work of Buppert15 and summarized from a Reiki in-hospital 2-day workshop offered by this author and colleagues* , be prepared to answer:
BUSINESS PLAN DEVELOPMENT Morjikian and Bellack14 discuss that a formal presentation and simplified business plan presented to
*Vitale AT, Brownell F. Reiki in Hospital Workshop, Philadelphia, PA; October 27–28, 2012. Workshop Producer: William Lee Rand and the Center for Reiki Research.
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
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1. What is a Reiki program? 2. Why start a Reiki program in this health care setting now? 3. What is the purpose of the Reiki program? 4. What is the key or central message to describe the Reiki program (in one sentence)? 5. Can you list 3 benefits of a Reiki program that will appeal to the health care organization? Are there any risks for the program? 6. Who is the initial target audience for the Reiki program? Who are future target audiences during program expansion? 7. What financial structure/Reiki program funding model would benefit the institution? 8. What resources are needed to manage the Reiki program?
9. What are the plans to recruit and train Reiki practitioners for the program? 10. What are possible Reiki program expansion ideas? What are Reiki outcome measures for the program that can assist to support program maintenance or expansion? 11. What are the major resources needed to sustain a Reiki program? There are business plan software programs that can be adapted as well.11 A sample business plan is included (see the Side Bar). Dr Anne Vitale’s reflective and personal story about networking to key stakeholders during her own experience with a hospital-based Reiki program
SIDE BAR. Business Plan Sample* Reiki Program for Your Health Care Institution EXECUTIVE SUMMARY This section includes a brief description of the Reiki program business plan, mission and vision strategies, and objectives of the program. Keep this section to 1 to 2 pages in length REIKI PROGRAM DESCRIPTION Describe the overall Reiki program, including background information about why start this program at the institution. Include succinct and cogent information about emerging Reiki research trends. Include all organizational program champions and stakeholders in this section. Keep this section to 3 to 4 pages in length. REIKI PROGRAM IMPLEMENTATION Describe the Reiki program implementation strategies with customized approaches for this health care organization. This section addresses the population to receive initial Reiki services, Reiki practitioners, and detail about providing Reiki sessions, how many practitioners needed at startup, and where services will take place. Here is an example: DETAIL EXAMPLE Client base: Patients and staff only Reiki practitioner level: Reiki masters only Initial scale of offering: 2 practitioners; 30 patients Scope of offering: Provide Reiki sessions only (no Reiki teaching) Location of offering: Oncology inpatient unit This section should also include how the Reiki program will be managed and personnel needed. Outline practitioner education and orientation, competencies, and Reiki program policies. Ideas about how to educate all staff about the Reiki program are included here. Address Program evaluation or metrics toward Reiki program effectiveness. Examples include length of stay, repeat visits, pain medication use, and patient satisfaction, among many others. Finally, Reiki program marketing plan strategies, that is, use of flyers and brochures, are offered. A brief section about expansion of Reiki services is outlined at the end of this section. Keep this section to a maximum of 5 pages in length. FINANCIAL STRATEGIES Remember that in today’s market ANY project or service must be revenue producing, supported by funding sources, cost savings, or at least cost neutral. Include budget categories of personnel costs, supplies and equipment needed, and projected administrative costs. To prepare this section, it is important to know what the business model approach of the organization may be, that is, Reiki volunteers versus paid; free versus revenue-generating. There have been many successful RIH programs that started out with nonpaid Reiki volunteers as well13 ! Keep this section to 1 to 2 pages in length or in a budget format with expense-revenue categories. *Vitale AT, Brownell F. Reiki in Hospital Workshop, Philadelphia, PA; October 27–28, 2012. Workshop Producer: William Lee Rand and the Center for Reiki Research.
