Table 4.

Closing the visit: recommendations for using trauma-informed practices to close the visit and prepare the patient for admission or disposition.

Recommendation	Rationale
Utilize shared decision making	By empowering the patient to take part in the decisions surrounding their care, the patient is less likely to feel trapped and outside of the locus of control. Several frameworks for shared decision making exist, but all models center around the deliberate consideration of advantages and disadvantages of evidenced-based options as well as the patient’s preferences and goals of care [50].
Assure appropriate resources are shared with the patient	Provide appropriate referral information to local, community, and national resources.
Utilize the teach-back method	In stressful and traumatic situations, especially when a person has a significant history of trauma or post-traumatic stress disorder, dissociation or altered or impaired memory formation can occur [51,52]. When closing a patient visit, it is beneficial to utilize strategies to help confirm patient understanding, such as the teach-back method, which has been shown to improve patient retention [53]. The teach-back method asks the patient to use their own words to tell you their follow-up and discharge instructions.
Encourage questions	Patients may have questions that they do not feel comfortable bringing up due to multiple reasons. Ask questions like “What questions do you have for me?” instead of “Any questions?” to create space for questions and make it clear that they are welcomed and expected.