Penny George Institute for Health and Healing Outcomes Report
mind clinical care
penny George institute for Health and Healing
O v e rv i e w a n d O u t c O m e s r e p O rt 2 0 1 0
Founded by the George Family Foundation and the
Ted and Dr. Roberta Mann Foundation
institute for Health and Healing
O v e rv i e w a n d O u t c O m e s r e p O rt 2 0 1 0
Table of Contents
1 Letter from the executive director
2 approach to care
5 Foundation of excellent care
10 education and community Outreach
15 the role of philanthropy
16 volume, Quality and Outcomes measures
20 publications and presentations, 2007-2009
24 staff Listing
27 about abbott northwestern Hospital
28 accessing abbott northwestern
Letter from the Executive Director
Lori Knutson, RN, BSN, HNB-BC
as the largest hospital-based program the Livewell Fitness center goes beyond traditional
of its kind in the country, the penny fitness training to help clients use exercise to
George™ institute for Health and promote health. this includes people whose health is
Healing is setting the national compromised and who want to return to good health
standard for enhancing health care or optimize their health through exercise. it also serves
through an integrative health approach. we do this by: as a fitness center for employees of allina, abbott
• blending evidence-based complementary therapies, northwestern and children’s Hospitals and clinics of
integrative medicine and conventional western medicine minnesota. the Fitness center is engaged in outreach
efforts with corporate partners and local businesses that
• providing direct service to inpatients and outpatients
are interested in developing an integrated approach to
• educating health care professionals employee health promotion.
• teaching the community about health promotion and
personal responsibility for health penny George institute researchers are actively
investigating many aspects of integrative health,
• conducting research to identify best practices and the
including the use of integrative modalities, the
economic impact of integrative health.
impact of integrative health services on specific
this Overview and Outcomes report highlights the patient populations and the health care system, and
accomplishments of the penny George institute’s programs the effectiveness of lifestyle change programs. these
and services in recent years. we have continued to expand initiatives are critical to developing best practices and
and enhance our inpatient and outpatient services by working gaining acceptance for integrative health services.
collaboratively with our colleagues throughout the hospital.
Our practitioners provide 900 inpatient visits a month, the penny George institute’s holistic approach is also
and our services have had a measurable impact on patients’ reaching across the allina Hospitals & clinics system.
self-reported pain and anxiety scores. we also have 700 visits when a new facility opens in 2010 to house unity
a month in our Outpatient clinic. Hospital’s virginia piper cancer institute®, the penny
George institute will be part of it. patients will have
on-site access to a variety of integrative services and
through our transformative nurse training (tnt) program,
complementary health therapies.
nurses from abbott northwestern Hospital and other area
hospitals are acquiring the knowledge, skills and confidence
in partnership with the Bravewell collaborative, we are
to enhance care through an integrative and holistic approach.
also engaged in the broader endeavor of advocating for
in partnership with the Bravewell collaborative, we sponsor
the role of integrative health in health care reform. we
physician and nurse practitioner training in integrative
believe that approaches like health promotion, wellness
medicine through the center for integrative medicine of the
and treating the whole person—like the penny George
university of arizona. through local, regional and national
institute promotes—can help to shape a more effective
conferences, we teach a wide range of professionals about
and efficient health care system. we are excited and proud
transforming their health care practice with integrative
to be part of this effort to improve health care for all.
approaches. Our ongoing classes and programs for the
community on topics like yoga, stress reduction, nutrition
and fitness attract more than 800 participants a year.
P E N N Y G E O R G E I N S T I T U T E F O R H E A LT H A N D H E A L I N G 1
approach to care
Holistic Care that Empowers Patients
Founded in 2003 through the support of the George Family
Foundation and the Ted and Dr. Roberta Mann Foundation, the
Penny George Institute for Health and Healing has created a national
model of patient care built on the foundation of integrative health.
Through its range of inpatient services, Outpatient Clinic, LiveWell
Fitness Center, integrative health research, and community and
professional educational programs, the Penny George Institute is the
nation’s largest hospital-based integrative health program.
2 O U T c O m E S R E P O RT 2 0 1 0
integrative health is defined as an
approach to health care that places the
patient at the center of care. it focuses on
prevention and wellness and attends to
the physical, psycho-social, emotional and
spiritual needs of each person. integrative
health is more than simply adding healing
therapies to a range of services a hospital
provides. it is a holistic approach to
health care that advocates treating the
whole person and involving the person as
an empowered partner. integrative health
also recognizes the value of conventional
medicine in treating many chronic and
acute conditions, as well as its limits in
dealing with the complex needs of the
institute. patients are referred for inpatient • advanced its research capabilities and
• blends conventional medicine with
integrative services by a physician, nurse or partnered with leading integrative
other caregiver, or they may self-refer. medicine clinics to evaluate the
therapies and integrative medicine
impact, efficacy and effectiveness of
• values relationship-centered care each month, the penny George institute’s integrative medicine/health services
• promotes a partnership between the team of integrative health professionals • launched new partnerships focused
patient and caregiver provides enhanced care through more on health promotion with major
than 900 inpatient visits and 700 visits to employers and formed consulting
• recognizes the whole patient and his
its Outpatient clinic. more than 60,000 relationships with other health care
or her individual needs
inpatient visits have been made since 2003. organizations
• focuses on healing as much as curing
• created unique clinical rotations in
• emphasizes patient empowerment since its inception, the penny George
partnership with northwestern Health
and personal responsibility institute has:
sciences university that develop
• advocates health promotion and • created the largest hospital-based inpatient skills for Oriental medicine
prevention of illness through integrative health program in the and therapeutic massage students.
