Application of a Framework to Implement Trauma-Informed Care Throughout a Pediatric Health Care Network

作者：Weiss Danielle; Kassam Adams Nancy; Murray Carol; Kohser Kristen L; Fein Joel A; Winston Flaura K; Marsac Meghan L^*

来源：Journal of Continuing Education in the Health Professions, 2017, 37(1): 55-60.

DOI：10.1097/CEH.0000000000000140

• trauma-informed care
• medical trauma
• changing perceptions in medical professionals
• framework of training health care professionals
• continuing education for health professionals
• interprofessional education
• knowledge translation
• organization learning and change
• patient safety
• program planning/curriculum development
• quality improvement/six sigma/lean
• research/evaluation

Introduction: To evaluate the initial application of a recently published three-step framework for implementing trauma-informed care (TIC) in a pediatric health care network by applying Framework for Spread.
Methods: In steps 1 and 2 of the framework, we established commitment from the health care network leadership and initial interest in TIC among clinical providers (step 1), set evidence-based training goals and created the associated TIC training content (step 2). In step 3, 440 health care professionals (from 27 health care teams) participated in single-session, 1-hour training that covered the psychological impact of injury-and illness-related trauma, identification of traumatic stress symptoms, and how to respond to children exposed to potentially traumatic events. A concomitant quality improvement project allowed us to assess potential changes in training participants' favorable attitudes toward the integration of TIC and confidence in delivering TIC.
Results: Compared with pretraining, participants demonstrated increases in attitude toward TIC, t(293) = 5.8, P < .001, Cohen's d = 0.32, and confidence in delivering TIC, t(293) = 20.9, P < .001, Cohen's d = 1.09.
Discussion: Trainings were effective in achieving proximal goals targeting attitudes and confidence, thereby demonstrating the feasibility and clinical relevance of TIC training when implemented according to the three-step framework. Future research should examine methods of training to reach wide audiences to promote systematic change and evaluate changes in patient outcomes associated with providers' implementation of TIC.

• 出版日期2017
• 单位国家自然科学基金委员会