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
The Art, Science, and Business of Starting a Reiki or CAM Program
journey honors the sacred practice of Reiki. Here is Anne’s story: Over 10 year ago, I was the Director of Nursing Research at a large nonteaching hospital located in the Northeast. As the hospital was seeking Magnet designation, several interested Reiki Master/nurses, a nurse manager/Reiki Master, and an obstetrician approached me to help them design and implement a Reiki research study. This was no easy task over 10 years ago, especially since I was unfamiliar with Reiki at the time. Before I went ahead with this project, I asked a nurse/Reiki Master to share Reiki with me so that I can experience a session. The learning was significant because I eventually became an attuned Reiki Master myself! The hospital’s Institutional Review Board approved the Reiki pilot study that I codesigned and implemented as the nurse researcher for the facility (not a Reiki practitioner). Conducted by Vitale and O’Connor,16 this Reiki study was completed in 2 years and examined the effects of Reiki on the pain and anxiety of postoperative abdominal hysterectomy patients. During the Reiki study period, the hospital leadership and nursing staff were in solid preparation for Magnet accreditation. The implementation of this Reiki research study served as a guiding light to unify both hospital-based and administrative support and “opened the door” for Reiki program development. There was “buy in” from nurses and doctors and this facilitated solid backing from other hospital stakeholders. This experience informs me that key stakeholders to support a Reiki program can vary from organization to organization. I found that a nurse administrator and unit-based nurse manager were the most interested stakeholders to support Reiki program development. Simply by asking around, this nurse manager networked to the nursing administrator and aligned herself with other key hospital personnel. Now with “champions” around us, a Reiki program business plan was developed and presented and we became well-versed about how a Reiki program can benefit patients, families, and staff. We found that hospitals seeking Magnet designation frequently adopt a holistically focused, caring-based vision for the delivery of services and are receptive to Reiki program development. Other stakeholders who “came to the Reiki program development table” were the head chaplain, a nurse case manager (RN/Reiki Master), and a massage therapist (Reiki Master). We also found that other interested stakeholders can be social workers, physical therapists, and grant/foundation office personnel. The Reiki program at this hospital started with services offered to the hospital staff using an affordable fee-for-service models. Eventually, the champion nurse manager became the director of the Reiki program!
379
In reflection, this Reiki program began with little information to share about scientific evidence and outcomes and the program was successfully launched! Today, there are resources such as National Center of Complementary and Alternative Medicine3 and nurse Reiki research/consultants that can serve to empower your Reiki or CAM program planning! My suggestion is to keep abreast of preventive health innovations that may result from health care reform and reimbursement changes as well as the growing Reiki research literature. Utilize this information to develop patient and staff outcomes with Reiki, such as the effectiveness of treatments with patient and employee satisfaction, utility in pain management, reduction in length of stay (LOS), reducing frequent readmissions (recivity), among others. Proposing a research study can spark the development of a Reiki program; however, starting a Reiki program with outcome data to assess program effectiveness can be proposed first, the research may follow later. Look for the “opening doors” in your institution . . . .find the champions among you! The lessons learned from this experience I hold as sacred and as a guiding light to serve others during their Reiki program development journey, Reiki practice, and research trajectory with Reiki.
REIKI PROGRAM STARTUP When networking to key organizational stakeholders is completed and your business plan is ready, develop a cogent, professional presentation and schedule that important first meeting! Remember to allow ample time for questions and answers during your program “pitch” to the decision-making stakeholders (Bupert, 2012).17 Follow-up meetings may be needed to assist the stakeholders to determine the right type/program model, including the financial structure and target audience outlined from your Reiki program business plan. Volunteer model-based Reiki program founder, Mega Mease (as cited in Rand5 ), and Kryak and Vitale6 share that organizational representatives will look to you for up-to-date information about Reiki program models and payment/fee structure for treatments. Help the stakeholders decide who the first Reiki session recipients will be—staff or a contained unit of patients? Remember, start small, go slow, and encourage program expansion based on collected outcome data, that is, employee satisfaction, patient satisfaction, etc. Your crucial role at these follow-up meetings may be more consultative, so be prepared and open to the possibilities! The stakeholders will appreciate your learned advice about how Reiki practitioners can be recruited
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
