Blog Housekeeping (Work in Progress)

You might want to skip this post unless you’re very interested in the nuts and bolts of acupuncture education.

As noted earlier: to quote the CNT manual, “AOM educational institutions now have...an accreditation mandate to cover bloodborne pathogens, safe practice, emergency procedures, risk management, and safety protocols in their curricula.” In other words, safety appears as a theme across a host of different classes in an acupuncture program. Sometime last year I realized it was very difficult to teach the safety topics that we need to without an overarching, safety-positive framework -- a way to tie it all together and help students pay attention to safety without being scared. (COVID was a wake up call.)

Since January I’ve been plugging away at building that safety-positive framework. Four months in, I could use a check in about the state of the project, what’s done, what still needs to be done, and where this blog is going afterwards. So that’s this post. (Link-fest ahead!)

Here’s a list of safety-related topics that acupuncture schools have an accreditation mandate to cover:

cultural sensitivity; providing a comfortable, safe environment for intakes; red flag referral/urgent referral; manage inappropriate patient behavior; administer treatment safely (CNT); OSHA; adverse events; draping; hygiene to prevent disease transmission “health, cleanliness, and safety practices”; recognize ethical issues; emergency first aid; emergency plans and documentation;

applying data and information concerning confidentiality and HIPAA, informed consent,scope of practice, professional conduct, malpractice and liability insurance, requirements of third-party payers, OSHA, professional development, other applicable legal standards to improve practice management, and records management systems; develop risk management and quality assurance programs; practice ethically and behave with integrity in professional settings.

Here’s a list of meta-topics I felt like our students needed to have a handle on in order to tackle that list in a meaningful way: risk, harm reduction, trauma informed care, culture of safety -- and of course the building blocks of safety -- boundaries, communication, organization, and self-care.

Okay, let’s take inventory! How does the “accreditation mandate” list of topics match up with the meta-topics, what have we got, what do we still need? (And as I write new posts, I’ll add links.)

Cultural sensitivity: in POCA Tech’s world, this is mostly about social safety and Trauma Informed Care, with some overlap with healthcare equity. We need a few more posts on social safety, including probably at least one post on Orientalism.

Providing a comfortable, safe environment for intakes: also overlaps with social safety. See: Intakes

Red flag referral/urgent referral: coming soon! Overlaps with risk and boundaries.

Manage inappropriate patient behavior: we’ve got quite a bit on this topic and I’m sure there will be more.

Administer treatment safely (CNT): same.

OSHA: this is a subset of organization. POCA Tech has a class on writing an OSHA manual and some of that material could go here.

Adverse events: oh, we’re just getting started! AERD and AERD Data

Draping: here.

Hygiene to prevent disease transmission; “health, cleanliness, and safety practices”: COVID was very illuminating in this area, and I’ve got a couple of posts in the queue about this.

Recognize ethical issues: we probably need to unpack the difference between safety and ethics. On a practical level, ethics overlaps with boundaries and transparency (see Trauma Informed Care).

Emergency first aid: at POCA Tech, we outsource this to organizations like the Red Cross.

Emergency plans and documentation: a subset of organization.

Confidentiality and HIPAA: a subset of social safety and organization. (Definitely we need more posts on social safety.) Also, POCA Tech has a privacy manual, maybe that should go under Resources?

Informed consent: a subset of consent.

Scope of practice: we need to unpack the relationship of safety to regulation/legislation.(First pass is here.) COVID has been illuminating in this area as well.

Professional conduct: in POCA Tech’s world, this is about boundaries and the practitioner persona. More posts planned on that topic, most of them branching off of this one.

Malpractice and liability insurance: subset of risk and organization. Also see Tasks and Tools.

Requirements of third-party payers, OSHA: see above, subset of organization.

Professional development: I think that might be another way of describing what this entire blog is for?

Other applicable legal standards to improve practice management; records management systems: subset of organization and communication.

Develop risk management and quality assurance programs: see risk. Also, organization.

Practice ethically and behave with integrity in professional settings: this standard seems like a combination of “recognize ethical issues” and “professional conduct”. See above.

Other topics on my list of posts to write: suicide prevention (subset of Red Flags); treating sexual complaints (for example, erectile dysfunction); sexual harassment; firing patients; dual relationships with patients and why not to date them (subset of boundaries); social media (subset of boundaries); mandatory reporting explained; more about self-care; more about perceived adverse events (plus an interview with our resident medical anthropologist); what does safety have to do with Liberation Acupuncture; more about the overlaps of organization and leadership with safety (here, here, and here)...

as well as another list-post with an overview of literal to-do items like manuals, policies, sample safety meeting agendas, incident reports, templates for communications and handouts, etc. All the THINGS that you need to have in order to make safety in your acupuncture practice.

And of course the point of this blog is to connect discussions of safety with the AERD, as part of working towards a more positive culture of safety for acupuncture, one which includes more feedback loops. Suzanne Morrissey, our academic advisor for the AERD, suggested that blogging about AERD data might be a way to encourage people to make reports, and I’m delighted to report that she was right -- since this blog started, there’s been a little uptick in AERD reporting. Thank you to everyone who has reported! I’m still working my way slowly through the data; once all of the posts listed above get written, I’ll have more time to focus on new posts about AERD data, so please keep them coming. I'm also hoping to continue unpacking safety incidents because that's a helpful teaching tool for POCA Tech.

Thanks, as always, for reading.