education and coaching. country
• transformed chronic depression and
Care Across all anxiety care through its outpatient
resilience training program
Each month, the Penny
Centers of Excellence • emerged as a national leader in George Institute’s team
at abbott northwestern, the concepts of cancer care and cancer survivorship
in partnership with the virginia piper
of integrative health
integrative health are fundamental to the
cancer institute and the sister Kenny professionals provides
care the hospital’s staff has provided for
decades. the penny George institute’s team rehabilitation institute enhanced care through
of health professionals supports this work • established a medical fitness center that more than 900 inpatient
by providing inpatient services throughout has been recognized by the american visits and 700 visits to its
abbott northwestern, including medical/ Heart association
surgical areas, the minneapolis Heart • developed an advanced nursing
institute®, neuroscience institute, education curriculum and mentorship
Orthopaedic institute, sister Kenny® program that leads to board certification
rehabilitation institute, spine institute, in holistic nursing
womencare and the virginia piper cancer
P E N N Y G E O R G E I N S T I T U T E F O R H E A LT H A N D H E A L I N G 3
Transforming Health Care
integrative health, with its emphasis on health promotion, self-responsibility,
wellness and treating the whole person, is critical to transforming the health
For example, the penny George institute’s work focuses on improving a
person’s overall health and well-being and puts the patient at the center
of care. patients have access to integrative services, such as physician
consultations, ayurveda, Oriental medicine and complementary therapies,
and classes or individual instruction on nutrition, fitness, resilience training
and mind-body stress reduction. the goal is to empower individuals to take
personal responsibility for their health, a vital step in improving the health of
our patients, communities and nation.
in recognition of the role that integrative health can play in health care
reform, the institute of medicine (the health arm of the national academy
of sciences) hosted the summit on integrative medicine and the Health of
VISION the public in February 2009. scientists, clinicians, policy experts and industry
The Penny George Institute seeks to leaders convened to address the principles of integrative health that could
transform health care by blending form the basis for effective health care reform. the summit also highlighted
the art of healing and the science of research results and success from clinical practice sites across the country,
curing to optimize the health of the including abbott northwestern’s penny George institute.
whole person—mind, body
and spirit. through its partnership with the Bravewell collaborative (bravewell.org), the
penny George institute is helping to shape a national model of hospital-based
integrative programs and services. Founded in 2002, the Bravewell collaborative
mISSION is a community of leading philanthropists who work together to transform our
The Penny George Institute health care system and improve the health of the american public through the
will transform health care advancement of integrative medicine. For example, Jeffery dusek, phd, research
locally through the provision of director at the penny George institute, is the lead principal investigator on
outstanding integrative care to a grant application to the national institutes of Health that seeks to expand
patients and employees in all resilience training to two Bravewell collaborative research centers. the penny
George institute also is helping to establish integrative health best practices as a
settings across Abbott Northwestern
member of the Bravewell clinical network by sharing information and lessons
and its related institutions. The
learned through Bravewell’s publications and online resources.
Penny George Institute will
transform health care nationally
through the development and Bravewell Clinical Network (Bravenet)
dissemination of integrative care
· Alliance Institute for Integrative Medicine
practices that demonstrably
· Center for Integrative Medicine, University of Maryland School of Medicine
enhance quality, ensure safety and
· Coordinating Center: Duke Clinical Research Institute, Duke University School of Medicine
· Duke Integrative Medicine, Duke University School of Medicine
· Jefferson-Myrna Brind Center of Integrative Medicine, Thomas Jefferson University Hospital
and Thomas Jefferson University
· Osher Center for Integrative Medicine, University of California, San Francisco
· Penny George Institute for Health and Healing, Abbott Northwestern Hospital
· Scripps Center for Integrative Medicine
· Simms-Mann Health and Wellness Center at Venice Family Clinic
· The Continuum Center for Health and Healing, Beth Israel Medical Center
4 O U T c O m E S R E P O RT 2 0 1 0
Foundation of excellent care
P E N N Y G E O R G E I N S T I T U T E F O R H E A LT H A N D H E A L I N G 5
Inpatient Care all of the penny George institute’s practitioners are cross-trained in a multitude
of complementary therapies. patients receive individualized care developed in
since it was founded in 2003, the partnership with the care team to enhance their experience and outcomes. patients
penny George institute’s care team has may be seen before surgery or immediately after surgery, and some practitioners
provided more than 60,000 consults have accompanied patients during a procedure or surgery. patients may receive one
to hospitalized patients at abbott or more of these therapies:
northwestern. through philanthropic • acupuncture/acupressure
support from the community, the
inpatient team brings pain relief,
anxiety reduction and healing to • energy healing including Reiki and healing touch
patients throughout the hospital. • healing arts
• Korean hand therapy
more than 22 highly credentialed
integrative health care professionals • mind/body therapies including relaxation response, guided imagery and
consult and work directly with patients biofeedback
and their family members to provide • music therapy
care. each weekday morning, the penny • reflexology
George institute practitioner team
• therapeutic massage.
meets to assign an average of 25 to
30 new patient referrals. On a typical
day, 60 to 75 patients will receive an
integrative medicine consult or service.
the penny George institute’s inpatient
professionals are fully integrated into
the hospital. they receive formal
referrals, round with physicians, consult
with nurses, provide bedside therapies
and document their care in the
electronic medical record system.
6 O U T c O m E S R E P O RT 2 0 1 0
The Penny George Institute
has transformed chronic
depression and anxiety
care through its Resiliency
Outpatient Clinic the Outpatient clinic provides
five popular group-based programs.
the penny George institute’s • The unique Resilience Training
Outpatient clinic opened in 2004 program is led by holistic
on the abbott northwestern campus. psychiatrist, Henry emmons,
clinic services are provided by md, and is inspired by his
15 highly credentialed practitioners. book The Chemistry of Joy.
participants in the eight-week
patient services include: program receive individual
• Oriental Medicine/acupuncture psychiatric, nutritional and
• Ayurveda fitness assessments and, as a
group, develop meditation skills
• energy healing
and personal insight for working
• healing coaching through difficult emotions and
• herbal consultations managing stress.
• integrative medicine physician • The Mindfulness-Based Stress
consultations reduction program helps
participants develop mindfulness Penny George Institute
• integrative nutrition counseling
skills based on the work of Jon researchers evaluated the
• mind/body therapies including Kabat-Zinn. impact of Resiliency Training
• The Art of Healing program on key measures of depression,
• spiritual coaching brings visual art, therapeutic quality of life and work
• massage therapy music and movement therapies, productivity among 38 Allina
• therapeutic yoga as well as “caring for the employees with moderate
caregiver” programming, into depression. The study
• classes and workshops on
clinical settings. showed that, compared to a
aromatherapy, drum circle,
healing through the arts and more. • Therapeutic yoga is offered control group, participants in
in group settings to promote Resiliency Training experienced
relaxation and support the significant improvement in
healing process. depression symptoms, quality
Classes for the community • Group acupuncture is offered to of life measures and work
offered by the Penny George facilitate more affordable access productivity. Read more about
to the service in a setting that this study on page 14.
