Tagged With "Plan of Care"
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AHRQ topic nomination and future for federal guidelines
TIHCER meeting. June 22, 2019. Thank you so much to Ellen Goldstein and Martina Jelley for allowing a brief presentation to the Oklahoma based meeting today re: the ACES TIC AHRQ topic nomination by the American College of Preventive Medicine ACPM work group. The dialog and slides from today were excellent (and I have shared some already with others). A notable quote was “all of our patients are traumatized”. Another take away is that supportive care for the effects of trauma “can reduce ED...
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Announcing Trauma and Resilience Competencies for Nursing Education
The authors are pleased to announce the Trauma and Resilience Competencies for Nursing Education. These competencies serve as a guideline of minimal expectations and reflect essential knowledge, skills and behaviors for three levels of nursing education: 1) undergraduate, 2) graduate, and 3) psychiatric nurse practitioner programs. The Trauma and Resilience Competencies, developed in 2018 at the Egan School of Nursing and Health Studies at Fairfield University in Connecticut by an Expert...
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APA Trauma Competencies - is this the latest?
Hi - a colleague just shared this - Priscilla may have access to a more recent version? Best, Megan
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August Meeting Minutes
Hello everyone, I've attached the meeting agenda from this month's call. Due to some technical difficulties, some of our meeting documentation was lost. However, we started some very important discussions on collaboration, successes in trauma informed care implementation, and obstacles we faced. I encourage everyone to continue having those conversations!
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Becoming Trauma Informed (Millstein JGIM 2020)
When I look at Victoria through a clearer lens, there are many clues—her anxiety, troubled marriage and family life, avoidance of physically intrusive examina- tions. I realize that I hardly know her at all. I focus on her health issues, and despite many stumbles, we have a nice rapport. I accept whatever she is willing to share about her tumultuous home life, but I do not ask how it all came to be so. Now I float with her in a reservoir of pain and shame.
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Becoming Trauma Informed: Validating a Tool to Assess Health Professional’s Knowledge, Attitude, and Practice
Way to go Binny! https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6831052/pdf/pqs-4-e215.pdf Simmy King, DNP, MS, MBA, RN-BC, NE-BC*; Kuan-Lung Daniel Chen, DrPH(c), MPH†; Binny Chokshi, MD‡§ Introduction: To effectively address the negative health effects of early childhood trauma and adversity, healthcare professionals and healthcare institutions must understand the impact of adverse childhood experiences and trauma on health. This study aimed to validate a tool to assess knowledge, attitude,...
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Book Review by Eve Rittenberg, MD (Trauma-informed Healthcare Approaches)
What is trauma-informed care? Often using spe- cific examples juxtaposed with cogent summarizes of the research literature, Trauma-Informed Healthcare Approaches effectively communicates the broad prin- ciples and necessary components of the TIC approach at both an individual and systems level. I find Leigh Kimberg’s 4 Cs (Calm, Contain, Care and Cope) particular useful as a mnemonic for how how to apply trauma-informed principles to clinical care.
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CA Surgeon General and DHCS Launch ACEs Aware Initiative and Website
Join a live webinar with California Surgeon General Dr. Nadine Burke Harris and Dr. Karen Mark Medical Director, Department of Health Care Services for a Medi-Cal provider introduction to the new ACEs Aware Initiative and the www.ACEsAware.org website. The Office of the California Surgeon General and the Department of Health Care Services (DHCS), in the first public unveiling of the initiative, will host a live webinar to share details of the new ACEs Aware Initiative for Medi-Cal providers...
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California Statewide Screening for Child Trauma in Primary Care [ChronicleofSocialChange.org]
California is leading the nation in our response to trauma. Newsom approved a budget in June that will help California move toward universal ACEs screening, a goal that Nadine Burke Harris has long supported. The state is setting aside about $45 million next year to reimburse Medicaid providers in the state for trauma screenings of adults and children, and another $50 million to train 88,000 primary care providers on how to administer these screenings and to respond with trauma-informed...
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Call for Grants Notification: Advancing the Science behind Childhood Adversity
Genentech is actively seeking applications for scientific project support. Click on a link below for more information and detailed instructions on submitting a Call for Grant Notification (CGN) application. NEW! CGN Application - Advancing the Science Behind Childhood Adversity (Application due on October 1, 2019) https://www.gene.com/good/giving/corporate-giving/scientific-project-support...