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and trained to share Reiki with patients and/or staff in the health care organization. Hospitals may require documentation of Reiki practitioner training and hospital orientation, periodic competency plans as well as Reiki program procedures and policies for the institution.6 Why? Shi and Singh8 remind us that health care institutions must be compliant with external licensing and fiscal regulations, especially for assessing and maintaining competencies of practice for those who have patient contact, even if the Reiki practitioners are brought into the hospital as volunteers. Offer to assist the organization to develop these important procedures and documents such as practitioner competencies and training resources and institutional policy for the Reiki sessions. Offer suggestions about how the Reiki program can be marketed using flyers, brochures, and even the health care organization’s Web site. Marketing information should include (a) a simple explanation about Reiki, (b) how to obtain a Reiki session or attend a Reiki class, and (c) payment/fees involved. Samples of Reiki program procedures and documents can be found in an article previously published in Holistic Nursing Practice in 2011 and include Reiki competency procedures and a Reiki treatment at the bedside policy.6 Finally, offer to present a workshop to introduce the hospital staff to the Reiki program and have a bulleted program fact sheet to disseminate. Most institutions have interdisciplinary staff continuing education opportunities, a perfect venue to inform, answer questions, and gain support from your health care provider colleagues.6
REFERENCES 1. Goldsteen RL, Goldsteen K. Jonas’ Introduction to the U.S. Health Care System. 7th ed. New York: Springer; 2013. 2. Andrews M. Hospitals are making room for alternative therapies. Los Angeles Times. 2012. http: //articles.latimes.com/2012. Accessed March 31, 2014. 3. National Center of Complementary and Alternative Medicine. Statistics on CAM use. http://www.nccam.nih.gov/health-. Published 2014. Accessed March 2, 2014. 4. Dossey BM, Keegan L. Holistic Nursing: A Handbook for Practice. Burlington, MA: Jones and Bartlett; 2013. 5. Rand W. Reiki at University Medical Center, Tuscon, Arizona, a Magnet hospital. Holist Nurs Pract. 2011;25(5):233-237. 6. Kryak E, Vitale AT. Reiki and its journey into a hospital setting. Holist Nurs Pract. 2011;25(5):1-8. 7. Baldwin AL, Vitale AT, Brownell E, Scicinski J, Kearn M, Rand W. The Touchstone Process: an ongoing critical evaluation of Reiki in the scientific literature. Holist Nurs Pract. 2010;24(3):260276. 8. Shi L, Singh DA. Delivering Health Care in America—A Systems Approach. 5th ed. Burlington, MA: Jones and Bartlett; 2012. 9. Kovner AR, Knickman JR, Jonas S. Health Care Delivery in the United States. 9th ed. New York: Springer; 2008. 10. McKeever MP. How to Write a Business Plan. 10th ed. Berkeley, CA: Nolo; 2011. 11. Pinson A. Anatomy of a Business Plans. 7th ed. Tustin, CA, OM IM; 2008. 12. Hines ME. Holistic nursing and healthcare reform: challenges and opportunities. AHNA Beginnings. 2012;32(6):4-7. 13. Vitale AT. An integrative review of Reiki touch therapy. Holist Nurs Pract. 2007;21(4):167-179. 14. Morjikian R, Bellack J. The RWJ executive nurse fellows program: Part 1: leading change. J Nurs Admin. 2005;35(10):431-438. 15. Buppert C. Nurse Practitioner’s Business Practice and Legal Guide. 4th ed. Sudbury, MA: Jones and Bartlett; 2012. 16. Vitale AT, O’Connor PA. The effects of Reiki on pain and anxiety in women with abdominal hysterectomies: a quasi-experimental study. Holist Nurs Pract. 2006;20(6):263-271. 17. Buppert C. Nurse practitioner’s business practice and legal guide. 4th ed. Sudbury, MA: Jones and Bartlett, 2012.
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Initiating a Reiki or CAM Program in a Healthcare Organization-Developing a Business Plan ■
Anne Vitale, PhD, APN, AHN-BC Complementary and alternative medicine (CAM) services, such as Reiki, continue to be offered to consumers in many hospitals and other health care organizations. There is growing interest among nurses, doctors, and other health care providers for the integration of CAM therapies into traditional settings. Health care organizations are responding to this need but may not know how to start CAM programs. Starting a Reiki program in a health care setting must be envisioned in a business model approach. This article introduces nurses and other health care providers to the basic concepts of business plan development and important steps to follow when starting a Reiki or CAM program. KEY WORDS: Reiki, Reiki in hospitals, CAM programs, Reiki business plans Holist Nurs Pract 2014;28(6):376–380
INTRODUCTION We are in an environment of significant change and transformation of health care. The Patient Protection and Affordable Care Act of 2010 and the Obama Health Plan include restructured reimbursement criteria for the delivery of health care services with little known impact on funding for complementary and alternative medicine (CAM) services.1 A trend in hospitals over the last 10 years included the addition of CAM services to other offerings, such as Reiki, acupuncture, massage therapy, and others for stress reduction.2 The American Hospital Association and Samueli Institute (as cited in Goldstein and Goldstein)1 recent survey research concluded that at least 1 CAM service was offered at the 714 hospitals response hospitals, an increase of CAM services from 27% to 42% in only 5 years. Andrews2 estimates that CAM treatment fee spent by consumers is sizeable and represents about 11% of total out-of-pocket expenditures on health care in the United States.
