TABLE OF CONTENTS

3 Letter from the Administrative and Medical Directors 4 Vision and Mission Statements 5 Our Unique Care Model 6 Inpatient Care 7 Outpatient Clinic 9 Class Offerings 10 Health Coaching 14 Programs 18 Network-Wide Involvement 28 National Membership Organizations 30 Collaborations 34 Friendraising 38 Communication Channels 42 Community Outreach 44 Team Member Listing 46 Contact Information

OVERVIEW AND OUTCOMES REPORT 2016 - 2017

A MESSAGE FROM OUR LEADERS

Lori Knutson, RN, BSN, HNB-BC, Administrative Director David C. Leopold, M.D., DABFM, Medical Director

This Overview and Outcomes Report will highlight our unique care model and the accomplishments of Hackensack Meridian Integrative Health & Medicine. In just two years, we went from a vision and concept to a full-fledged program delivering outpatient services, inpatient care, providing education and training, and launching our first research study. We have solidified partnerships in the community, and integrated programs and services network-wide. We are deeply grateful for the generosity of our donors who have supported our entrepreneurial efforts in creating a new service for our patients, team members, and community as a whole. There have definitely been challenges along the way. Just six months into our build, we experienced large scale cultural changes with the merger of Hackensack University Health Network and Meridian Health; and 2017 saw the launch of Epic, our new electronic health record. We have developed an amazing committed team of professional experts who are personally passionate about transforming health care and optimizing the health experience for all those we serve.

Our future is unlimited. In the near future, we look forward to: • Additional outpatient locations • Transforming nursing care at the bedside

through our integrative nurse training program

• Ensuring strong collaborations with our physician colleagues both in primary care and specialty services to enhance the overall health and well-being of patients

• Demonstrating our clinical effectiveness and the return on investment

• Exploring new ways to move further upstream in the health of our community through addressing social determinants of health

• Developing partnerships with employers • Delivering integrative medicine curriculum

for Seton Hall Medical School Our intention is to be the regional experts in supporting individuals to optimize their health and well-being and to develop a national presence as leaders in the field of integrative health and medicine.

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VISION STATEMENT

We, as integrative health leaders, will humanize and optimize the healthcare experience and create a culture of health through clinical care, education, research, and collaboration.

MISSION STATEMENT

Our mission is to empower and partner with those we serve to reach the highest expression of themselves in mind, body and spirit. We are dedicated to optimizing health through excellent service at a value our community deserves. We facilitate this through our unique care model, based on Five Pillars of Health & Well-being: Sleep, Activity, Purpose, Nutrition, and Resilience.

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OUR UNIQUE CARE MODEL

Hackensack Meridian Integrative Health & Medicine’s mission is to empower community members to reach the highest expression of themselves in mind, body and spirit and to promote optimal health. We work as partners with primary care physicians and specialists to humanize care and create a culture of health.

We approach care and service from our Five Pillars of Health & Well-being (Five Pillars).

SLEEP: Quality and quantity of sleep is essential for the body and brain to heal, repair, and prepare for the next day. Sleeping disorders or not getting enough sleep can lead to many chronic illnesses such as heart disease and diabetes. ACTIVITY: Physical activity is fundamental to the circulatory and respiratory systems and produces bio-chemicals such as endorphins that promote positive emotions and brain functions. PURPOSE: A sense of purpose is that which gives meaning to one’s life. Having a reason to get up in the morning adds not only years to your life, but also life to your years. NUTRITION: Food is the fuel by which our mind and body function. Proper nourishment helps to keep people sustained through life’s challenges. RESILIENCE: The ability to “bounce back” and adapt to adversity are the skills needed to respond to stress in order to thrive versus survive.

OUR UNIQUE CARE MODEL

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Since 2004, Raritan Bay Medical Center’s (RBMC) care team has provided integrative health therapies to patients at Perth Amboy and Old Bridge campuses.

Our integrative health professionals consult and work directly with patients and their family members to provide care. The integrative team members are fully involved in the hospital. They receive formal referrals, consult with nurses, provide bedside therapies and document their care in the medical record system.

Patients may receive the following

therapies:

• Holistic Nurse Consultation

• Board Certified Aromatherapist

Consultation

• Energy healing, including reiki and

healing touch

• Movement therapy, including tai chi

and qigong

• Hand massage

• Guided imagery

• Reflexology

• Breath work

Since the creation of the Complementary Medicine

Committee in 2004, Raritan Bay Medical Center has

supported an integrative approach to healthcare. This

commitment was solidified in 2009 by the creation of

the Division of Integrative Medicine. In 2016 we were

excited to become a part of the Hackensack Meridian

Integrative Health & Medicine program.

The Integrative Health & Medicine program at RBMC

is comprised of two healthcare providers who consult

with patients and their families to support wellness

and holistic care through the delivery of individualized

patient care services. In 2017, our credentialed

practitioners provided over 3,000 patient visits.

Referrals are made by physicians and nurses, as well

as patients and their families. These services are also

available to staff and family members. In addition,

integrative health and well-being is supported through

the provision of education to team members and the

community.

INPATIENT CARE

FUTURE INPATIENT CARE PLANS • Build inpatient integrative health consultation teams

at every hospital site within Hackensack Meridian Health (HMH)

• Inpatient Epic inclusive of Integrative Health & Medicine module

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GRAND OPENING OF OUTPATIENT CLINIC: “TURN THE LIGHTS ON”

The Integrative Health & Medicine clinic opened in July 2016 at the Hackensack Meridian Health Village at Jackson with the Turn the Lights On ceremony. Tim Hogan, Regional President, and Lori Knutson, Administrative Director, flipped the switch.

Clinical services are provided by nine highly credentialed practitioners. The clinic continues to grow in terms of providers, services, and partnerships. 2017 saw the addition of Dr. David Leopold (Medical Director), Amy Grutzmacher (Massage Therapist), and Mary Brighton (Integrative Nutritionist).