Institute attract more than
creates a sense of community and
800 participants a year. support.
P E N N Y G E O R G E I N S T I T U T E F O R H E A LT H A N D H E A L I N G 7
the Livewell Fitness center
encourages clients to seek their
highest level of well-being each day.
the center supports the journey
to optimal health by offering a full
spectrum of programs and services
to enhance an individual’s lifestyle.
a highly credentialed, professional
staff of exercise physiologists, physical
therapists, licensed nutrition experts, a
wellness coach and aftercare specialists
is available to help design exercise and
nutrition plans that help clients meet
personal health and fitness goals.
services include fitness assessments and Health Promotion and Wellness
consulting, body composition testing, the Livewell Fitness center is committed to helping communities promote health
exercise training, fitness rehabilitation, and wellness.
nutrition counseling, metabolism • It provides expertise in health promotion and wellness to various corporations
testing, wellness coaching and more. and community organizations. creating quality fitness and nutrition programs
innovative and/or enhanced programs with a mind/body approach provides opportunities for employers and community
include: leaders to encourage and support a culture of good health and well-being.
• Body in Balance Program for posture • In collaboration with Allina’s Employee Benefits Department, LiveWell staff
enhancement designed and coordinated the six-week Health is wealth contest for 840
• Cancer Survivorship Program, which employees at abbott northwestern Hospital and the allina commons. this
includes the nationally renowned incentive program motivated participants to engage in healthy exercise, nutrition
Healthy steps group exercise classes and stress management practices at work and home.
• The Take Action Weight • LiveWell’s Take Action Weight Management Program and Fitness Profile
management program, which assessment are included in allina’s Be Fit employee health program. Be Fit offers
includes a new, flexible one-to-one programs that enhance the overall health of employees. successful completion of
format to complement an already these programs qualifies employees for wellness rewards.
successful group program
• Pilates Reformer Training for
customized strength and flexibility
The LiveWell Fitness Center received the
2009 VOLUmE American Heart Association’s Gold Star
Memberships: 650 Award. The award recognizes employers
that champion the health of their
employees and work to create a culture of
physical activity in the workplace.
8 O U T c O m E S R E P O RT 2 0 1 0
The Art of Healing
at abbott northwestern, creative arts are used to support healing, and research
is being conducted to measure the impact of the arts in patient care.
the art of Healing program offers positive, creative and constructive arts
programming for patients, visitors, employees and volunteers. patients can
explore art as a healing tool during their hospitalization. music therapy is
used to reduce anxiety, stress and pain. exhibits, concerts, classes and other
events explore the healing aspects of art. the caring for the caregiver
program offers a series of classes designed to support abbott northwestern
employees and volunteers in the art of self-care, including visual journaling,
movement and the meditative aspects of painting.
the penny George institute is a member of the society for arts in
Healthcare. this national organization demonstrates the valuable role the
arts can play in the healing process and encourages and supports research into
the benefits of arts in health care. Life After Cancer
Through collaborative work across
Abbott Northwestern, the Penny
George Institute offers a synergistic,
integrative approach to optimizing
life after cancer. In partnership with
the Virginia Piper Cancer Institute
and the Sister Kenny Rehabilitation
Institute, the Penny George Institute
is emerging as a national leader
in the promotion of wellness and
well-being after cancer—bringing
together all of its resources to
promote nutritional, physical,
mind-body and spiritual health. For
example, cancer patients have an
opportunity to work with a healing
coach in all stages of their journey,
from diagnosis to post-treatment
and beyond. Health promotion tools
and resources that focus on stress
reduction, nutritional guidance,
weight management and exercise
offer individualized support and
Penny George Institute Team Mandala, Richard Bonk, artist instruction.
Mandalas symbolize the universe and have been used in many cultures as tools to
focus the mind and support transformation. This mandala was created by collecting
information in and around the Penny George Institute Outpatient Clinic: photographs
of the space, audio recordings of ambient sounds, hand-written vision statements from
the staff and video recordings of patient interviews. Using computer software, the artist
translated the materials into raw data and created this visual representation.
P E N N Y G E O R G E I N S T I T U T E F O R H E A LT H A N D H E A L I N G 9
education and community Outreach
Serving Patients, Pre-Hospital Program
Professionals and the pre-Hospital program helps people prepare for an upcoming surgery
or procedure at abbott northwestern. it is designed for patients who are
the Community anxious about their visit, worried about pain, need help developing a
self-care plan or want to learn skills to enhance recovery.
The Penny George Institute offers
educational programming in three areas: through mind-body skills training, participants discover tools, skills
professional education on integrative and information that will help make their hospitalization and recovery
care, patient and community education a positive, healing experience. a mind-body coach helps participants
learn to use skills like meditation, breath work, relaxation techniques,
that focuses on health promotion,
guided imagery, biofeedback and self-care practices. the participants
and community classes and programs learn to apply their new skills toward:
that provide an understanding of the • reducing pain to a tolerable level
principles and therapies of integrative • shifting feelings of anxiety to feelings of calm and confidence
medicine. • planning for and experiencing a positive outcome after surgery
• taming the stress response and eliciting the relaxation response.
10 O U T c O m E S R E P O RT 2 0 1 0
the transformative nurse training
program is one example of abbott
northwestern’s commitment to
excellence in nursing. the program brings
nurses back to the essence of nursing
practice and teaches the foundations and
principles of holistic nursing.
Over the course of six day-long
sessions, nurses acquire practical skills
to promote and enhance self-care and
care for patients, including massage,
guided imagery, physiologic relaxation
response, meditation, Oriental
medicine, nutrition and much more.
an important and unique component
of the program is mentorship. after
completing the course, each participant
has the opportunity to work with an
integrative health nurse clinician to
integrate what they have learned into
their own lives and use it to enhance
Transformative Nurse Training is an approved course for upper
patient care. this has led to increased
nurse engagement and patient satisfaction division credits at St. Mary’s University of Minnesota.
and has improved patient outcomes.
researchers are evaluating the changes
in nurses’ attitudes and their knowledge
Outreach • Creating Personal Resilience
through mind-Body skills and
and application of therapies that are the penny George institute is dedicated spiritual practices
addressed in the transformative nurse to wellness, health promotion and
• Discovering the Art of Healing
training program. the prevention of illness—issues that
need to be addressed with urgency • Growing Healthy Families
since it was established in 2006, in the community and throughout • Harmonizing World Medicine in the
192 nurses from abbott northwestern the nation. Outreach and education 21st century: traditional chinese &
and other health care organizations are key components of the penny western medicine
(including courage center, children’s George institute’s work within abbott • Integrative Health Care Conference:
Hospitals and clinics of minnesota, northwestern, allina Hospitals & transforming Health care practice.
