Trauma Informed Care Training Using the Adverse Childhood Experiences Framework: Effects on Workplace and Care Environments in the Emergency Department

Abstract

Problem: Despite the high likelihood of caring for patients with a history of trauma and the volume of research to support implementation of trauma informed care (TIC), there is currently no TIC training in place for emergency department (ED) health care professionals at a Midwest Level I Trauma Center. Project Aim: This quality improvement project aims to examine the impact of a TIC training program that integrates concepts of adverse childhood experiences on health care workers’ implicit bias and workplace civility scores, as well as patient satisfaction scores, in the ED setting. Project Method: Pre- and post-survey design using a convenience sample of ED staff in an urban Level I Trauma Center is employed. Measures of central tendency, independent-samples t-test scores, and other descriptive statistics are analyzed. Project Results: Results indicate that implicit bias improved, workplace civility declined and patient satisfaction scores did not change. Statistical significance could not be calculated for any measures due to small sample size. Conclusion: Practitioners in all settings can benefit from utilizing a TIC approach by, at a minimum, embracing the application of “universal precautions” and the paradigm shift from asking, “What is wrong with this person” and asking instead, “What happened to this person?” Future research would benefit from a mixed-method or randomized control design with larger sample sizes. Keywords: trauma informed care, adverse childhood experiences, health care worker, implicit attitudes, workplace civility, patient satisfaction