OUTPATIENT CLINIC

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Patient services at the Hackensack Meridian Health Village at Jackson include:

• Integrative physician consultation

• Nurse practitioner consultation

• Acupuncture

• Health psychology

• Massage therapy

• Nutritional counseling

• Health coaching

• Movement therapy (yoga, tai chi, qigong)

• Classes and workshops

We continue to develop satellite sites, working with like-minded practitioners to increase integrative health & medicine services throughout HMH. Exploration projects include Raritan Bay Medical Center - Old Bridge, Bayshore Community Hospital, Ocean Medical Center, Riverview Medical Center, Hackensack University Medical Center (John Theurer Cancer Center), and JFK Health.

OUTPATIENT CLINIC

Actual revenue for the majority of the year was greater than forecasted, due to insurance reimbursement. Revenue peaked in August as a result of high referrals rates and higher than expected reimbursement. September saw a drop due to the loss of our Nutritionist. This position was replaced in December.

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10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov

Do

llars

Gross Revenue Budgeted Gross Revenue ActualNet Revenue Budgeted Net Revenue Actual

Integrative Health & Medicine 2017 Gross & Net Revenue

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CLASS OFFERINGS

PILLAR OF HEALTH CLASS NAME

Sleep

• Get Better Sleep

Activity • Creating an Active Life • Beginner Integral Qigong/Tai Chi • Advanced Integral Qigong/Tai Chi • Yoga • Yoga for Those Living with Cancer – Restoring to Meet the Day • Yoga for Those Living with Cancer – Restore for Rest

Purpose

• How Can Health Coaching Help You? • Introduction to Health Coaching • Are You Really Healthy?

Nutrition

• Anti-inflammatory Diet and Workshop • Fundamentals of EFT for Healthy Eating • Grocery Store Tours • Popular Diets Demystified • Sugar Blues

Resilience • Fundamentals of EFT for Stress Management • Introduction to Mindfulness • Mindfulness Awareness for Stress Relief • Mindfulness Based Stress Reduction (MBSR) • Stress Management & Resiliency Training Program (SMART)

Other • Acupuncture and You, Perfect Together • What is Integrative Health – A Five Pillar Overview

A full class schedule based on our Five Pillars is offered and includes classes such as:

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At Hackensack Meridian Integrative Health & Medicine, the coaching process is built on an exploration of our Five Pillars.

BENEFITS OF HEALTH COACHING Increased life satisfaction Increased self-awareness Personal growth Improved overall health, motivation,

empowerment Coach serves as an accountability partner Develop sustainable lifestyle change Whole person approach Live a healthy, energized life Become your best self

FUTURE OF HEALTH COACHING Our vision for the future is to position our Integrative Nurse Health Coaches to be at the forefront of a new paradigm that includes health and well-being promotion. Our Integrative Nurse Health Coaches recognize the economic, nutritional, environmental, social, and cultural challenges impacting individuals, families, and the communities we serve.

HEALTH COACHING

Integrative Nurse Health Coaches: Kathleen Welshman, Sara Scheller, Marjorie Catone, Pamela Jansky

The role of a health coach is to partner with people to create and implement a plan for positive change towards optimal well-being. In addition to providing a structure of support and accountability, coaches assist people to generate solutions and strategies that are aligned with the larger context of their life, so they can experience sustainable lifestyle change. Research shows that the therapeutic presence and interaction between a nurse and patient can be a healing moment, providing comfort, support, and lowering the stress response. An Integrative Nurse Health Coach promotes wellness and resiliency by guiding people to deepen the connection to their inner healing resources and their capacity to make meaningful choices to help establish goals and strategies for healthier lifestyle behaviors. All of our Integrative Nurse Health Coaches are Registered Nurses. They have achieved National Board Certification in Health & Wellness Coaching through the International Consortium for Health and Wellness Coaches (ICHWC), which is the accrediting body for health coaches.

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The Personal Resilience Empowerment Program (PREP), led by an Integrative Nurse Health Coach, is designed to assist a person in developing mind/body skills to assist in overall health and well-being. This approach to health addresses our Five Pillars. The program introduces key concepts of self-care to assist an individual to feel empowered to manage their own health by building their resilience in order to thrive.

The PREP is customized according to the needs of the attendees. The self-care skills that are taught and reinforced during each of the customized programs are based on our Five Pillars. Some examples of the tools are:

• SLEEP: Creating a healthy sleep environment at home and in the hospital; i.e., a body scan meditation for stress management and to promote relaxation

• ACTIVITY: Empowering movement/exercise to level of ability; i.e., a chair yoga routine with 8 poses

• PURPOSE: Connecting and reflecting on purpose and meaning; i.e., creating a purpose statement

• NUTRITION: Optimizing nutrition by eating food that decreases inflammation and avoiding food that increases inflammation in the body

• RESILIENCE: Recognizing the mind/body connection as it relates to the stress response in the body; i.e., practicing the 4-7-8 breathing technique to turn on the relaxation response in the body

PREP: PERSONAL RESILIENCE EMPOWERMENT PROGRAM

HEALTH COACHING

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In the PREP for people preparing for a planned hospital admission for surgery or other procedure, the coach uses the hospital admission as an opportunity for an individual to assess their lifestyle choices. In this 90-minute interactive group class, evidence-based tools for each of our Five Pillars are taught, practiced and reinforced.

HB-PREP: HOSPITAL-BASED PERSONAL RESILIENCE EMPOWERMENT PROGRAM

HEALTH COACHING

RESEARCH A clinical research project has been submitted for Internal Review Board approval: Personal Resilience Empowerment Program (PREP) in the Perioperative Setting of Surgically Treated Cancer Patients. Following the attendance of the group class, a person receives individual coaching support around behavior and lifestyle interventions from an Integrative Nurse Health Coach through five in-person and over the phone sessions before the hospitalization, during the hospital stay and in the post-operative recovery period. The goal of this project is to investigate whether using the PREP as an intervention delivered by a Integrative Nurse Health Coach in patients diagnosed with cancer would result in:

• improving knowledge and awareness related to our Five Pillars • empowerment to manage one’s own health and well-being • decreased usage of pain medication and more rapid return to previous

functional status according to Eastern Cooperative Oncology Group (ECOG) The study will include 30 - 50 patients over approximately three months and will take place at Jersey Shore University Medical Center.