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Center for Healthcare Strategies: Great Practice-based Resource
I am increasingly finding myself sharing pdfs, infographics from this wonderful organization's site, I am sure most of you have seen it but just in case: https://www.traumainformedcare.chcs.org/screening-for-adverse-childhood-experiences-and-trauma/
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Change Package is Now Available!
Click here for the Change Package : Fostering Resilience and Recovery: A Change Package for Advancing Trauma – Informed Primary Care Earlier this year, to help primary care address the impacts of trauma, the National Council for Behavioral Health, with the support of Kaiser Permanente, launched a three-year initiative, Trauma-Informed Primary Care: Fostering Resilience and Recovery . “Trauma work is not new to the National Council. With effects across the lifespan, we’ve spent the last...
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#CHCSchat: Getting Started with Trauma-Informed Care
This Tweet Chat by the Center for Health Care Strategies will focus on ways health care organizations can get started on becoming trauma-informed. Join us!
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Consequences of Military Sexual Trauma for Perinatal Mental Health: How Do We Improve Care for Pregnant Veterans with a History of Sexual Trauma?
Sharing our recent editorial which includes a call for TIC in maternity care: "Nevertheless, there are ways in which VA may be able to augment the maternity care pregnant veterans receive to empower and facilitate more trauma-informed approaches to obstetric care. These include investing in programs to ensure peer support, possibly through use of mobile health technology; facilitating collaboration with maternity care providers through provision of handheld/electronic maternity records...
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Georgia Health Students Plan Trauma Informed Care Training Day, Oct. 19, 2019
Home to the Center for Disease Control, Atlanta is a city full of great minds focused on all issues related to public health. Despite this, a group of students and faculty at neighboring health professional schools including Emory School of Medicine, Emory’s Nell Hodgson Woodruff School of Nursing, Georgia State University, Morehouse School of Medicine, Mercer University School of Medicine, and the Medical College of Georgia at August University, found that education and awareness around one...
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How trauma-informed care promotes healing: Patient Narrative
So pleased that KevinMD published this patient narrative. I was encouraged to share it here as well! https://www.kevinmd.com/blog/2...romotes-healing.html By MEGAN R. GERBER, MD | CONDITIONS | JULY 26, 2019 As physicians, we face the formidable task of working with patients who appear angry, never content with care or “made better” by anything we do. They may be known as “difficult,” unpleasant, or demanding. These patients are the most challenging and often the least rewarding to care for.
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Implementation of the Adverse Childhood Experiences Conversation in Primary Care [academic.oup.com]
By Victoria Bodendorfer, Afton M Koball, Cary Rasmussen, et al., Oxford University Press, November 23 ,2019 Abstract Background Research has focused on screening for adverse childhood experiences, rather than provision of education as a part of routine anticipatory guidance. An adverse childhood experiences ‘conversation’ is one method that has not been studied empirically but represents a complimentary or alternative approach to screening which could overcome many existing barriers.
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January TIHCER Zoom meeting
Our next TIHCER monthly meeting will be on Monday, Jan 27 th (3-4p) CT. Binny Chokshi and Daniel Chen will be presenting on their recent publication, Becoming Trauma Informed: Validating a Tool to Assess Health Professional’s Knowledge, Attitude , and Practice (see attached). In addition, Binny will give us her practical wisdom on considering an adaptive leadership approach for ACEs screening. See articles attached. Martina Jelley is inviting you to a scheduled Zoom meeting. Join Zoom...
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Links from Oct. 24 webinar
For all who attended — and who watch today's webinar — thank you for taking the time to do so. Below are some links you requested. Please don't hesitate to contact me if you have other questions. ACEs science and opioid addiction: Addiction doc says: It’s not the drugs. It’s the ACEs…adverse childhood experiences. Bad news-good news: Each additional ACE increases opioid relapse rate by 17%; each ACE-informed treatment visit reduces it by 2% Dr. Sumrok cofounded Integrative Health Centers...
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Medical students' ACE scores mirror general population, study finds
A national survey published in 2014 revealed a disturbing finding. Compared to college graduates pursuing other professions, medical students, residents and early career physicians experienced a higher degree of burnout. Citing that article, a group of researchers at University of California at Davis School of Medicine wondered whether medical students’ childhood adversity and resilience played a role in their burnout, said Dr. Andres Sciolla, an associate professor of psychiatry and...