ridgeview medical center, united clinics, the community and the health
Hospital, walker methodist Health care system nationally. the penny George institute has also
center and waseca medical center) formed new partnerships with corporations
have participated in the 48-hour as part of this commitment, the penny and employers to promote integrative
training program. the program will George institute regularly sponsors health programs and services that focus on
also be provided to nurses at two conferences and seminars for community prevention, health and wellness.
department of veterans affairs members and professionals on a range of
hospitals in california as part of a integrative health and health promotion
scientific study. topics, such as:
P E N N Y G E O R G E I N S T I T U T E F O R H E A LT H A N D H E A L I N G 11
Measuring exhaled levels of nitric oxide allows researchers to study the effects of integrative therapies on clinical outcomes. Nitric oxide is known
to dilate blood vessels and reduce blood pressure.
Identifying Best Practices Through Research
Innovative research conducted by the Integrative in randomized controlled trials, the iHrc uses psychological and
Health Research Center (IHRC) establishes biological measurement to understand how integrative therapies
influence clinical outcomes.
measurable patient outcomes and identifies best
practices through data analysis and clinical trials. iHrc research involves patients across abbott northwestern’s
centers of excellence. with a large inpatient integrative service
the iHrc maintains a balance of basic science, randomized and documentation in an electronic medical record system,
controlled trials and observational studies in support of allina’s the penny George institute maintains the largest integrative
research goals. medicine dataset of its kind in the country. using this dataset,
the iHrc is unique in its ability to conduct observational studies
Led by Jeffery dusek, phd, the iHrc collaborates with assessing the best practices and effectiveness of integrative
Harvard medical school teaching hospitals (massachusetts services in the “real world” setting of an acute care hospital.
General Hospital) in using innovative gene expression to detect
genomic mechanisms of how integrative therapies affect the through rigorous research, the penny George institute is testing
body and mind. new models of care and is sharing this knowledge through
training and publishing and by replicating its programs and
services at other allina facilities and beyond.
12 O U T c O m E S R E P O RT 2 0 1 0
STUDY PURPOSE/DESCRIPTION NOTES
BRAVENET To evaluate the demographics, quality of life and characteristics of individuals This multi-center study includes about 4,000
SURVEy choosing to receive services at the Penny George Institute Outpatient Clinic. people at eight integrative medicine centers
comprising Bravenet, the Bravewell Collaborative’s
practice-based clinical network.
BREAST CANCER To collect quality of life measures from 50 women choosing to receive services In progress.
SURVEy at the Piper Breast Center. The goal is to include these measures in the
electronic medical record system so that physicians and nurses can track their
patients’ changing quality of life as they go through treatment and follow-up.
CONGESTIVE To assess the incidence of depression, anxiety and stress in heart failure The study uses three short self-report
HEART FAILURE outpatients treated at the Minneapolis Heart Institute®’s Outpatient Clinic. questionnaires, a brief structured qualitative
CROSS-SECTIONAL interview, and a biologic panel of outcomes.
INTEGRATIVE To assess the effectiveness of more than 60,000 integrative medicine Pain was reduced by 50 percent in more than
MEDICINE visits in reducing pain and anxiety among patients hospitalized at Abbott six out of 10 patients and was eliminated in 30
EFFECTIVENESS Northwestern from July 2004 to December 2009. Services were provided percent of patients. Similar results have been
across all areas of the hospital including medical/surgical services, neurology, shown for anxiety reduction. Further research is
Sister Kenny Rehabilitation Institute, orthopaedics, spine, WomenCare and the underway on the impact on pain medication use,
Minneapolis Heart Institute®. quality of life, sleep quality and the hospital length
of stay. The initial results were published in 2010.
GyNECOLOGy To examine if an integrative medicine approach to care for women The study will also evaluate physiologic
ONCOLOGy undergoing surgery for endometrial, ovarian or cervical cancer has an outcomes (pain, nausea, time to first ambulation,
ALIMENTARy impact on the length of hospital stay compared to usual care. time to discontinuation of bladder catheter, time
LENGTH OF STAy to first void) during hospitalization and compare
(GOALS) psychological symptoms (anxiety), quality of
life and self-care knowledge before and after
RESILIENCE To evaluate whether an eight-week resilience training intervention reduces Results indicate there are significant reductions
TRAINING FOR depression symptoms and improves self-reported quality of life among Allina in depression symptoms, perceived stress and
EMPLOyEE Hospitals & Clinics employees (see page 14). anxiety, and improvement in presenteeism.
RESILIENCE To determine whether including specific biological samples should become a In progress.
TRAINING standard of care in the Penny George Institute’s Resiliency Training Program.
SIMTAP: To assess the impact of an integrative medicine approach in treating In progress.
BRAVENET chronic pain among 400 people treated at eight integrative medicine
OUTCOMES centers that comprise Bravenet, the Bravewell Collaborative’s practice-
STUDy based clinical network.
P E N N Y G E O R G E I N S T I T U T E F O R H E A LT H A N D H E A L I N G 13
Research Summary Continued
STUDY PURPOSE/DESCRIPTION NOTES
SySTOLIC To test whether an eight-week stress management intervention reduces The study will enroll 80 older adults in a
HyPERTENSION systolic blood pressure and pulse pressure without significant side effects randomized, controlled trial. Primary outcome
and whether this occurs by increasing nitric oxide production and/or by measures are systolic blood pressure and pulse
reducing stress hormone levels (epinephrine and cortisol). pressure. Secondary outcome measures are blood
levels of nitric oxide and stress hormones as
well as psychological well-being. Funded by the
National Center for Complementary and Alternative
Medicine – National Institutes of Health.
TRANSFORMATIVE To survey nurses who have completed a 48-hour training program in More than 100 nurses are enrolled in the survey.
NURSE TRAINING evidence-based holistic nursing approaches that could be used for Data are currently being analyzed.
SURVEy patient care.