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The Behavioral Health Personal Resilience Empowerment Program is an eight-week group coaching program designed to work with the Behavioral Health Home clients. The program consists of clients with a persistent mental illness, as well as a chronic medical condition. The purpose of the group coaching is to empower clients to live sustainable healthy lifestyles, through education regarding our Five Pillars. Clients develop a SMART (Specific, Measurable, Action-oriented, Realistic, Timed) goal each week. At the end of the program, clients will have developed their self-care plan.

BH-PREP: BEHAVIORAL HEALTH PERSONAL RESILIENCE EMPOWERMENT PROGRAM

Behavioral Health Home Team Members: Paula Degesero, Kerry Kornett, Dana Boettinger, Kimberly Olenczuk, Diane Dandeo. Not pictured: Melissa Card

BH Integrative Nurse Health Coach: Kathy Welshman

HEALTH COACHING

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• MBSR: Mindfulness-Based Stress Reduction Program

• SMART: Stress Management and Resiliency Training

• CBT-I: Cognitive Behavioral Treatment for Insomnia

• The Learning Gardens

• MCVTS (Middlesex County Vocational Technical School) Culinary Arts Program

PROGRAMS

Hackensack Meridian Integrative Health & Medicine

provides several signature programs to enhance an

individual’s health and well-being:

PROGRAMS

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Sleep is one of our Five Pillars. When we don't get enough sleep, our risk increases for weight gain, motor vehicle accidents, mood disorders, decreased quality of life, and conditions such as heart disease, dementia, and stroke. Insomnia is one of many sleep disorders. It is treatable, and the first line of intervention is behavioral.

Cognitive Behavioral Treatment for Insomnia (CBT-I), is at least as effective as medication, with sustainable results that last after the treatment has concluded, without the side effects that medication can bring on.

Hackensack Meridian Integrative Health & Medicine has partnered with Dr. Adrian Pristas, Corporate Medical Director HMH Centers for Sleep Medicine, and our sleep centers and primary care practices, to bring these cutting edge sleep restoration interventions to our patients in the community we serve. CBT-I utilizes a number of strategies which help to reverse the vicious cycle of insomnia and break the negative patterns that maintain it over time.

Through initial evaluation we assess if CBT-I will be helpful, and customize a treatment that is based on the patient's needs, as well as refer to one of our sleep centers. We tailor or expand the treatment to include interventions such as nutrition and supplements, integrative medicine consultation, acupuncture, massage, health coaching, activity, and stress-management.

CBT-I: COGNITIVE BEHAVIORAL TREATMENT FOR INSOMNIA

PROGRAMS

Health Psychologist: Lisa Sussman, Psy.D.

Our health psychologist, Lisa Sussman, Psy.D., has undergone training on CBT-I through the University of Pennsylvania Sleep Medicine Program. In addition, Dr. Sussman is participating in the CBTH4Fatigue Study, which is run through the Integrative Behavioral Medicine Program at the Icahn School of Medicine at Mount Sinai and funded by the National Cancer Institute. The goal of this study is to evaluate the effectiveness of CBT and Hypnosis for women with breast cancer who experience fatigue due to radiotherapy.

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MBSR: MINDFULNESS-BASED STRESS REDUCTION PROGRAM

Jon Kabat-Zinn, Ph.D., developed the Mindfulness-Based Stress Reduction (MBSR) program in 1979 at the University of Massachusetts Medical Center. Since its inception, MBSR has evolved into a common form of complementary medicine addressing a variety of health problems. The central focus of the program is intensive training in mindfulness meditation and its integration into the challenges/adventures of everyday life.

The 8-week course teaches attendees skills to reduce stress by tapping into their own natural resources. This evidence-based program has helped many participants to practice positive behavior changes, reverse stress related health problems and improve quality of life. Participants learn how to use their innate resources and abilities to respond more effectively to stress, pain, and illness.

Hackensack Meridian Integrative Health & Medicine offers this program at various convenient locations throughout our system.

SMART: STRESS MANAGEMENT AND RESILIENCY TRAINING

The SMART program teaches self-care practices that help buffer daily stress, making participants less emotionally and physically vulnerable to illness. This program is designed to help participants regain control and build resilience through a variety of mind-body principles and self-care interventions, leading to reduced medical symptoms and enhanced quality of life. The program is administered over eight weekly two-hour group sessions.

In a recent survey conducted by the National Emergency Medical Services (EMS) Association, 86% of EMS workers surveyed reported “critical stress” as a result of their job and 37% contemplated suicide. In response to this, we have launched a pilot project providing our SMART program for local EMS workers, police and fire department. The health and well-being of EMS providers is an imperative to the health and well-being of our community.

We have established a partnership with Robert Clawson, Corporate Manager Life Support Training Center. Previously, he was the clinical manager and paramedic for Monmouth Ocean Hospital Service Corporation and served as a research scientist at the New Jersey Department of Health and Senior Services in their Division of Health Infrastructure Emergency Preparedness Response. Mr. Clawson is well known in emergency response and police departments and recognizes the opportunity and value in partnering with us for SMART training for these valued members of our community.

PROGRAMS

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In an effort to encourage healthy eating and proper nutrition, Raritan Bay Medical Center (RBMC) Perth Amboy, started The Learning Gardens program. Now in its third year, the mission of The Learning Gardens is to educate RBMC team members and the community about the importance of eating fresh produce as part of a healthy diet and provide instruction on gardening through hands-on and interactive education. The container garden education program is funded and supported by the RBMC Medical Staff and has received strong support from hospital administration. Numerous team members and community volunteers assist with planting, watering, weeding, and harvesting. Guidance and education is provided by Integrative Health & Medicine team members and our Master Gardener Constance Elek. The Learning Gardens serves many purposes and provides an opportunity for everyone to not only learn the basics of gardening and nutrition, but also get some exercise, socialize, and empower them to create their own gardens at home.