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Meeting Minutes for September 23rd
Hello everyone! I've attached the meeting minutes to this post. I want to thank Pat Rush and Audrey Stillerman for an incredible presentation on their work at the THEN Center. Just a note- our meeting was recorded and will be posted on this site. I've outlined specific time marks on the document that correlate with topics at the meeting.
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Mount Sinai Announces Center for Stress, Resilience and Personal Growth [newswise.com]
Newswise — (New York, NY – April 30, 2020 ) -- Mount Sinai Health System (MSHS), one of New York’s largest integrated health systems, announced today the launch of the Mount Sinai Center for Stress, Resilience and Personal Growth, a first-of-its-kind initiative in North America that is designed to address the psychosocial impact of COVID-19 on the mental health and lives of frontline health care providers at Mount Sinai and will serve as a model for institutions and communities around the...
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NHCVA WEBINAR: A CHANGE PACKAGE FOR ADVANCING TRAUMA INFORMED CARE IN PRIMARY CARE SETTINGS
https://www.futureswithoutviolence.org/nhcva-webinar-tic-change-package/ This webinar will provide an overview of a new Change Package, released in October 2019, for advancing trauma-informed approaches in primary care. This resource is the result of a three year initiative between the National Council for Behavioral Health (National Council) and Kaiser Permanente. Presenters will provide information about the development of the Change Package by the National Council’s transformation team...
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Opinion: All Doctors Should Practice Trauma-Informed Care [calhealthreport.org]
By Bob Erlenbusch and Drew Factor, California Health Report, November 21, 2019 “Adverse childhood experiences are the single greatest unaddressed public health threat facing our nation today,” Dr. Robert Block, former president of the American Academy of Pediatrics, has been widely quoted as saying. According to the Adverse Childhood Experiences Study, conducted in the 1990’s by the Centers for Disease Control & Prevention and Kaiser Permanente, adverse childhood experiences are common,...
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RCT of simulation-based communication training improves patient-centeredness & health risk communication
https://www.sciencedirect.com/science/article/pii/S0738399110000340 This article is one of the few (only) RCTs looking at simulation-based communication training relevant to ACEs, which included a 2-year follow-up of observed skills in medical visits.
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SW Core Curriculum - borrow elements?
We found this helpful in designing learning expeiences in GME - it's PBL & evaluated, forgive if this is duplicate information. Aspects that could translate well to UME include: 'Five primary aims of the Core Concepts portion of the CCCT include: (a) enhance practitioners’ empathic understanding of the nature of traumatic experiences (b) facilitate the development of clinical reasoning and clinical judgment in practitioners who work (or plan to work) with [trauma-exposed pts] ...(e)...
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The Heart of Trauma-Informed Care
Excellent and simple explanation of trauma-informed care in a medical setting http://closler.org/lifelong-learning-in-clinical-excellence/the-heart-of-trauma-informed-care
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The State of the Science on Trauma Inquiry
Beautifully written and well done colleagues! Lewis-O'Connor A, Warren A, Lee JV, Levy-Carrick N, Grossman S, Chadwick M, Stoklosa H, Rittenberg E. Womens Health (Lond) . 2019 https://www.ncbi.nlm.nih.gov/pubmed/31456510
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THEN presentation at our Sep 23 meeting
Looking forward to talking with everyone on Monday. Pat and I (if I am lucky enough to get out of jury duty) will present about our work at THEN (Center for Collaborative Study of Trauma Health Equity and Neurobiology) with special emphasis on why learning and teaching the basic science is essential for understanding, implementing and creating trauma-informed clinical care and systems; if we don't anchor our work in the basic (in terms of framework, communication and development of...
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TIHCER April Zoom meeting - 4/27/20, 3-4pm CST
Please join in to our next scheduled TIHCER Zoom meeting - Monday, April 27 th at 3pm Central. Our guest speaker will be Courtney Barry, PsyD (meeting will be recorded and available on our ACEs Connection Community site for those not able to join live) Dr. Barry is an Assistant Professor in the Department of Psychiatry and Behavioral Medicine and the Department of Family and Community Medicine. She is a licensed Clinical Psychologist, with a specialization in Health Psychology. She completed...
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TIHCER March Zoom meeting tomorrow!
