Nationwide efforts for trauma-informed care implementation and workforce development in healthcare and related fields: a systematic review

Abstract

There is building evidence that Adverse Childhood Experiences without early and proper intervention leads to subsequent short- and long-term behavioral, social, physical and mental health problems. Practitioners, researchers, and healthcare systems have been implementing trauma-informed care (TIC) in a variety of health and human services settings, resulting in improvements in clinical care and prevention of illness by identifying high risk populations. This has led to positive health outcomes including improved compliance, better access to mental health services and reduced health care costs. A systematic review was conducted of studies that focused on TIC implementation in healthcare settings, statewide TIC implementation, impact of adverse childhood experiences on health outcomes, impact of TIC on health outcomes, and evaluation of TIC implementation. A search was conducted in March 2019 to identify studies in PubMed, Medline, and other online literature. We limited our search to articles published in English after 2000. This article aims to review the components of TIC phases of implementation in healthcare settings, success stories across the nation to help the readers understand the importance of a paradigm shift to improve healthcare delivery and health outcomes and to prevent illness starting from childhood with a family centered care perspective.

Collective Occupational Trauma, Health Care Quality, and Trauma-Informed Leadership

“…Implementation of TIC by health care organizations has yielded higher levels of patient (and family) engagement, satisfaction, and more successful outcomes (Brown, 2018; Oral et al, 2020).…”

“…Trauma-informed leadership is the antidote for COT (Fink-Samnick, 2021). The model has been associated with easing organizational burdens from practitioner burnout, high workforce turnover, and enhancing the quality of patient care (Knight & Borders, 2020; National Council for Behavioral Health [NCBH], 2019; Oral et al, 2020; Purtle, 2020). Using this novel approach, managers are encouraged to step in and support staff in distinct ways.…”

Optimising outcomes for complex trauma survivors: assessing the motivators, barriers and enablers for implementing trauma informed practice within a multidisciplinary health setting

“…Complex trauma is often experienced as interpersonal violence, sexual assault or child abuse [ 3 ], the rates of which are alarmingly high, both in Australia and internationally [ 3 – 5 ]. The financial cost of complex trauma to the Australian health system is estimated at $22B per year [ 6 ], a cost which increases when health services fail to make the link between complex trauma and the presenting issue [ 7 ]. Complex trauma survivors present across the whole health system, with a range of physical, psychological, and interpersonal issues [ 7 ].…”

“…The financial cost of complex trauma to the Australian health system is estimated at $22B per year [ 6 ], a cost which increases when health services fail to make the link between complex trauma and the presenting issue [ 7 ]. Complex trauma survivors present across the whole health system, with a range of physical, psychological, and interpersonal issues [ 7 ]. These include, but are not limited to, unwanted pregnancy, disability, chronic health conditions (such as cancer, liver and heart disease) [ 8 ], depression, substance use issues, and psychiatric or personality disorders [ 9 , 10 ].…”

“…A clear message from previous research is that the successful implementation of TIP requires addressing systems barriers and building workforce motivation, knowledge and skills [ 26 ], with consideration of the context in which it is being implemented [ 19 ]. Despite the growing body of evidence supporting TIP implementation in Australia and internationally [ 2 , 7 , 20 ], the majority of TIP implementation studies within the healthcare sector have been discipline and/or departmentally specific, with a strong focus on mental health and drug and alcohol services. Evidence however is limited, within a multi-disciplinary, multi-service type, community health setting, which is outside of a mental health or drug and alcohol service context.…”