Author Affiliation: InnerlightResearch, LLC, Toms River, NJ and Drexel University College of Nursing and Health Professions, faculty adjunct. The author has disclosed that she has no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Correspondence: Anne Vitale, PhD, APN, AHN-BC, 1708 Waterberry Ct., Toms River, NJ 8755 ([email protected]). DOI: 10.1097/HNP.0000000000000052
Hospitals continue to offer CAM services to patients, families, and staff for many reasons, including recognition that CAM therapies can be effective in certain circumstances by balancing the biofields, for example, for pain reduction and stress relief management for hospitalized patients.2–4 There is also growing consumer and health care provider demand for the integration of CAM therapies into traditional health care settings).5,6 There is emerging research about the effectiveness of Reiki and this is of growing interest to nurses, doctors, and other health care providers.4,7 There is no better time than the present to start or facilitate the development of a Reiki or other CAM program! Starting a Reiki program in a health care setting must be envisioned as a new program for the hospital or institution.8 Shi and Singh (2012) remind us that hospitals are in the business of caring for patients and families and interested in innovative programs to help fulfill their humanistic missions. Hospitals are starting to tap into consumer interest and willingness to spend money on CAM.1,8 It is important to understand that similar to other organizations, hospitals function in a business model approach and are accustomed to business plan reviews to assist in new program development decision-making.9 This article introduces nurses and other health care providers to the basic concepts of business plan development and important steps to follow when
376 Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
The Art, Science, and Business of Starting a Reiki or CAM Program
starting a Reiki or CAM program. The first step includes a fundamental exercise before business plan development, that is, to access and come to know the mission/vision of the organization.10 A well-thoughtout business plan must “speak” to the overarching goals of the organization.11 For example, how will the Reiki or CAM program assist the organization to fulfill their vision of caring for patients, families, and staff? Does the institution support a nursing theory as a guiding framework for holistic care? Remember that a CAM program can be an especially good fit for a hospital that strives to deliver holistic, caring, and healing health care environments.12
ENSURING INSTITUTIONAL CONGRUENCE It is important to network to key institutional stakeholders in the health care organization and discuss the organizational “climate” and need for a Reiki program. This is an integral step to gain health care institution support for a Reiki or CAM program. Nurses, health care providers, and lay Reiki practitioners interested in starting Reiki programs must understand how health care organizations are structured, including “chain of command” reporting lines.1 Goldsteen and Goldsteen (2013) discuss the hierarchal structures of these organizations to better understand that collaboration among key administrative, managerial, and staff personnel is needed to develop, support, and implement patient-centered care and programs. A variety of services are needed to help meet the physical, emotional, and psychosocial needs of patients and families, facing both acute and chronic health conditions.8 Health care organizations are responding to the contemporary need to offer and integrate CAM services within traditional health care services, but may not know how to go about doing so.8 This is vital information for professional nurses and physicians to understand as these providers represent the leading health care disciplines supporting Reiki use in health care environments, with holistic nurses taking the lead in conducting Reiki research.4,13
377
identified organizational stakeholders are integral to new program development. Nurses and others need to understand that the work of Morjikian and Bellack is foundational to starting a Reiki or CAM program in any setting. A comprehensive business plan can run 25 to 40 pages; however, a short version may be sufficient when proposing a Reiki program to a health care organization. Benefits of a business plan for program development include the following: (a) forecast the growing market for the program within an organization; (b) determining opportunities and risks; (c) how to get services to where they are needed; (d) a clear blueprint for program decision-making; and (e) planning to evaluate program effectiveness.14 Business plan development basic steps offered by McKeever10 and Pinson11 can be applied to your Reiki or CAM business plan and include: 1. An executive summary about the Reiki program 2. Reiki program description, that is, program type— volunteer, paid, and initial target audience 3. Vision/mission statement congruent with the organization’s vision/mission/philosophy of care, that is, to provide 4. Background information that supports why start a