Our TIHCER March Zoom meeting will feature Dr. Megan Gerber presenting "Is SoMe for me? Academic Use of Twitter" Megan ("Meegan") Gerber is a general internist and Associate Professor of Medicine at the BU School of Medicine. She serves as Medical Director of Women's Health at VA Boston where she is also the fellowship director and as a Senior Consultant, Comprehensive Health, Women's Health Services, VHA (VA Central Office). Megan's academic focus has been on improving outcomes and care for...
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TIHCER May Zoom meeting - Thursday, May 14, 3pm Central
Next month’s TIHCER presentation series will feature Annie Lewis O’Connor, Eve Rittenberg, and Nomi Levy-Carrick. They will be presenting: “ Trauma Inquiry and Impact of COVID-19 on Trauma Informed Care Initiatives ”. Annie Lewis-O’Connor, PhD, NP-BC, MPH, FAAN a oconnor@bwh.harvard.edu Senior Nurse Scientist, Founder & Director of the C.A.R.E Clinic, Brigham and Women’s Hospital; Instructor- Harvard Medical School Dr. Annie Lewis-O’Connor is a Board Certified Pediatric and Women’s...
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Tomorrow’s Doctors will Diagnose the Mental Toll of Climate Change [ozy.com]
By Carly Stern, Ozy, July 22, 2019. First-year medical student Anna Goshua was interviewing an emergency room physician in March to learn more about the job when she heard about a patient who had come all the way from Puerto Rico to that ER in Massachusetts for health care. Hurricane Maria had wiped out all prospects of the patient seeking care at home. A surprised Goshua pored over her Stanford University curriculum to learn more about climate migrants. She realized the school offered no...
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Trauma-Informed Care May Ease Patient Fear, Clinician Burnout [jamanetwork.com]
By Bridget M. Kuehn, JAMA Network, January 29, 2020 For many sexual assault survivors whom Anita Ravi, MD, MPH, sees as a New York City–based family physician, the prospect of even basic medical care can be frightening. Some have put off Papanicolaou tests and mammograms for years or even decades. To help them, Ravi has adopted a trauma-informed approach that works to restore patients’ trust and give them a greater sense of control over their visit. This may include asking permission before...
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Trauma Informed Care: Understanding and Responding to the Effects of Adverse Experiences Throughout the Lifespan (Webinar)
Please join the Project Co-Directors (TICHER Members) for an overview of 42 innovative and original (free to the pubic) virtual cases. These cases highlight a patient centered approach to the care of patients who have survived traumatic life experiences. Experiences that include, for example, sexual assault, interpersonal and community violence, military sexual trauma, and child abuse. The virtual cases comprise a comprehensive online training curriculum created for physicians and other...
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Trauma-informed Healthcare Approaches: A Guide for Primary Care
Our recently published book, Trauma-informed Healthcare Approaches was written to share basic principles of trauma-informed care and ACEs science with general medical practitioners and administrators. As the recent #METOO movement has demonstrated, interpersonal trauma is widespread. A growing literature has demonstrated the impact of traumatic experiences on mental, physical health and wellbeing. Trauma survivors commonly access healthcare but their histories and needs are commonly...
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Trauma-informed primary care for residents
Andrea Garroway recently joined TIHCER. She published the following article describing a brief interdisciplinary intervention to train medical residents in trauma-informed primary care at a Veterans Affairs hospital. See attached article. "We generated a trauma- informed care curriculum involving five 1- hour didactic sessions, 10- minute group reflection regarding patient interactions prior to each didactic session, and optional patient care observation and feedback."
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Trauma-informed Telehealth Podcast Interview
I enjoyed joining the Women-Centered Health Podcast hosts nursing scholars Drs. Nicole Loew and Stephanie Edmonds to talk about how to apply principles of trauma-informed care to our telehealth encounters. This is so critical during COVID-19 and beyond. http://womancenteredhealth.com/telehealth/
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Tulsa meeting outcome
This weekend brought 25+ people together in Tulsa to further the discussion around competencies and curriculum development to advance the concept of Trauma-Informed Health Care. A rich discussion ensued with presentations from a number of institutions across the country where various approaches are being considered or have been instituted to integrate these concepts into the healthcare environment. One of the hoped-for outcomes of the meeting was to begin to develop a working document around...