The Learning Gardens has led to a collaboration with the Culinary Arts Program at the Perth Amboy campus of the Middlesex County Vocational Technical School.

THE LEARNING GARDENS PROGRAM

In 2016 the Middlesex County Vocational Technical School Culinary Arts Program became the first diploma granting culinary secondary school in the nation to be certified “green” by the Green Restaurant Association. Part of that designation includes the utilization of locally grown and organic produce. RBMC has an agreement to provide the school with produce from our Learning Gardens. In addition, this collaboration has resulted in culinary students working in the hospital kitchen and others volunteering at the hospital.

THE MIDDLESEX VOCATIONAL TECHNICAL SCHOOL CULINARY ARTS PROGRAM

PROGRAMS

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Chronic health conditions have become an epidemic. According to the Centers for Disease Control and Prevention, 85% of these conditions are lifestyle related. This poses a challenge for primary care physicians (PCPs), as their medical training generally does not address healthy lifestyle choices, but yet they are required to meet quality metrics that reflect these outcomes.

NETWORK-WIDE INVOLVEMENT

PRIMARY CARE INITIAVE

Quality Outcome

Measures

PCP Office Materials

(Education Materials) Classes & Public Offerings IHM Direct Services

CMS122V5-Diabetes:

Hemoglobin A1C poor

control (>9%)

Anti-Inflammatory Diet

Blood Sugar Balance

Healthy Weight Loss

Building Balanced Meals

Five Pillars of Health

Sugar Blues

Are You Really Healthy?

Active Life

De-Stress

Health Coaching

Nutrition Consultation

Nurse Practitioner (NP)

Consultation

CMS159-Depression

Remission at Twelve

Months

4-7-8 Breathing and Offer

Gratitude

Centering for Stress

Reduction

Positive Statements

Unhelpful Thinking Habits

with Alternatives

EFT Handout

Healing Awareness Practice

Introduction to

Mindfulness

EFT

MBSR

Active Life

De-Stress

Are You Really Healthy?

Health Coaching

Health Psychology

Acupuncture

Chronic pain

(System Wide

Initiative

non-CMS Metric)

Managing Pain Without

Medication

Beginners Guide to Getting

Acupuncture

Beginners Guide to

Mindfulness & Meditation

Five Pillars of Health

Introduction to

Mindfulness

EFT

MBSR

Active Life

De-Stress

Are You Really Healthy?

Gentle Yoga, Tai Chi

Acupuncture and You

Creating An Active Life

Reiki

MD or NP Consultation

Health Coaching

Health Psychology

Acupuncture

Massage therapy

Nutrition Consultation

Recognizing the burden on PCPs, we are collaborating with them to both support them in meeting their regulatory requirements and advancing the health and well-being of the patients we all serve.

We have designed a method for PCPs to determine how incorporating our Five Pillars positively impacts their ability to meet the quality metrics. See matrix.

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NETWORK-WIDE INVOLVEMENT

With the increase of chronic disease in children ages 4 – 17, parents are seeking additional options to minimize invasive and pharmacological interventions. A 2012 National Health Interview Survey (NHIS) identified approximately 12% of the pediatric population is utilizing integrative health and medicine approaches. In response to this need, we have developed a partnership with HMH pediatricians to educate and train them in integrative approaches and to customize our services for children.

In 2018, we will submit a grant to the Weil Foundation to fund pediatricians in the training of integrative pediatrics. The Weil Foundation is a long-term funding mechanism for the advancement of integrative medicine through training, research, the education of the public, and policy reform.

PEDIATRIC CARE

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NETWORK-WIDE INVOLVEMENT

INTEGRATIVE APPROACH TO CANCER CARE

We understand that receiving a cancer diagnosis is a very personal and sensitive issue. We provide patients with a range of treatments in caring environments that respect their individual needs. We hosted an event inviting patients to learn integrative approaches to cancer care based upon our Five Pillars. Current and past cancer patients, caregivers, and family members attended a variety of workshops and hands-on demonstrations with our integrative health experts: • Acupuncture • Nutrition • Mind/body therapies (biofeedback, mindfulness,

meditation) • Relaxation techniques • Movement therapy (yoga, tai chi, qigong) • Aromatherapy • Art therapy • Energy therapy (reiki, healing touch) • Pet therapy This event took place at the recently expanded Jane H. and John Booker Cancer Center at Riverview Medical Center in March 2017.

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We thank Dean’s Natural Food Market for their generous donation of fresh produce and providing juice demonstrations and samples for this event.

NETWORK-WIDE INVOLVEMENT

In 2016, HMH launched the Second Victims committee to develop our approach to support team members who had been part of a traumatic event at work. In 2017, the Second Victim committee developed the HMH program, WeCare.

The WeCare team provides a form of “emotional first aid” specifically designed to provide crisis support and critical incident stress management interventions for health care events that are emotionally challenging and stressful. Hackensack Meridian Integrative Health & Medicine has created a resiliency component that will be part of the WeCare response team’s toolkit.

Melissa Harker, Education and Training Manager, and Lori Knutson, Administrative Director, are Second Victim Committee Members.

SECOND VICTIMS: WECARE PROGRAM

WeCare Kit includes: Sleep:

• Calm Aromatherapy sticks

• Sleep masks

Activity

• Instruction cards for stretching and gentle

yoga poses to decrease physical stress

Purpose

• WeCare Journal to record feelings associated

with experience

• Affirmation cards with positive and

encouraging statements

Nutrition

• Instruction cards listing anti-inflammatory

foods to promote the healing process

Resilience

• Instruction cards with breathing techniques

to decrease the stress response and increase

the relaxation response

• Adult coloring books to reframe the mind

from stressful events

Other

• Contact information for the Integrative Nurse

Health Coach

• Information on the HealthStreams®

Mindfulness module (and other Integrative

Health & Medicine modules for self-care) 21

SETON HALL HACKENSACK MERIDIAN SCHOOL OF MEDICINE

The new Seton Hall Hackensack Meridian School of Medicine is offering an innovative team-based approach to medical education that mirrors how healthcare is being delivered in the future. Graduates learn to apply the most advanced scientific knowledge and tools to assist patients in their communities as well as in hospitals and clinics in New Jersey and beyond.

