Play: Adopting a Trauma-Informed Approach to Improve Patient Care: Foundational Organizational-Level Steps

Play Strategy
What is a Play? Box

Individuals with complex health and social needs often have a history of exposure to traumatic events such as abuse, neglect, discrimination, and violence. Exposure to trauma can have lasting adverse effects on mental, physical, social, and/or emotional well-being, leading to greater incidence of health-risk behaviors, chronic conditions, and poor health outcomes. Trauma-informed care, a person-centered approach to health care, acknowledges that providers should have a more holistic picture of patients’ life situations to provide quality care. Adopting a trauma-informed approach to care has the potential to improve patient engagement, enhance health outcomes, and prevent staff burnout.

For trauma-informed care to be fully effective, changes must be made to both organizational and clinical practices and policies. Organizational practices reorient the culture of a health care setting to address the potential for trauma in patients and staff, while trauma-informed clinical practices address the impact of trauma on individual patients. Ideally, organizational changes should be made before implementing clinical changes. The goal of this play is to help practitioners understand potential organizational-level steps to begin incorporating trauma-informed care into a health care organization. This play is based on a Center for Health Care Strategies brief that offers practical recommendations for providers and other health care organizations interested in taking foundational steps to become more trauma-informed.

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How to run the Play
  1. Build awareness and generate buy-in.
    • Communicate to staff the value of trauma-informed care and its potential for improving patient outcomes and staff well-being.
    • Provide training on the impact of trauma on health and behavior for all staff, including senior leadership, clinical team members, and non-clinical employees like front-desk staff and drivers.
    • Include patients early on in the planning and awareness-building processes and solicit ongoing patient and community member feedback to inform efforts for adopting a trauma-informed approach.
  2. Support a culture of staff wellness.
    • Educate staff on secondary traumatic stress, vicarious trauma, burnout, and self-care.
    • Engage leadership to set an example and demonstrate that they value their employees’ well-being.
    • Incorporate staff wellness activities like meditation, stretching, and mindfulness exercises into meetings and daily work.
    • Promote a work/life balance by encouraging employees to take paid time off as needed.
  3. Hire a trauma-informed workforce.
    • Hire staff who embrace the values of trauma-informed care by using behavioral interviewing strategies and incorporating questions about trauma into the interview process.
    • Involve employees from diverse cultural and racial backgrounds and positions within the organization to be a part of the interview process.
    • Seek to hire staff from the community and who have similar life experiences and backgrounds as the patient population served.
  4. Create a safe physical, social, and emotional environment. Make changes to the clinical environment to improve patients’ feelings of safety and create an atmosphere that reduces the likelihood of re-traumatization. Examples include:
     
    • Physical
      • Keep parking lots, common areas, bathrooms, and entrances/exits well lit;
      • Retain low noise levels in the waiting room; and
      • Decorate with warm colors and artwork from or that represents the community.
    • Social and Emotional
      • Use positive and welcoming language on waiting room signage;
      • Encourage staff to communicate with patients in a warm and welcoming manner;
      • Understand how an individual’s culture affects how they perceive trauma, safety, and privacy; and
      • Ask patients whether they are comfortable with having the door shut during exams or meetings.
Tips and tricks
  • Adopting a trauma-informed approach to care takes time to implement and there is no one-size-fits-all approach. Take the time necessary to ensure a strategic approach tailored for your population and setting.  
  • Early on in the planning process, identify trauma-informed care champions within your organization who can generate interest in trauma-informed care and sustain momentum when adopting new organizational practices. Establish talking points for making the case to leadership for a trauma-informed approach.
  • Oftentimes, non-clinical staff like front-desk staff or security interact with patients the most and play a large role in making patients feel safe. It is important to include them and all staff in trainings and awareness-building events.
  • Gaining buy-in from senior leadership is important, as their support is needed to encourage all staff to participate in trainings, promote staff wellness through policy and practice, and other organizational changes.

Additional Resources