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Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic [jamanetwork.com]
By Tait Shanafelt, Jonathan Ripp, Mickey Trockel, JAMA, April 7, 2020 The coronavirus disease 2019 (COVID-19) pandemic has become one of the central health crises of a generation. The pandemic has affected people of all nations, continents, races, and socioeconomic groups. The responses required, such as quarantining of entire communities, closing of schools, social isolation, and shelter-in-place orders, have abruptly changed daily life. Health care professionals of all types are caring for...
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UPDATED CALL-IN DETAILS: Trauma Informed Care: Understanding and Responding to the Effects of Adverse Experiences Throughout the Lifespan (Webinar)
Please join the Project Co-Directors (TICHER Members) for an overview of 42 innovative and original (free to the pubic) virtual cases. These cases highlight a patient centered approach to the care of patients who have survived traumatic life experiences. Experiences that include, for example, sexual assault, interpersonal and community violence, military sexual trauma, and child abuse. The virtual cases comprise a comprehensive online training curriculum created for physicians and other...
Comment
Re: TIHCER April Zoom meeting - 4/27/20, 3-4pm CST
@Courtney Barry excellent presentation so grateful this was recorded so I could attend post-hoc. Have you considered retooling review as either a scoping review or an evidence map? Sometimes for areas with less published that format flies better with journals. JGIM accepts narrative reviews and is daily high impact for a primary care journal. Just a thought. Best, Megan
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Re: Center for Healthcare Strategies: Great Practice-based Resource
Thank you for sharing your experience in using the ACE findings clinically. Attached is an article describing our doing this in a 135,000 adult patient sample where the ACE Questions were integrated into a lengthy medical history questionnaire filled out at home as Step 1 of comprehensive medical evaluation. The benefits were major. Unexpectedly, colleague (but not patient) resistance was also significant. Our getting this information initially by an inert mechanism rather than face-to-face...
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Re: Excellent Harvard Health Blog Post
Excellent overview of the logic and premises behind trauma informed care written by a practicing general internist, Dr. Monique Tello.
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Re: Trauma-informed primary care for residents
Hello TIHCER Members, Please let us know when you publish an article, book chapter, etc, record a presentation, have an experience and reflections to share with us, or you want to pose a question to the community for input and feedback. This is our trauma-informed care learning community and we want to hear from you! Let us know about your successes so that we can celebrate and learn from you!
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Experience of emergency department use among persons with a history of adverse childhood experiences [bmchealthservres.biomedcentral.com]
By Eva Purkey, Colleen Davison, Meredith MacKenzie, et al., BMC Health Services Research, May 24, 2020 Background Adverse childhood experiences (ACEs) are associated with increased morbidity and mortality, lower levels of distress tolerance, and greater emotional dysregulation, as well as with increased healthcare utilization. All these factors may lead to an increased use of emergency department (ED) services. Understanding the experience of ED utilization among a group of ED users with...
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Health Risk Behaviors and Resilience Among Low-Income, Black Primary Care Patients (Family and Community Health)
By: Ellen Goldstein, PhD; Susan Flowers Benton, PhD; Bruce Barrett, MD, PhD Qualitative Findings From a Trauma-Informed Primary Care Intervention Study This study describes an intervention with low-income, Black primary care patients and their experience in changing a health risk behavior. Participant themes, including behavioral coping, personal values, accomplishments and strengths, barriers and strategies, and social support, are understood in relationship to health behavior theories. Two...
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Addressing adverse childhood experiences and health risk behaviors among low-income, Black primary care patients: Testing feasibility of a motivation based intervention (General Hospital Psychiatry)
Ellen Goldstein, James Topitzes, Jen Birstler, Richard L. Brown a University of Wisconsin-Madison, Department of Family Medicine, United States of America b University of Wisconsin-Milwaukee, Helen Bader School of Social Welfare, United States of America c University of Wisconsin-Madison, Biostatistics d Concerto Health, United States of America A B S T R A C T Objective: This pilot study tests the feasibility of implementing a two-session intervention that addresses adverse childhood...
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NEW Trauma-informed Care Podcast (CME provided)
Join us as we delve into the paradigm-shifting ethos of trauma-informed care with renowned expert Dr. Megan Gerber. Dr. Gerber is an Associate Professor of Medicine at Boston University School of Medicine and serves as Medical Director of Women’s Health for VA Boston where she directs the Women’s Health Fellowship. Dr. Gerber edited the textbook, “Trauma-informed Health Care Approaches: A Guide for Primary Care.” We discuss the framework for trauma-informed universal precautions, as well as bas