Hackensack Meridian Integrative Health & Medicine plays a significant role in building the integrative medicine components for the medical school. Our Medical Director, Dr. David Leopold, is a faculty member on the curriculum development team. The curriculum is based on the Human Dimension, a framework for United States Army to Optimize Human Performance.

Through immersive and longitudinal experiences, students understand the role of community and social determinants of health and well-being, as well as the role of the physician in all elements that contribute to promoting health and preventing disease.

NETWORK-WIDE INVOLVEMENT

Integrative medicine is an approach to healthcare that places the patient at the center and attempts to address the totality of the individual including physical, emotional, socioeconomic, spiritual; and environmental influences which directly and indirectly affect the health of the individual.

Curriculum Overview: Introduction to Integrative Health and Medicine Clinician Wellbeing Motivational Interviewing Introduction to Nutrition Mind-Body Foundations Spirituality Integrative Sleep Health Common Dietary Supplements Environmental Medicine Physical Activity Integrative Management of Chronic Conditions Ethical, Business and Legal Issues Whole Systems Contemplative Care/Death & Dying/Palliative Medicine Clinical Application and Case Study

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Integrative Health & Medicine in partnership with Georgian Court University (GCU) – Hackensack Meridian Health School of Nursing collaborated to offer a weeklong Heathy Campus Healthy Community conference in April 2017. The conference week was based on our Five Pillars, exploring ways to create a culture of health on the college campuses and empower the students and community to live the healthiest lives they can. The final day of dialogue featured interactive sessions with Sara Scheller, Integrative Nurse Health Coach, and a presentation on “Creating a Resilient Life on Purpose”.

NETWORK-WIDE INVOLVEMENT

GEORGIAN COURT UNIVERSITY

In addition, we developed an integrative health and medicine curriculum for the new graduate Nurse Residency program. The course is taught as part of their monthly didactic day of curriculum and covers the fundamentals of our Five Pillars. The nurse residents learn about mindfulness and self-care as tools to help them as they transition from academic clinical experiences to actual practice in acute care with full patient accountability.

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CARING SCIENCE/CARING THEORY TRANSFORMING SELF AND SYSTEM FROM INSIDE OUT

NETWORK-WIDE INVOLVEMENT

Our team presented the following topics: • Overview of Integrative Health & Medicine -- Shaping the Resilient Nurse, Lori Knutson,

Administrative Director • Cultivating Well Being: Creating Your Self-Care Plan, Sara Scheller, Integrative Nurse Health Coach • Integrative Healing Arts Academy™ Program and the Launching of the Health and Wellness

Council, Marie Feiter, Hospital & Care Transformation Integration Manager

With the HMH Nursing Department in September 2017, we created an extraordinary opportunity to host Dr. Jean Watson, Ph.D., RN, AHN-BC, FAAN, world renowned nurse theorist and nursing professor who is best known for her Theory of Human Caring. Caring Science values, ethics, and philosophy contribute to “the search for new vision to sustain caring for humanity” and the evolved caring consciousness and intentionality for humankind. Three hundred HMH nurses attended the event which included a workshop and presentation that focused on whole person health and healing.

Marie Feiter, Lori Knutson, Dr. Jean Watson, Dr. Maureen Sintich, Sara Scheller

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THE INTEGRATIVE HEALING ARTS ACADEMY™ (IHAA) PROGRAM

Our partnership with The BirchTree Center for Healthcare Transformation delivers three cohorts for The Integrative Healing Arts Academy ™ (IHAA) Program that run from September 2017 to May 2019. The intent of this customized program is to bring a more holistic approach to the bedside and provide a non-pharmacological approach to pain management.

The IHAA is designed to prepare nurses for pivotal roles in the emerging healthcare paradigm. This is an in-depth program in which participants are engaged in creating caring cultures and healing environments within their hospitals. The program brings nurses back to the essence of nursing practice and teaches the foundations and principles of holistic nursing. Managing clinical issues of pain, anxiety, nausea, stress and sleep is an ongoing challenge in the acute care environment. Health care systems are looking for more efficient, cost-effective ways to improve patient outcomes. This program teaches nurses how to deliver integrative therapies at the bedside.

Benefits and Outcomes of the IHAA Program:

• Develop an integrative therapy skillset for use in acute care setting

• Improve pain management through non- pharmacological interventions

• Increase nurse engagement and retention

• Increase patient satisfaction

• Prepare nurses for the holistic board certification exam

NETWORK-WIDE INVOLVEMENT

Participants were overwhelmingly impacted by the program’s first session:

• “This is the nursing we’ve been waiting for”

• “The entire experience was impactful. The importance of self-care to create the compassion, culture, and healing environment is a priority in nursing”

• “Coming to realize the connection we all have to our patients and each other and the power we all have inside…we just need to harness it. I feel humbled by the whole experience.”

• “This program is a great gift, extremely uplifting and transformational. It is beneficial to develop a self- care focus and practice which would transform their ability to care for patients and families and renew their commitment to their nursing careers and help them to grow and develop personally and professionally.”

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First cohort nurses pictured below.

The Academy of Integrative Health and Medicine is part of the HMH HealthStream® learning management system. Team members in all job categories have access to the curriculum and are able to work through and internalize the didactic information at their own learning pace. The training modules created in all three domains: cognitive, affective and psychomotor. They are designed to address the learning needs of the auditory, visual, and kinesthetic learner. The use of our learning management system provides us with quantitative and qualitative data measurement in many different domains.

NETWORK-WIDE INVOLVEMENT

HMH ACADEMY OF INTEGRATIVE HEALTH AND MEDICINE

A central component of 2017 was preparing for the rollout of Epic electronic health record build. Our program was selected to be in the first wave of implementation for outpatient clinics. Being a new program, we had the opportunity to build the Integrative Health & Medicine documentation templates. In addition, we needed to develop tools that insurers and health care providers would find transparent and useful in order to validate and measure clinical

EPIC ELECTRONIC HEALTH RECORD

effectiveness and improved outcomes for patients and health care practitioners. We developed a note structure to optimally capture our Five Pillars approach and track data to demonstrate effectiveness of treatment. We will utilize Epic as an information technology platform to demonstrate success.