WOMENCARE To define the “dose” of treatment that delays delivery among women with As a result of this study, researchers hope to gain
PILOT pre-term labor and premature ruptured membranes. the ability to recommend standard integrative
protocols to patients and their caregivers.
Evaluating the Effectiveness of Resiliency Training
in a controlled trial of 38 allina employees with Quality of life scores using the SF-12 Health Survey:
moderate depression, researchers at the penny George Mental Status Subscale
institute evaluated the impact of resilience training • Quality of life scores improved 71 percent in the
on psychological endpoints. participants completed rt group from 28.6 to 49.1, relative to a 19 percent
questionnaires assessing depression symptoms, quality increase in the control group (29.5 to 35.1). the
of life and presenteeism scores at the start and end of difference between the groups was statistically
the eight-week program. presenteeism is defined as lost significant (p<0.01).
productivity that occurs when employees report to work
but perform below par due to any kind of illness or life Presenteeism scores using the Workplace Productivity
stressor distraction. and Activity Impairment (WPAI) questionnaire
• Presenteeism decreased 63 percent in the RT group
(31.2 to 11.5), relative to a 25 percent increase in the
Depression scores using the Patient Health Questionnaire-9
control group (31.5 to 40.5).
• This reduction in presenteeism was statistically
• Average depression scores dropped 71 percent from more
significant (p<0.01) and translates to a cost savings of
than 12.3 to less than 3.6 in the resilience training (rt)
more than $1,676 for each rt participant during the
group (n=19). in the wait list control group, scores dropped
eight-week study. the return on investment is $1.86 for
10 percent from 14.1 to 11.8 (n=19). the difference
every dollar spent.
between the groups was statistically significant (p<0.01).
• Importantly, more than 60 percent of the RT group these results demonstrate the value of providing rt in
achieved remission of their depression (defined as a workplace settings. Future efforts seek to expand rt to other
pHQ-9 score of less than 5) without the addition of any centers and possibly to additional patient and nonpatient
medications. the control group experienced a 16 percent populations.
14 O U T c O m E S R E P O RT 2 0 1 0
Founding donors of the Penny George Institute
include Penny and Bill George (left), and Dr. Roberta Mann
(right). A gift from Blythe Brenden (center), Dr. Mann’s daughter, established
the award-winning LiveWell Fitness Center at the Penny George Institute.
the role of philanthropy
Visionary Support for Health Care Innovation
Through philanthropy, the Penny George the penny George institute is supported by the
Institute has created a national model for financial generosity of the community. it came
into existence in 2003 through the visionary FUNDING
integrative health with its comprehensive support of the George Family Foundation and Abbott
programs and services delivered the ted and dr. roberta mann Foundation. in
throughout Abbott Northwestern and 2006, the penny George institute established its
award-winning Livewell Fitness center with a Hospital
Allina Hospitals & Clinics.
gift from Blythe Brenden. Foundation:
dedicated to innovation, the penny George $1.9 million
institute is transforming health care while to learn more or to make a gift, call the
providing options for self-care, wellness and abbott northwestern Hospital Foundation
maximizing quality of life. at 612-863-4126.
P E N N Y G E O R G E I N S T I T U T E F O R H E A LT H A N D H E A L I N G 15
volume, Quality and Outcomes measures
Inpatient Visits, 2004-2009
A total of 60,783 inpatient
visits with services were 15,000
Visits with Services Provided
provided between July 11,644 11,460
2004 and December 2009.
2004 2005 2006 2007 2008 2009*
Number of Individuals Receiving Inpatient Integrative
Penny George Institute Health Services, 2004-2009
staff provided services 5,000
to 17,215 individuals 3,850
between July 2004 and 4,000
Number of Individuals
2004 2005 2006 2007 2008 2009*
*In 2009, the Penny George Institute refined referral criteria to focus on the patient populations that can
benefit most from integrative health services. The change resulted in a slight decrease in the number of visits.
Types of Patients Receiving Inpatient Integrative Health Services,
The Penny George 2004-2009
Institute serves patients
across all Centers of WomenCare 14%
3,031 Cardiovascular 15%
Excellence at Abbott 3,236
16 O U T c O m E S R E P O RT 2 0 1 0
Average Length of Inpatient Integrative Health Visit,
Average Number of Integrative Health Visits per Hospital Stay,
3.0 2.6 2.6
2004 2005 2006 2007 2008 2009
Number of Outpatient Visits, 2004-2009
2004 2005 2006 2007 2008 2009*
*In 2009, the Penny George Institute refined referral criteria to focus on the patient populations that can
benefit most from integrative health services. The change resulted in a slight decrease in the number of visits.
P E N N Y G E O R G E I N S T I T U T E F O R H E A LT H A N D H E A L I N G 17
volume, Quality and Outcomes measures
Inpatient Self-Reported Pain Scores by Type of Patient Served, 2008-2009
Cardiovascular (n=1,540) 3.14
Medical/Surgical (n=4,050) 51% Decrease
Neuroscience/Rehabilitation (n=3,506) 53% Decrease After Intervention
Orthopaedic/Spine (n=1,671) 53% Decrease p=<.01
January 2008-December 2009
WomenCare (n=2,529) 67% Decrease
0 2 4 6 8 10
Pain Intensity Numeric Rating Scale 0-10 (10 = worst)
Inpatient Self-Reported Anxiety Scores by Type of Patient Served, 2008-09
Cardiovascular (n=1,405) 57% Decrease
Medical/Surgical (n=3,683) 59% Decrease
1.44 Before Intervention
2.05 After Intervention
Neuroscience/Rehabilitation (n=2,988) 64% Decrease
Orthopaedic/Spine (n=1,453) 65% Decrease
1.25 January 2008-December 2009
WomenCare (n=2,409) 66% Decrease
0 2 4 6 8 10
Anxiety Intensity Numeric Rating Scale 0-10 (10 = worst)
Read more about the Penny George Institute’s
pain management study:
Dusek JA, Finch M, Plotnikoff GA, Knutson L. The impact of
integrative medicine on pain management in a tertiary care
hospital. J Pat Safety. 2010;6(1):48-51.
18 O U T c O m E S R E P O RT 2 0 1 0
Productivity and Workflow:
Inpatient Integrative Health Practitioners
Time Spent in Direct Care vs. Indirect Care
Activities Included in Indirect Care
(28% of Inpatient Practitioner Time)
Staff and Visitor Treatment
34% With a large patient base
and integrative services
documented directly into
7% each patient’s electronic
Community Program Development medical record, the
Penny George Institute
has the largest integrative
medicine data set of its
Activities Included in Direct Care kind in the country.
