Table 2.

Framework for transforming healthcare networks to implement trauma-informed care practices

Prepare for spread

Actions:

• Engage executive leadership in supporting trauma-informed care initiatives (e.g., provide information on patient and staff outcomes)

• Designate leaders to champion the desired changes by creating partnerships with departments and/or clinical group

• Initiate early communication across the institution about why trauma-informed care is important

Questions:

• Does this institution value trauma-informed care?

• Is the institution ready for this shift in care?

• What resources are available to support training and implementation of trauma-informed care?

• What resources are available to support staff in self-care?

• Does the institution have the expertise in-house to lead trauma-informed care training or are external consultants needed?

Establish an aim for spread

Actions:

• Determine which departments/clinic groups will first receive training

• Define goals (e.g., 90% of direct care staff will complete a trauma-informed care seminar; staff confidence in preventing/minimizing medical traumatic stress will increase; patient satisfaction scores will increase; staff job satisfaction will increase)

• Set a timeline

Questions:

• What type of training will be provided?

• Will each training be tailored to that department/clinic or will everyone receive the same information?

• Will training be multi-disciplinary or discipline specific?

• How will the training be delivered?

• How will training be sustainable over time?

• How will goals be measured?

Develop, execute, and refine a spread plan

Actions:

• Determine who is/are the decision-makers about training and implementing trauma-informed care practices

• Plan for who will be responsible for the trauma-informed care training program once the decision is made to initiate training

• Identify barriers to training (e.g., no room in the lecture schedule, need for additional buy-in from leadership and providers, concerns that identifying more trauma will result in more referrals)

• Collect feedback/data as plan begins (e.g., is the training relevant, is more training needed, do departments support the implementation of the skills learned in the training)

Questions:

• What are the current attitudes towards trauma-informed care training?

• Are some trauma-informed care practices already occurring? If so, how can we build on them?

• How does the feedback/data suggest a need for changes in the training program?

• Is it best to start with one department and or should everyone be trained simultaneously?

• How are rotating trainees (e.g., residents) provided the training?

• Can cost-effectiveness be demonstrated?