Factors that influence interprofessional implementation of trauma‐informed care in the emergency department

Abstract

BackgroundTo describe factors that influence interprofessional staff decisions and ability to implement trauma‐informed care (TIC) in a level‐one emergency department (ED) trauma center.MethodsThis qualitative research study consisted of semi‐structured interviews and quantitative surveys that were conducted between March and December 2020 at an urban trauma center. Eligible participants were staff working in the ED. Interview questions were developed using the Theoretical Domains Framework (TDF), which is designed to identify influences on health professional behavior related to implementation of evidence‐based recommendations. Interview responses were transcribed, coded using Atlas software, and analyzed using thematic analysis.ResultsKey themes identified included awareness of TIC principles, impact of TIC on staff and patients, and experiences of bias. Participants identified opportunities to improve care for patients with a trauma history, including staff training, more time with patients, and efforts to decrease bias toward patients. Most participants (85.7%) felt that a TIC plan, tiered trauma inquiry, and warm handovers would be easy or very easy to implement.ConclusionWe identified key interprofessional staff beliefs and attitudes that influence implementation of TIC in the ED. These factors represent potential individual, team‐based, and organizational targets for behavior change interventions to improve staff response to patient trauma and to address secondary trauma experienced by ED staff.

Realizing the promise of trauma‐informed care through hospital staff support programs

“…In their recent publication, Dr. Lewis-O'Connor and colleagues' findings offer a nuanced consideration of the challenges and great opportunities for trauma-informed care (TIC) models in emergency departments. 1 We applaud their efforts and the editors for highlighting a strong example of qualitative research that offers actionable guidance for supporting victims of trauma, whether these victims are patients or staff.…”

“…Scott A. Simpson MD, MPH 1 Maria Schimpf MA, MT-BC 1 Evelyn Fox MPH 2 1 Division of Behavioral Health Services, Denver Health, Denver, Colorado,…”