(72% of Inpatient Practitioner Time)
Bedside Treatment for Caregiver
Staff and Patient Visitors 8%
Inpatient Treatments Clinical Program
61% Development 9%
Patient Education 8%
Clinical Research 2%
P E N N Y G E O R G E I N S T I T U T E F O R H E A LT H A N D H E A L I N G 19
publications and presentations, 2007-2009
20 O U T c O m E S R E P O RT 2 0 1 0
Publications Knutson L. Exploring integrative medicine: The
story of a large urban tertiary care hospital. In:
Plotnikoff GA, Amano T. A culturally appropriate,
student-centered curriculum on medical
Evans KC, Dougherty DD, Schmid AM, Scannell Dossey BM, Keegan L. eds. Holistic Nursing: A professionalism: Successful innovations at Keio
E, McCallister A, Benson H, Dusek JA, Lazar SW. Handbook for Practice. 5th ed. Sudbury, MA: Jones University in Tokyo, Japan. Minnesota Medicine.
Modulation of spontaneous breathing via limbic/ and Bartlett; 2009. 2007;90(8):42-3.
paralimbic-bulbar circuitry: An event related fMRI
study. Neuroimage. 2009;Sep;47(3):961-71. Epub Knutson L. Exploring integrative medicine and Reaney JB, Plotnikoff GA. Culture and spirituality
2009 May 18. the healing environment. In: Dossey BM, Keegan in integrative pediatrics. In: Culbert TP, Olness
L. eds. Holistic Nursing: A Handbook for Practice. 4th K, eds. Integrative Pediatrics, New York: Oxford
Casey A, Chang BH, Huddleston J, Virani N, Benson ed. Sudbury, MA: Jones and Bartlett; 2007. University Press; 2010.
H, Dusek JA. A model for integrating a mind/body
approach to cardiac rehabilitation: outcomes and Plotnikoff GA. Herbal medicines. In: Snyder M, ed. Smith DA. Chapter contributor: Ezra S., Reed T.
correlators. J Cardiopulm Rehabil Prev. 2009;July/ Complementary/Alternative Therapies in Nursing. 6th An idea whose time has come. In: Maxwell J, ed.
August;29(4):230-238. Edition. New York, NY: Springer Publishing; 2009. Guided Imagery and Beyond: Stories of Healing and
Transformation. Denver, CO: Outskirts Press; 2008.
Dusek JA, Benson H. Mind-body medicine: A Plotnikoff GA. What are our priorities for
prevention? Minneapolis Star-Tribune, Nov. 11, 2008.
model of the comparative clinical impact of the
acute stress and relaxation responses. Minn Med. Presentations
Plotnikoff GA, Weisberg MB. Why emphasize pills
2009;92:47-50. Arnold S, Kerber K, King J, Kinney M, Knutson
more than skills? BMJ. 2009;338:a3148.
L, Lindell M, Smith D. Holistic nursing and
Ospina M, Bond K, Karkaneh M, Buscemi N, Dryden mentorship: Transforming clinical practice.
Gepshtein Y, Plotnikoff GA, Watanabe K. Kampo
DM, Barnes V, Carlson LE, Dusek JA, Shannahoff- Presented at: American Holistic Nurses Association
in women’s health: Japan’s traditional approach to
Khalsa D. Clinical trials of meditation practices in Annual Conference; June 7-10, 2007; Lake Tahoe, CA.
premenstrual symptoms. The Journal of Alternative
healthcare: Characteristics and quality. J Altern
and Complementary Medicine. 2008;14(4):427-35.
Complement Med. 2008;14:1199-213. Blair J. Dietary therapy according to the principles
Plotnikoff GA, Culbert T, Kemper KJ. Integrative of Chinese medicine. Presented at: University of
Dusek JA, Otu HH, Wohlhueter AL, Bhasin M, Minnesota; November 2009; Minneapolis, MN.
pediatric medicine. In: Hoekelman RA, ed. Primary
Zerbini LF, Joseph MG, Benson H, Libermann TA.
Pediatric Care. Elk Grove Village, IL: American
Genomic counter-stress changes induced by the Blair J. Dietary therapy according to the principles
Academy of Pediatrics; 2008:455-466.
relaxation response. PLoSOne 2008;3:e2576. of Chinese medicine. Presented at: Dieticians
Plotnikoff GA, Watanabe K, Yashiro F. Kampo: Association; March 2009; Roseville, MN.
Dusek JA, Hibberd PL, Buczynski B, Chang BH,
From old wisdom comes new knowledge.
Dusek KC, Johnston JM, Wohlhueter AL, Benson Blair J. Acupuncture in the acute care setting.
H, Zusman RM. Stress management versus Presented at: Northwestern Health Sciences
lifestyle modification on systolic hypertension and University, Minnesota College of Acupuncture and
Plotnikoff GA, Watanabe K, Yashiro F. Interview
medication elimination: A randomized trial. J Altern Oriental Medicine; Bloomington, MN
with Masaki Kitajima, MD: World famous surgeon
Complement Med. 2008;14:129-138.
and prescriber of Kampo. HerbalGram. 2008;78:57.
Donley KS. The healing energy of music.
Carei TR, Fyfe-Johnson AL, Breuner CC, Marshall Presented at: The Pancreatic Cancer Symposium;
Plotnikoff GA. Fatty acid and vitamin D status in
M. Randomized controlled clinical trial of yoga in Sept.12, 2009; Minneapolis MN .
the EPIC trials of Crohn’s disease treatment. JAMA.
the treatment of eating disorders. J Adolesc Health.
April 2010 (in press). Donley KS. The healing energy of music.
Plotnikoff GA. Misleading 25-hydroxyvitamin D Presented at: Health Partners Wellness Study;
Fyfe-Johnson AL. The Year in Health 2009: Yoga. March and May 2009; Bloomington, MN.
laboratory reference ranges. BMJ. Epub June 17, 2008.
Time Magazine Web site. www.time.com/time/
specials/packages/article/0,28804,1942543_194248 Donley KS. Clinical uses of the reverie harp in
Plotnikoff GA. Nutritional interventions and the
7_1942498,00.html. Accessed December 30, 2009. music therapy. Presented at: The Great Lakes
possibility of type II errors. BMJ. Epub March 16, 2008.
