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Vital Signs

Winter 2012

Bringing a Sense of Zen to the Patient Bedside

UCLA Health is the first medical system on the West Coast to adopt Urban Zen Integrative Therapy, a program that delivers yoga therapy, mindfulness meditation, nutrition, Reiki and aromatherapy to the bedside of interested patients. These Eastern approaches, offered in conjunction with traditional Western therapies, are designed to address discomfort due to pain, anxiety, nausea, insomnia and constipation. The program is being implemented at UCLA in partnership with the Urban Zen Foundation, which is providing extensive training in the techniques to members of the hospital staff. Urban Zen was founded by world-renowned fashion designer Donna Karan based on her experience when her husband was dying of lung cancer in 2001. Distressed that the hospital in New York where he was being treated offered little to ease her husband's pain and anxiety, Karan went on to create a new model for patient wellness. David T. Feinberg, M.D., M.B.A., president of UCLA Health, has been a primary advocate for the program.

What appealed to you about Urban Zen Integrative Therapy?
I met Donna Karan, and within 10 minutes I realized we were saying the same things. At UCLA, we have been very focused on patient-centered care - doing everything we can to make sure our patients are cared for in the way we would want our family members treated, which means not only technologically advanced but compassionate care. Donna's program combines Eastern techniques with Western medicine so that the therapist comes to the patient's room with additional tools that can make healing more complete.

What convinced you that this approach could be successful at UCLA?
I went to Beth Israel Medical Center in New York City, where the program is being implemented in an oncology unit, and saw it with my own eyes. With very simple techniques - in some cases just helping patients to breathe the right way - I saw anxiety decrease dramatically. I watched as a cancer patient told a nurse he was becoming quite nauseous and needed medicine. A therapist did some exercises with the patient, and by the time the nurse had returned to deliver the medication, the patient was sleeping restfully. I'm not an expert in these techniques, but I am an expert in patient care, and I witnessed just how therapeutic these tools can be.

How will Urban Zen be integrated into everyday patient care?
First, all of these techniques have to be adapted for an acute-care setting. Obviously, seriously ill hospital patients aren't going to be doing advanced yoga poses. In addition, all of this will be done in consultation with the patient's physician and will require a physician's order. Beyond that, the only thing that will change is that not only will the patient's nurse provide great nursing care - monitoring his or her progress, getting meds, helping with the activities of daily living - but that nurse might also suggest, for patients who are interested, deep-breathing exercises, yoga positions adapted for bed, or mindfulness techniques to assist with digestion, decrease anxiety, reduce pain and enhance healing. Some of this, of course, has already been happening; this is just formalizing it and training our staff in these approaches.

How much scientific evidence is there about the effectiveness of these techniques?
There is some, but it is preliminary. We are approaching this in the typical UCLA way, in that we want strong data to prove that this does or doesn't work. From the start, we will hold randomized clinical trials in which we
will compare patients who get this treatment with patients who don't on a host of measures.

UCLA is among the first large academic medical centers to integrate Eastern techniques in such a systematic way. Do you expect others to follow?
My personal opinion is that this is something that has been missing from our nation's healthcare system and is a great addition. Whether it takes off will depend on two things. One is whether we can prove it is effective, because there are going to be skeptics. But even with that proof, it has to make sense from a business standpoint. And I believe this has an incredible business application. If you can reduce patients' pain, anxiety, nausea, insomnia and constipation, it's going to decrease the amount of time the patient is in the hospital and decrease the amount of medication that's needed - which automatically means fewer side effects. That would be a huge cost-saver, and if that's the case, this will take off like wildfire.

As part of its mission, Urban Zen seeks to "change the healthcare paradigm, to help create a healthcare system where the patient is treated, not just the disease." Do you see this as a paradigm shift for UCLA?
That may be the case elsewhere, but at UCLA patient-centered care is our paradigm. Urban Zen is another step toward doing everything possible to make our patients more comfortable and to assist in their healing - to alleviate their suffering, promote their health and deliver acts of kindness. This program does exactly that. So it's not changing our paradigm; it's accentuating what we already do. 

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