With Natalie Abbott, Alexandra Buchanan, Alexandra Winter, and Susan Eller
Service and companion animals have increasingly become an important part of healthcare. Although a 2014 survey by the Human Animal Bond Research Institute reported that healthcare practitioners had a generally positive attitude towards animals, including improved job satisfaction;1,2 data are limited and information on incorporation of therapy animals as part of the healthcare team and in medical education is lacking. There are several types of animal-assisted interventions (AAIs); however, all utilize trained therapy animals and handlers and have specific therapeutic goals.a Animal assisted activities (AAAs) are typically less structured and may involve such things as a “meet and greet” with a therapy dog for inpatients; whereas a therapeutic horseback riding program (eg for individuals with cerebral palsy) is an example of animal-assisted therapy (AAT). An increasing number of studies suggest benefits of AAIs, including for pediatric patients.3 Although most studies to date are small, with mostly qualitative outcome measures, a recent multicenter investigation of pediatric patients with cancer suggested benefits of therapy dog visits including decreased heart rate.4
The principles of Crisis Resource Managementb have been extensively utilized for teamwork training in medicine; particularly in anesthesiology. Specific purposeful education in debriefing enhances communication between all members of the healthcare team. For pediatric patients in particular, we suggest that tools to decrease anxiety, improve cooperation and decrease sensory overload are beneficial. A central principle of patient-centered care is that clinical decisions are respectful of and responsive to individual patient preferences, needs, and values. As such, animals, notably therapy dogs, can be important care facilitators in the provision of patient-centered care for vulnerable patients in these settings.5,6 Although healthcare providers may be aware of AAT, currently there is minimal available information discussing techniques for incorporating therapy animals into the health care team; particularly in relatively high stress situations such as the emergency department or the perioperative setting where this may be particularly beneficial for patients and caregivers. Furthermore, tools to incorporate AAT into teamwork and simulation training in medical education are lacking. Because AAT may be particularly valuable to enhance communication for vulnerable patients, incorporation of animals into formal communication skills training for health care professionals is suggested. This presentation will utilize storytelling to recreate several clinical scenarios with low fidelity simulation and role-play. By use of the principles of Crisis Resource Management the scenarios will be discussed with a focus on the potential value of use of AAT to improve quality of care for patients by use of a shared decision-making approach. The objectives are to encourage interaction and dialogue between presenters and attendees.