Region Music Therapy Conference; March 2009;
King J. A rose is a rose: A story of spirit in acute Bloomington, MN.
Watanabe K, Nishimura K, Plotnikoff GA, Ishige
care. Beginnings: A Publication of the American
A, Aiso S, Kitajima M, Amano T. Education about
Holistic Nurses Association, Winter 2008;26. Donley KS. Integrating music therapy into the medical
Kampo medicine at Keio University Medical
School. Medical Education. 2008;39:125-9. environment. Presented at: The Pre-Conference
Rakel D, Bolles S, Knutson L, Herman P, Hiza D, Institute, Great Lakes Region Music Therapy
Weeks J. Medical homes: Defining cost-effective Conference; March 4, 2009; Bloomington, MN.
health care teams. Alternative and Complementary
Plotnikoff GA. Kampo clinical research in the
Therapies Journal. 2009;15(1):248-250. Donley KS. The healing energy of music.
United States: Challenges and lessons. Kampo
Medicine. 2007;58(4):636-39. (Japanese) Presented at: Health Partners Wellness Study; June
and September 2008; Bloomington, MN.
P E N N Y G E O R G E I N S T I T U T E F O R H E A LT H A N D H E A L I N G 21
Donley KS. Clinical uses of the reverie harp in King J, Kinney M. Co-creative mentoring: a new Knutson L. Creating healing environments
music therapy. Presented at: The Great Lakes era of nurse relationships. Presented at: American in hospitals. Presented at: American Hospital
Region Music Therapy Conference; April 2008; Holistic Nurses Association Annual Conference; Association Health Forum: Integrative Medicine
Naperville, IL. June 2008; Mount Washington, NH. for Health Care Organizations; February 2007; San
Donley KS. The healing energy of music. King J. Compassionate, intentional touch: An
Presented at: Hutchinson Integrative Therapies integral acute care intervention; Holistic therapies: Lindell M. Oncology nursing: The integrative
Conference; October 2007; Hutchinson, MN Discovering health and harmony. Presented at: approach. Presented at: Dimensions in Oncology;
University of Minnesota Continuing Education; Oct. 29-30 and May 7-8, 2009; Minneapolis, MN.
Dusek JA. Integrative medicine for oncology Feb. 15, 2008; Minneapolis, MN.
patients at Abbott Northwestern Hospital. Presented Lindell M. Oncology nursing: The integrative
at: International Meeting, Society for Integrative King J. Compassionate intentional touch: approach. Presented at: Dimensions in Oncology;
Oncology; November 2009; New York, NY. An integral part of acute care. Presented at: May 15-16 and Oct. 2-3, 2008; Minneapolis, MN.
Integrative Health and Healing Expo; Oct. 27, 2007;
Dusek JA. Integrative medicine for oncology Hutchinson, MN. Lindell M. Oncology nursing: The integrative
patients at Abbott Northwestern Hospital. approach. Presented at: Dimensions in Oncology;
Presented at: National Meeting, Avera Cancer King J. Compassionate, intentional touch: An March 1-2 and Nov. 28-29, 2007; Minneapolis, MN.
Institute; October 2009; Sioux Falls, SD. integral part of nursing practice. Poster presented at:
American Holistic Nurses Association 27th Annual Masemer S, Pereira R. Creating a multi-disciplinary
Dusek JA, Knutson L, Plotnikoff GA. From Conference; June 7-10, 2007; Lake Tahoe, CA. approach for patient success. Presented at: 2008
bench to bedside to boardroom: Successful Regional Medical Fitness Association Meeting,
implementation of integrative medicine in a large Knutson L. Integrative medicine at the bedside: Courage Center; April 5, 2008; Minneapolis, MN.
hospital and healthcare system. Presented at: The Allina health care model. Presented at:
International Meeting, North American Research Integrative and Holistic Nursing Conference – Masemer S. Resilience training: an integrative
Conference on Complementary and Integrative Scripps Center for Integrative Medicine; May 2009; approach to the recovery and prevention of
Medicine; May 2009; Minneapolis, MN. San Diego, CA. depression. Presented at: Integrative Mental Health
Conference; May 11, 2009; Minneapolis, MN.
Dusek JA, Knutson L, Plotnikoff GA. Integrative Knutson L. Integrating music therapy in the
medicine at Abbott Northwestern Hospital: medical environment (panel presentation). Plotnikoff GA. Vitamin D and optimal health.
The first 43,726 integrative medicine inpatient Presented at: Great Lakes Music Therapy Presented at: The Marsh; Aug. 13, 2009;
visits. Presented at: International Meeting, Conference; March 2009; Bloomington, MN. Minnetonka, MN.
North American Research Conference on
Complementary and Integrative Medicine; Knutson L. Restoring harmony: Holistic nursing Plotnikoff GA. 2009 Update on the Vitamin D
May 2009; Minneapolis, MN. principles for self-care. Presented at: Cardiovascular controversies. Presented at: St. Paul Public Health
Nursing Conference; September 2008; Department; June 29, 2009; St. Paul, MN.
Dusek JA. The relaxation response – 35 years of Minneapolis, MN.
research and practice: An Invited Symposium. Plotnikoff GA. Integrative medicine in the United
Presented at: International Meeting, Society for Knutson L. Investing in your health: Creating your States: 2009 update. Presented at: Japanese
Behavioral Medicine; April 2009; Montreal, CA. personal health portfolio. Presented at: Minnesota Society for Oriental Medicine 60th Annual
Women’s Economic Roundtable; September 2008; Meeting; June 19, 2009; Tokyo, Japan.
Dusek JA. The integrative medicine experience Minneapolis, MN.
at Abbott Northwestern Hospital. Presented at: Plotnikoff GA. 2009 Update on medicinal
American Heart Association International Meeting; Knutson L. Lifestyles and stress. Presented at: mushrooms. Presented at: Nutrition and Health:
November 2008; New Orleans, LA. Women’s Health Seminar M & I Bank; April 2008; State of the Health and Clinical Applications; May
Minneapolis, MN. 12, 2009; Chicago, IL.