TECHNOLOGY PLATFORMS

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A major highlight included a moderated discussion and Q & A with best-selling author and entrepreneur Bobbi Brown about her new lifestyle platform that celebrates confidence and wellness. The free event also featured inspirational talks by local “womenologists’’ and several HMH experts, including our health psychologist, Lisa Sussman, Psy.D. Two dozen food, health and wellness vendors offered interactive activities, tips, and giveaways focused on our Five Pillars. Some of the activities included: sleep tips from leading experts; yoga, tai chi, and dance demos; cooking demonstrations; meditation pod; mindful labyrinth walk; and assessing life goals. HMH partners, Cumulus Radio (NASH-FM), Townsquare Media (94.3 The Point), and Sky Blue FC were vendors as well, bringing their streets teams, on-air personalities/players, and interacting with the crowd. The second class of Women Who ROCK winners were inducted into the Hall of Fame for their dedication and commitment to their communities, families and friends.

WOMEN ROCK NETWORK-WIDE INVOLVEMENT

HMH held the 2nd Annual Women ROCK event in October 2017 at Asbury Park Convention Hall & the Paramount Theatre to help women of all ages enjoy a day dedicated to well-being, fun, friendship and inspiring ways to live. An estimated 1,040 people attended.

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NATIONAL MEMBERSHIP ORGANIZATIONS

In 2006, The Culinary Institute of America (CIA) and Harvard T.H. Chan School of Public Health — Department of Nutrition launched the Healthy Kitchens, Healthy Lives® conference, to provide medical professionals with state of the science updates relating to nutrition science, exercise and movement, mindfulness, and health coaching. These presentations are interspersed with culinary instructors from the CIA demonstrating how health-enhancing take-home messages can be translated into the preparation of healthy, delicious, easy-to-make, affordable, sustainable recipes.

Hackensack Meridian Integrative Health & Medicine is a Member of the Teaching Kitchen Collaborative, whose mission is to advance personal and public health through culinary literacy and integrative lifestyle transformation.

Hackensack Meridian’s Women’s Heart Fund generously supported 15 HMH team members (including 12 physicians) to attend the Healthy Kitchens, Heathy Lives® conference in Napa Valley, CA in February 2017. The conference is an annual gathering of physicians, registered dietitian nutritionists, nurses, and other healthcare professionals whose goal is to bridge nutrition science, healthcare, and the culinary arts.

Hackensack Wellness Center and Integrative Health & Medicine hosted David Eisenberg, M.D., Course Co-Director, Director, Culinary Nutrition, Harvard T.H. Chan School of Public Health, as he presented The Science of Nutrition as Medicine lecture to physicians and other healthcare providers earning Continuing Medical Education credits. The lecture taught how to provide nutritional guidance to patients with proven teaching techniques that will improve how patients can create exciting and highly desirable healthy food.

TEACHING KITCHEN COLLABORATIVE

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Dr. Sylva Takvorian, Lori Knutson, Dr. David Eisenberg, Dr. David Leopold, Jason Kreitner, VP Senior Operations Officer, Catherine McDougall, RN, Operations Manager Wellness Center

Our membership in the Consortium provides national opportunities for collaborations in research, education, and training. The Academic Consortium for Integrative Medicine & Health recognizes the opportunity to affect the direction, assumptions and outcomes of healthcare. The involvement of strong academic institutions and their representatives allows them to provide a forum for those committed to the values of integrative medicine. The Consortium provides the cohesion necessary to maximize individual institutional efforts, and also move the field forward in a way that no one institution is able.

NATIONAL MEMBERSHIP ORGANIZATIONS

Hackensack Meridian Integrative Health & Medicine was inducted as a Member of the Academic Consortium for Integrative Medicine & Health in 2017. The Consortium’s mission is to advance integrative medicine and health through academic institutions and health systems.

ACADEMIC CONSORTIUM FOR INTEGRATIVE MEDICINE & HEALTH

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Hackensack Meridian Integrative Health & Medicine launched the Health & Wellness Series in sponsorship with the historic Count Basie Theatre to promote physical, emotional, mental, social, spiritual and environmental wellness through the arts. The arts are an imperative part of the health and well-being of the whole person – mind, body, and spirit.

BASIE HEALTH & WELLNESS SERIES

Author and renowned alternative medicine advocate Deepak Chopra lectured in November 2017, and Eat Pray Love author and self-help champion Elizabeth Gilbert visits the theater in March 2018. Two additional speakers aligning with our Five Pillars will also give talks in 2018.

Dr. Mimi Guarneri, president of the Academy of Integrative Health & Medicine and author of The Heart Speaks, presented “Find Your Happy, Find Your Healthy: The Heart Speaks” in August 2016. Dr. Mimi Guarneri revealed ground breaking new research that healing the heart can have more to do with healing the mind and soul than we've ever known.

COLLABORATIONS

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Fulfill, formerly the Monmouth Ocean Food Bank, has had an existing relationship with HMH for years. Their recent name change has shifted their mission to not only being a resource for food insecure community members, but to also provide healthy meals and education on nutrition to those they serve. Hackensack Meridian Integrative Health & Medicine began their affiliation with Fulfill through the Women ROCK event. Fulfill chef Ray Cattley worked with our staff to create a healthy recipe that he demonstrated live at the event. In addition, at Women ROCK, attendees brought a healthy food item donataion and we offered massages at $1 per minute to benefit Fulfill. Through that event, we raised over 1600 meals for our community. We are involved in their chef training program and collaborating on other opportunities for providing education on healthy nutritious meals for all.

Count Basie’s Mind Aligned program is an arts integration pilot program serving six school districts in Monmouth and Ocean counties. We have partnered to infuse mindfulness education into the specific lessons being taught to the teachers, who will be teaching the lessons to their students. The program also includes a health coaching component, providing an Integrative Nurse Health Coach available to teachers to assist in their own self-care. Trained instructors attend professional development days to teach the teachers the lesson strategies, which can be used across multiple curriculums.