Reiki program (include emerging research data from the workshop delivered in understandable terms) 5. Reiki program objectives 6. Reiki practitioner educational requirements, that is, evidence of Reiki training level 7. Program management requirements (resources needed) 8. Capital/financial requirements to implement and sustain a Reiki program 9. Marketing strategies 10. Potential outcomes, that is, benefits of a Reiki program and potential risks 11. Future expansion of Reiki services A well-written and cogent business plan begins with the forecast of key questions that organizational stakeholders may ask when starting new programs. Applied from the work of Buppert15 and summarized from a Reiki in-hospital 2-day workshop offered by this author and colleagues* , be prepared to answer:
BUSINESS PLAN DEVELOPMENT Morjikian and Bellack14 discuss that a formal presentation and simplified business plan presented to
*Vitale AT, Brownell F. Reiki in Hospital Workshop, Philadelphia, PA; October 27–28, 2012. Workshop Producer: William Lee Rand and the Center for Reiki Research.
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
378
HOLISTIC NURSING PRACTICE • NOVEMBER/DECEMBER 2014
1. What is a Reiki program? 2. Why start a Reiki program in this health care setting now? 3. What is the purpose of the Reiki program? 4. What is the key or central message to describe the Reiki program (in one sentence)? 5. Can you list 3 benefits of a Reiki program that will appeal to the health care organization? Are there any risks for the program? 6. Who is the initial target audience for the Reiki program? Who are future target audiences during program expansion? 7. What financial structure/Reiki program funding model would benefit the institution? 8. What resources are needed to manage the Reiki program?
9. What are the plans to recruit and train Reiki practitioners for the program? 10. What are possible Reiki program expansion ideas? What are Reiki outcome measures for the program that can assist to support program maintenance or expansion? 11. What are the major resources needed to sustain a Reiki program? There are business plan software programs that can be adapted as well.11 A sample business plan is included (see the Side Bar). Dr Anne Vitale’s reflective and personal story about networking to key stakeholders during her own experience with a hospital-based Reiki program
SIDE BAR. Business Plan Sample* Reiki Program for Your Health Care Institution EXECUTIVE SUMMARY This section includes a brief description of the Reiki program business plan, mission and vision strategies, and objectives of the program. Keep this section to 1 to 2 pages in length REIKI PROGRAM DESCRIPTION Describe the overall Reiki program, including background information about why start this program at the institution. Include succinct and cogent information about emerging Reiki research trends. Include all organizational program champions and stakeholders in this section. Keep this section to 3 to 4 pages in length. REIKI PROGRAM IMPLEMENTATION Describe the Reiki program implementation strategies with customized approaches for this health care organization. This section addresses the population to receive initial Reiki services, Reiki practitioners, and detail about providing Reiki sessions, how many practitioners needed at startup, and where services will take place. Here is an example: DETAIL EXAMPLE Client base: Patients and staff only Reiki practitioner level: Reiki masters only Initial scale of offering: 2 practitioners; 30 patients Scope of offering: Provide Reiki sessions only (no Reiki teaching) Location of offering: Oncology inpatient unit This section should also include how the Reiki program will be managed and personnel needed. Outline practitioner education and orientation, competencies, and Reiki program policies. Ideas about how to educate all staff about the Reiki program are included here. Address Program evaluation or metrics toward Reiki program effectiveness. Examples include length of stay, repeat visits, pain medication use, and patient satisfaction, among many others. Finally, Reiki program marketing plan strategies, that is, use of flyers and brochures, are offered. A brief section about expansion of Reiki services is outlined at the end of this section. Keep this section to a maximum of 5 pages in length. FINANCIAL STRATEGIES Remember that in today’s market ANY project or service must be revenue producing, supported by funding sources, cost savings, or at least cost neutral. Include budget categories of personnel costs, supplies and equipment needed, and projected administrative costs. To prepare this section, it is important to know what the business model approach of the organization may be, that is, Reiki volunteers versus paid; free versus revenue-generating. There have been many successful RIH programs that started out with nonpaid Reiki volunteers as well13 ! Keep this section to 1 to 2 pages in length or in a budget format with expense-revenue categories. *Vitale AT, Brownell F. Reiki in Hospital Workshop, Philadelphia, PA; October 27–28, 2012. Workshop Producer: William Lee Rand and the Center for Reiki Research.