Dusek JA. Meditation and yoga-based
interventions in behavioral medicine: An Knutson L, Arnold S. Holism: The essence Plotnikoff GA. Vitamin D deficiency: Impact
introduction to conceptual, research and practice of nursing from the inside out. Presented at: on dentition and orofacial pain. Presented at:
issues. Presented at: Society for Behavioral Metropolitan State University Nursing Student University of Minnesota Dental School; May 5,
Medicine; April 2008; San Diego, CA. Assembly; April 2007; St. Paul, MN. 2009; Minneapolis, MN.
Ericson G. Exercise is medicine, “Are you Knutson L, Arnold S, Kerber K, Kinney ME, Plotnikoff GA. Pediatric care and hypovitaminosis
healthier than a 5th grader?” Presented at: Nurses King J, Lindell M, Smith D. Transformative D. Presented at: Hennepin Country Medical
Cardiovascular Conference; September 2009; nurse training: Holistic nursing education Center Pediatric Grand Rounds; April 16, 2009;
Edina, MN. and mentorship. Presented at AHNA Annual Minneapolis, MN.
Conference; June 2007; Tahoe City, CA.
22 O U T c O m E S R E P O RT 2 0 1 0
Plotnikoff GA. Medical professionalism and the Weiss-Farnan P. Acupuncture and traditional
white coat: Lessons for today. Presented at: Keio Chinese medicine. Presented at: Twin Cities
University School of Medicine Hakui Shiki; March Orthopedic Nurses Association; October 2008;
28, 2009; Tokyo, Japan. Minneapolis, MN.
Plotnikoff GA. Western bioethics in eastern Weiss-Farnan P. Exploring healing choices: 21st
cultures? A linguistic analysis of the challenges. century medicine. Presented at: Blue Cross Blue
Presented at: Keio University School of Medicine Shield of Minnesota; May 2008; Minneapolis, MN.
Grand Rounds; March 27, 2009; Tokyo, Japan.
Weiss-Farnan P. Integrative therapies for
Plotnikoff GA. Music and medicine: A new respiratory concerns. Presented at: Minnesota
perspective. Presented at: American Music Therapy Association of Cardiovascular and Pulmonary
Association Great Lakes Conference; March 4, Rehabilitation; May 6, 2008; Minneapolis, MN.
2009; Bloomington, MN.
Weiss-Farnan P. Traditional Chinese medicine
Plotnikoff GA. Integrative nutrition and assessment. Presented at: Harmonizing World
inflammatory bowel disease. Presented at: Crohn’s Medicine; October 2007; Minneapolis, MN.
and Colitis Disease Association of Minnesota; Feb.
19, 2009; Minneapolis, MN.
Plotnikoff GA. Integrating medicine, agriculture and
the environment: A focus on food systems. Presented
at: LifeScience Alley 7th Annual Conference and Expo;
Dec. 10, 2008, Minneapolis, MN.
Plotnikoff GA. Frontline integrative medicine
in neurology. Presented at: Frontline Neurology
Conference; Oct. 3, 2008; Minneapolis, MN.
Plotnikoff GA. Vitamin D deficiency: A new
modifiable risk factor for cardiovascular disease?
Presented at: Cooper Institute; Sept. 30, 2008;
Plotnikoff GA. Kokoro: New insights on
spirituality. Presented at: Whole Hearted Health
Care; Sept. 12, 2008; Minneapolis, MN.
Plotnikoff GA. Interventional nutrition: The
American experience. Presented at: Monterrey
Tecnologica Medical School; April 15, 2008;
Plotnikoff GA. Eastern perspectives for western
innovations: Three insights from Japan. Presented at:
LifeScience Alley; March 10, 2008; Minneapolis, MN.
Plotnikoff GA. Neither common nor sense:
Western bioethics in Japan. Presented at:
University of Minnesota Center for Bioethics
Faculty Seminar; March 7, 2008; Minneapolis, MN.
Smith DA. Holistic nursing and mentorship:
transforming clinical care. Presented at: American
Holistic Nurses’ Association Annual Conference;
June 2007; Tahoe City, CA.
P E N N Y G E O R G E I N S T I T U T E F O R H E A LT H A N D H E A L I N G 23
About Our Staff Leadership
The staff of the Penny George Institute includes integrative Lori Knutson, rn, Bsn, HnB-Bc
health professionals with extensive experience and the highest
credentials in healing therapies. Our practitioners bring a Jeffery a. dusek, phd
balance of conventional and complementary experience and research director
are certified or licensed in the therapies they provide. susan masemer, ms
exercise physiologist, manager
business systems and operations manager
patricia vitale, Licsw
patient care manager
24 O U T c O m E S R E P O RT 2 0 1 0
Inpatient Kathryn Kerber, rn, msn, ma, cHtp,
debbie smith, rn, Bsn, ma, HnB-Bc,
susan arnold, rn, Ba, cHtp integrative health nurse clinician integrative health nurse clinician
integrative health nurse clinician
Jayson King, rn, Bs, nctmB, HnB-Bc Bobbee Bee vang, Lac, maOm
tony Balluff, arcB integrative health nurse clinician licensed acupuncturist
mary ellen Kinney, rn, Ba, Hn-Bc, cpca pam weiss, phd, mpH, Bsn, rn, dipl ac, Lac
Jennifer Blair, Lac, maOm integrative health nurse clinician licensed acupuncturist
Zena Kocher, Lac, maOm
Jan Boettcher, rn, nctmB
massage therapist Outpatient Clinic
mimi Lindell, rn, man, Bsn, Ocn,
Jennifer Blair, Lac, maOm
mary corlett HnB-Bc, cHtp
executive administrative assistant integrative health nurse clinician
Kimberly donley, mt-Bc, ms cynthia miller, rn, Lac, mtOm
board-certified music therapist licensed acupuncturist
Gary carlson, md, daBFm, daBma
wendy Farrar, Ba, nctmB Jeremy e. miller, Lmt, wv, nctmB, Bs
integrative medicine physician
massage therapist massage therapist
nancy cox, rn
vicky Grossman, Bs, nctmB mollie O’Brien, ma, nctmB
healing coach, integrative health nurse clinician
massage therapist massage therapist
douglas dandurand, phd, mdiv, ma
christian m. Hanson, Lac, maOm, pauli payne, Ba, nctmB
dipl ac massage therapist
licensed acupuncturist Kate darkstar, nctmB
Judy riggs, Lmt
Barbara Hopperstad, ma massage therapist
P E N N Y G E O R G E I N S T I T U T E F O R H E A LT H A N D H E A L I N G 25