MIND ALIGNED

FULFILL

We are working with Shop Rite of Jackson and Dean’s Natural Food Market to conduct grocery store tours by our nutritionists or medical director. Participants learn to incorporate healthy meal planning and grocery shopping for a healthy diet. Attendees have hands-on application and visual demonstrations of foods to incorporate into their diet while walking through aisles of the supermarket. These tours are designed for community members who would like to learn more about food labels, specific healthy foods, and how to grocery shop for a healthy lifestyle.

GROCERY STORE TOURS

COLLABORATIONS

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Purpose is the foundation of our Five Pillars. In January 2017, we hosted a think tank with national experts to help us develop our philosophy and our practice for the Purpose Pillar. Our distinguished guests included:

COLLABORATIONS

THE POWER OF PURPOSE

Eric Kim, Ph.D., recognized by Forbes’ 30 Under 30 in Healthcare, Research Fellow, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, has received multi-million dollar grants to research the topic of Purpose and its relationship to health outcomes such as personal growth, optimism, resilience, positive emotions.

Richard Leider is widely recognized as one of America's preeminent executive-life coaches. His book, The Power of Purpose, was featured as a PBS special. As a Senior Fellow at the University of Minnesota’s Center for Spirituality and Healing, he founded The Purpose Project.

Christine B. Whelan, Ph.D., Clinical Professor, Department of Consumer Science, University of Wisconsin - Madison and author of The Big Picture: A Guide to Finding Your Purpose in Life. Dr. Whelan is a nationally recognized thought leader on purpose-focused approaches to health.

In addition, we were honored to have our HMH Behavioral Health senior leaders present: Ramon Solhkhah, M.D., Co-Network Medical Director Behavioral Health and Joseph Miller, Ph.D., FACHE, VP Behavioral Health.

We are grateful for the George Family Foundation’s gift which supported this inspiring think tank.

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COLLABORATIONS

Shanghai Forum invites leaders of the world’s top companies and institutions to form an international advisory group. Our Administrative Director, Lori Knutson, was invited to give a talk on “Integrative Health and Medicine: A Catalyst for Healthcare Transformation” at Fundan University in May 2017.

The Leadership Program in Integrative Healthcare at Duke University is a one-year robust, combined in-person and distance-based leadership development and mentoring program for Integrative Healthcare leaders that teaches the knowledge and skills necessary to successfully develop, launch, lead, sustain, and grow an Integrative Healthcare culture across all healthcare settings.

Shanghai FORUM 2017

Seeking Innovation in Change

Lori Knutson, Administrative Director, is co-creator and core faculty at Duke University’s Leadership Program in Integrative Healthcare.

SHANGHAI FORUM

DUKE INTEGRATIVE MEDICINE

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We actively connect with key community leaders to create awareness about the services and programs at Hackensack Meridian Integrative Health & Medicine.

The kick-off event, Today, Tomorrow, The Future, formally introduced the Integrative Health & Medicine program to community members and legacy Meridian leaders at Two River Theater in April 2016. Attendees learned about the Five Pillar Care Model from Tim Hogan and Lori Knutson, visited Wellness Stations, received a Five Pillar Self-Care Kit, and enjoyed an evening of healthy food and fun.

Joseph Stampe, President Meridian Foundation, Joan and Bob Rechnitz, Tim Hogan, Regional President

FRIENDRAISING: COMMUNITY SUPPORT BUILT ON PASSION, PURPOSE, COMMITMENT, AND GENEROSITY

FRIENDRAISING

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FRIENDRAISING

Dr. David Leopold, Lori Knutson, Dr. Ken Verni, Mary Burke, David Graham

Hackensack Meridian Integrative Health & Medicine is grateful to Mary Burke and David Graham for hosting a healthy dinner reception to introduce our program’s Medical Director, Dr. David Leopold.

Dr. Leopold was joined by chef and psychologist Dr. Ken Verni as he prepared several dishes and discussed the relationship between mindfulness and food during this transformative evening.

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Board members and friends of Riverview Medical Center Foundation enjoyed an evening at Undici Taverna Rustica, a local fine restaurant, where they learned about the exciting developments of our program, which is dedicated to empowering community members with the healthy balance of mind, body, and spirit. Many thanks to Jonathan Schultz, Board Member, Riverview Medical Center Foundation, for making this evening possible.

FRIENDRAISING

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FRIENDRAISING

Internal friendraising is important to build strong referral partnerships. We hosted two physician engagement luncheons for the health care professionals at the Hackensack Meridian Health Village at Jackson. Attendees were invited to get to know our practice philosophy and meet our clinicians.

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ADVERTISING

Print vehicles Asbury Park Press Count Basie Theater Showtime playbill HealthViews Industry Jackson Times KidViews Living In Monmouth County Monmouth County Woman Ocean County Woman Sickles Farm & Table St. Aloysius weekly bulletin The Monmouth Journal Toms River Times Two River Times Two River Theater playbill

Outdoor billboards Townsquare radio interviews and ads

COMMUNICATION CHANNELS

THE BRAND IN ACTION

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DJs Lou & Liz with Dr. David Leopold

DJ Shawn Michaels with Dr. Vivian Kominos

THE BRAND IN ACTION: PRINT ADVERTISING CAMPAIGN

2016 - 2017

COMMUNICATION CHANNELS

2018

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COMMUNITY OUTREACH

Community Outreach efforts in 2017 have focused on building relationships in each of the following spokes: schools, faith based organizations, civic organizations and employers. We have touched over 6,000 community members through our outreach programs, lectures, health fairs and special events. We have also identified partners who align with our Five Pillars: • Multiple school districts to provide programs for teachers on self-care through professional

development days • Count Basie’s Mind Aligned pilot program to infuse mindfulness into arts integration lessons • St. Aloysius Roman Catholic Church in Jackson: provide screenings and educational programs

for their 5,000 parishioners • Fulfill, the Monmouth & Ocean Food Bank: partnering on community education programs in

line with our nutrition pillar

COMMUNITY OUTREACH: PROFESSIONAL EDUCATION/HMH LECTURES

• Abridged Nurse Residency Program • Bayshore Palliative Care Presentation • Caring Science/Caring Theory • Celebration of Life Event • Celebration of Life Luncheon • Cultivating Well-Being for Leadership:

Creating your self-care plan • Cultural Ambassador Program • Director of Nursing Retreat • EPIC Town Hall Meeting • Intern Orientation: Introduction to PREP • Introduction to IHM/PREP • Introduction to Integrative Health & Medicine

for BCH Nurse Council • NJ Center for the Healing Arts • Nursing Grand Rounds at JSUMC in CVICU • Nursing Oncology Update • Nursing Orientation • Nursing Residency: Supporting the Caregiver • Overview of IHM

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COMMUNITY OUTREACH

• 2017 NJSPA Fall Conference • Acupuncture and You • Are you Really Healthy? A Five

Pillar Interactive and Integrative Approach to your Ultimate Wellness

• Asbury Fresh Farmers' Market • Breast Cancer Survivor Support

Group Lecture • Brick Township HS Career Day • Cancer Survivorship

Celebration • Cooking with Heart • Cancer Care Event • Celiac Disease: The Facts • De-Stress to Feel Your Best This

Holiday Season • Food as Medicine • Four Seasons at Manalapan • Fulfill Wellness EFT Demo

• Garden Side Chat • Grocery Tour: Shop with a Doc • Grocery Tour: Shop with Nikki

the Nutritionist • Health Fair • Healthy Campus Healthy

Community Conference • Incorporating Mindfulness to

Build Self-Resilience • Integrative Approaches to

Cancer Care • Integrative Nutrition • Integrative Health and

Medicine, A Five Pillar Approach to Patient Care

• Jackson Health Village Diabetes • Jackson School District

Professional Development • Joyful Heart Tea • Mended Hearts Support Group

• New Monmouth School Day • NHS Jump Start Lecture • NJ State Association

Occupational Health Nurses • Physician Luncheons • Popular Diets Demystified • Resilience! Learning to Love

our Stress and Ourselves! • Reiki, Relaxation and Resilience • Science of Nutrition as

Medicine • Stress Management • Successful Sleep • The Learning Gardens • Understanding Mindfulness • Women's Health Night • Women ROCK

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ADMINISTRATIVE LEADERSHIP TEAM:

Lori Knutson, RN, BSN, HNB-BC Administrative Director Marie Feiter, RN, BSN Hospital & Care Transformation Integration Manager Wendi Goble Practice Manager, Outpatient Clinic Melissa Harker, MSN, RN, BC Education and Training Manager Kathy Hendrick, MBA Business Manager Anastasia Kerris, MBA Marketing Manager

David Leopold, M.D., DABFM Medical Director Paula O’Neill, M.S., RN-BC Clinical Program Manager Nina K. Regevik, M.D., FACP, ABIHM Co-Director, Division of Integrative Health Medical Director, Division of HIV Services Michelle Stacy Administrative Assistant Lisa Wielgomas Community Outreach Manager

TEAM MEMBERS

ABOUT OUR TEAM

Team members at Hackensack Meridian Integrative Health & Medicine include innovative business leaders and caring health professionals who intentionally incorporate our Five Pillars in their own life and are passionate about reaching their own personal best.

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INPATIENT TEAM MEMBERS: OUTPATIENT TEAM MEMBERS:

Mary Brighton, MS, RDN Integrative Nutritionist Judson Chaney, ND, LAc Acupuncturist Angelica DiPippa Medical Receptionist Casey Gothelf Certified Medical Assistant Amy Grutzmacher, L.M.T. Licensed Massage Therapist David Leopold, M.D., DABFM Medical Director Vivian Kominos, M.D., FACC, ABOIM Integrative Cardiologist/Integrative Physician Emma Stafford, RN, APN-C, ACHPN, APHN-BC Nurse Practitioner Lisa Sussman, Psy.D. Health Psychologist Ramdra Villanueva Scribe, Certified Medical Assistant Marisa Winters MA, RDN Integrative Nutritionist

Grace Orosz, RN-BC, CCAP Integrative Health Nurse Sara Quiles Administrative Assistant Sharon Yeskel, BA Integrative Health Associate

Marjorie Catone, RN, BSN, CCRN, CSC Integrative Nurse Health Coach Pamela Jansky RN-BC, CDE, AAACN Integrative Nurse Health Coach Sara Scheller, BSN, RN, CCRN, NBC-HWC Integrative Nurse Health Coach Kathleen Welshman, RN-BC, BA, NBC-HWC Integrative Nurse Health Coach

INTEGRATIVE NURSE HEALTH COACHES:

Team building project completed at 2017 Retreat. The leaves on this tree were created by the thumb prints of our team members. Trees represent life, prosperity, and strength. The leaves represent balance, learning, growth and harmony. These values keep our team rooted as we grow and flourish.

TEAM MEMBERS

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Connect with us digitally to learn about our events and more HackensackMeridianHealth.org/IntegrativeMedicine

Hear from our providers through our weekly blog HackensackMeridianHealth.org/IntegrativeHealthBlog

Follow our social media for daily health & well-being information

HMIntegrativeHealth

Hackensack Meridian Integrative Health & Medicine

Outpatient Clinic Hackensack Meridian Health Village at Jackson

27 South Cooks Bridge Road, Suite 2-3, Jackson, NJ 08527 732-994-7855

Inpatient Services

Raritan Bay Medical Center – Perth Amboy 530 New Brunswick Ave., Perth Amboy, NJ 08861

Raritan Bay Medical Center – Old Bridge 1 Hospital Plaza, Old Bridge, NJ 08857

732-324-5257

Administrative Offices 16 Spring Street

Red Bank, NJ 07701 732-530-2573

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The Bodhi tree provides a multi-layered, rich, and complex symbol of the self and its journey towards enlightenment.