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
The Art, Science, and Business of Starting a Reiki or CAM Program
journey honors the sacred practice of Reiki. Here is Anne’s story: Over 10 year ago, I was the Director of Nursing Research at a large nonteaching hospital located in the Northeast. As the hospital was seeking Magnet designation, several interested Reiki Master/nurses, a nurse manager/Reiki Master, and an obstetrician approached me to help them design and implement a Reiki research study. This was no easy task over 10 years ago, especially since I was unfamiliar with Reiki at the time. Before I went ahead with this project, I asked a nurse/Reiki Master to share Reiki with me so that I can experience a session. The learning was significant because I eventually became an attuned Reiki Master myself! The hospital’s Institutional Review Board approved the Reiki pilot study that I codesigned and implemented as the nurse researcher for the facility (not a Reiki practitioner). Conducted by Vitale and O’Connor,16 this Reiki study was completed in 2 years and examined the effects of Reiki on the pain and anxiety of postoperative abdominal hysterectomy patients. During the Reiki study period, the hospital leadership and nursing staff were in solid preparation for Magnet accreditation. The implementation of this Reiki research study served as a guiding light to unify both hospital-based and administrative support and “opened the door” for Reiki program development. There was “buy in” from nurses and doctors and this facilitated solid backing from other hospital stakeholders. This experience informs me that key stakeholders to support a Reiki program can vary from organization to organization. I found that a nurse administrator and unit-based nurse manager were the most interested stakeholders to support Reiki program development. Simply by asking around, this nurse manager networked to the nursing administrator and aligned herself with other key hospital personnel. Now with “champions” around us, a Reiki program business plan was developed and presented and we became well-versed about how a Reiki program can benefit patients, families, and staff. We found that hospitals seeking Magnet designation frequently adopt a holistically focused, caring-based vision for the delivery of services and are receptive to Reiki program development. Other stakeholders who “came to the Reiki program development table” were the head chaplain, a nurse case manager (RN/Reiki Master), and a massage therapist (Reiki Master). We also found that other interested stakeholders can be social workers, physical therapists, and grant/foundation office personnel. The Reiki program at this hospital started with services offered to the hospital staff using an affordable fee-for-service models. Eventually, the champion nurse manager became the director of the Reiki program!
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In reflection, this Reiki program began with little information to share about scientific evidence and outcomes and the program was successfully launched! Today, there are resources such as National Center of Complementary and Alternative Medicine3 and nurse Reiki research/consultants that can serve to empower your Reiki or CAM program planning! My suggestion is to keep abreast of preventive health innovations that may result from health care reform and reimbursement changes as well as the growing Reiki research literature. Utilize this information to develop patient and staff outcomes with Reiki, such as the effectiveness of treatments with patient and employee satisfaction, utility in pain management, reduction in length of stay (LOS), reducing frequent readmissions (recivity), among others. Proposing a research study can spark the development of a Reiki program; however, starting a Reiki program with outcome data to assess program effectiveness can be proposed first, the research may follow later. Look for the “opening doors” in your institution . . . .find the champions among you! The lessons learned from this experience I hold as sacred and as a guiding light to serve others during their Reiki program development journey, Reiki practice, and research trajectory with Reiki.
REIKI PROGRAM STARTUP When networking to key organizational stakeholders is completed and your business plan is ready, develop a cogent, professional presentation and schedule that important first meeting! Remember to allow ample time for questions and answers during your program “pitch” to the decision-making stakeholders (Bupert, 2012).17 Follow-up meetings may be needed to assist the stakeholders to determine the right type/program model, including the financial structure and target audience outlined from your Reiki program business plan. Volunteer model-based Reiki program founder, Mega Mease (as cited in Rand5 ), and Kryak and Vitale6 share that organizational representatives will look to you for up-to-date information about Reiki program models and payment/fee structure for treatments. Help the stakeholders decide who the first Reiki session recipients will be—staff or a contained unit of patients? Remember, start small, go slow, and encourage program expansion based on collected outcome data, that is, employee satisfaction, patient satisfaction, etc. Your crucial role at these follow-up meetings may be more consultative, so be prepared and open to the possibilities! The stakeholders will appreciate your learned advice about how Reiki practitioners can be recruited
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and trained to share Reiki with patients and/or staff in the health care organization. Hospitals may require documentation of Reiki practitioner training and hospital orientation, periodic competency plans as well as Reiki program procedures and policies for the institution.6 Why? Shi and Singh8 remind us that health care institutions must be compliant with external licensing and fiscal regulations, especially for assessing and maintaining competencies of practice for those who have patient contact, even if the Reiki practitioners are brought into the hospital as volunteers. Offer to assist the organization to develop these important procedures and documents such as practitioner competencies and training resources and institutional policy for the Reiki sessions. Offer suggestions about how the Reiki program can be marketed using flyers, brochures, and even the health care organization’s Web site. Marketing information should include (a) a simple explanation about Reiki, (b) how to obtain a Reiki session or attend a Reiki class, and (c) payment/fees involved. Samples of Reiki program procedures and documents can be found in an article previously published in Holistic Nursing Practice in 2011 and include Reiki competency procedures and a Reiki treatment at the bedside policy.6 Finally, offer to present a workshop to introduce the hospital staff to the Reiki program and have a bulleted program fact sheet to disseminate. Most institutions have interdisciplinary staff continuing education opportunities, a perfect venue to inform, answer questions, and gain support from your health care provider colleagues.6
REFERENCES 1. Goldsteen RL, Goldsteen K. Jonas’ Introduction to the U.S. Health Care System. 7th ed. New York: Springer; 2013. 2. Andrews M. Hospitals are making room for alternative therapies. Los Angeles Times. 2012. http: //articles.latimes.com/2012. Accessed March 31, 2014. 3. National Center of Complementary and Alternative Medicine. Statistics on CAM use. http://www.nccam.nih.gov/health-. Published 2014. Accessed March 2, 2014. 4. Dossey BM, Keegan L. Holistic Nursing: A Handbook for Practice. Burlington, MA: Jones and Bartlett; 2013. 5. Rand W. Reiki at University Medical Center, Tuscon, Arizona, a Magnet hospital. Holist Nurs Pract. 2011;25(5):233-237. 6. Kryak E, Vitale AT. Reiki and its journey into a hospital setting. Holist Nurs Pract. 2011;25(5):1-8. 7. Baldwin AL, Vitale AT, Brownell E, Scicinski J, Kearn M, Rand W. The Touchstone Process: an ongoing critical evaluation of Reiki in the scientific literature. Holist Nurs Pract. 2010;24(3):260276. 8. Shi L, Singh DA. Delivering Health Care in America—A Systems Approach. 5th ed. Burlington, MA: Jones and Bartlett; 2012. 9. Kovner AR, Knickman JR, Jonas S. Health Care Delivery in the United States. 9th ed. New York: Springer; 2008. 10. McKeever MP. How to Write a Business Plan. 10th ed. Berkeley, CA: Nolo; 2011. 11. Pinson A. Anatomy of a Business Plans. 7th ed. Tustin, CA, OM IM; 2008. 12. Hines ME. Holistic nursing and healthcare reform: challenges and opportunities. AHNA Beginnings. 2012;32(6):4-7. 13. Vitale AT. An integrative review of Reiki touch therapy. Holist Nurs Pract. 2007;21(4):167-179. 14. Morjikian R, Bellack J. The RWJ executive nurse fellows program: Part 1: leading change. J Nurs Admin. 2005;35(10):431-438. 15. Buppert C. Nurse Practitioner’s Business Practice and Legal Guide. 4th ed. Sudbury, MA: Jones and Bartlett; 2012. 16. Vitale AT, O’Connor PA. The effects of Reiki on pain and anxiety in women with abdominal hysterectomies: a quasi-experimental study. Holist Nurs Pract. 2006;20(6):263-271. 17. Buppert C. Nurse practitioner’s business practice and legal guide. 4th ed. Sudbury, MA: Jones and Bartlett, 2012.
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