Tagged With "well child visits"
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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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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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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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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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#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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FPs Are Best Equipped to Tackle Adverse Childhood Experiences [aafp.org]
By Brent Sugimoto, American Academy of Family Physicians, January 29, 2020 Quick quiz: Which of the following is not associated with exposure to adverse childhood experiences, also known as ACEs? [child being threatened] A) Heart disease B) Cancer C) Chronic lung disease D) Obesity E) Parkinson's disease The answer: All of the above conditions have been closely associated with ACEs except Parkinson's disease, but a recent study suggests that even Parkinson's disease(www.ncbi.nlm.nih.gov) may...
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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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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 Impact of Childhood Adversity on Health and COVID-19 [acpm.org]
By Kevin Sherin, American College of Preventive Medicine, May 7, 2020 There is a growing dialog about COVID-19 and its impacts on childhood adversity (ACEs), chronic stress, and mental health across the lifespan. The fear and social isolation associated with COVID-19 commonly exacerbates existing chronic stresses. Reports are surfacing of increased mental health problems, anxiety, partner violence, depression, suicidality, child abuse, opioid use disorder, other substance abuse, drug...
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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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TIHCER monthly meeting Thursday, Oct 24th (3-4p) CT
Jane Stevens, founder and publisher of ACES Connection will be be our featured speaker for the TIHCER monthly meeting this Thursday, Oct 24th (3-4p) CT - see Zoom details below. Jane Stevens will review the status of ACEs Connection, and provide a sneak preview of their plans for providing more guidelines and tools for ACEs initiatives in communities, as well as details of the Cooperative of Communities that they are adding to ACEsConnection.com in early November. Jane Stevens Founder,...
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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 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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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: 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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Case-John.FINALa.pdf
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Re: TIHCER June Zoom 2020
This is a very interesting presentation, and I look forward to reading Dr. Strait's article in The Permanente Journal. The subject has great relevance for the military because there is highly suggestive evidence that ACE Scores and their generally not-understood sequelae may be more common in a volunteer military that in a draft military. Attached as Item 3 is an article describing how routine ACE screening was carried out on a very large scale in one Kaiser Department, and its effects and...
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Re: TIHCER June Zoom 2020
Thank you Dr. Felitti for your kind words and helpful attachments. Your paper is so important, especially in light of the military families I work with. Your words are inspiring and transformative: "We realized that asking , initially via an inert mechanism with later followup in the exam room, coupled with listening and implicitly accepting the person who had just shared his or her dark secrets, is a powerful form of doing ."
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Re: Trauma-Informed Telehealth in the COVID-19 Era and Beyond
Thank you for posting @Ellen Goldstein and for your enduring kind support! The pdf is now available and attached.....
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Trauma-Informed Telehealth in the COVID-19 Era and Beyond
https://www.mdedge.com/fedprac/article/225184/coronavirus-updates/trauma-informed-telehealth-covid-19-era-and-beyond Background: The Veterans Health Administration (VHA) entered the COVID-19 pandemic crisis with an existing and robust telehealth program, but it still faces a fundamental paradigm shift as most routine outpatient in-person care was converted to telehealth visits. Veterans are a highly trauma-exposed population, and VHA has long offered effective telemental health services.
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Trauma-Informed Medical Education (TIME): Advancing Curricular Content and Educational Context
Trauma-Informed Medical Education (TIME): Advancing Curricular Content and Educational Context Given that key perspectives and practices are cemented during medical education, the authors advocate teaching trauma-informed care in UME, including curricular content, clinical skills, and self-care techniques. Taylor Brown, Sarah Berman, Katherine McDaniel, MSc, Caitlin Radford, Pooja Mehta, MD, Jennifer Potter, MD, and David A. Hirsh, MD
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Re: TIHCER ZOOM JULY 2020
Well done Drew and Mike. There is almost a total lack of attention to the pathophysiological impact of child hood trauma on adult physical as well as mental disease. The medical establishment has a tremendous inertia as you learned...from the clinic to the medical group to the professional society to medical schools and graduate training to clinical research there is a near ubiquitous resistance to considering the impact of childhood abuse and neglect on adults. A large CDC study showed that...
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Emergency departments look inward to deepen practices that support traumatized patients
An interdisciplinary team of clinicians from Brigham and Women’s Hospital had a bold idea in 2017. They would completely change the way things worked in their hospital’s emergency department so that the care provided to their patients was infused with a trauma-informed approach. That means recognizing how widespread trauma is and using a myriad of techniques to mitigate its harmful effects among patients, providers and staff. The realization of just how widespread trauma is came to light in...
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Introducing ACEs (Adverse Childhood Experiences) and Resilience to First-Year Medical Students [mededportal.org]
By Edore Onigu-Otite, Sindhu Idicula, MedEdPORTAL, September 15, 2020 Abstract Introduction: Adverse childhood experiences (ACEs) are associated with negative mental and physical health outcomes and predictive of higher sociodemographic risk. Introducing ACEs into undergraduate medical education is key to prevention, early recognition, and intervention. Methods: In a 1-hour lecture, held live and viewed online, we delivered a condensed introduction to ACEs to first-year medical students.
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Free 2020 Virtual Trauma-Informed Care Conference
Each year, STAR hosts a Trauma-Informed Care Conference to help educate the next generation of leaders and build a strong network of Trauma-Informed professionals in the state of Georgia. The conference will be held on Saturday, October 3rd from 10:00am- 1:00pm EST and Sunday, October 4th , 2020 from 2:00pm-5:00pm EST conducted virtually via Zoom.
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Doctor's Orders: Program Prescribes Fresh Fruits, Vegetables to Idahoans [publicnewsservice.org]
Eric Tegethoff, Public News Service (12/10/2020) BOISE, Idaho -- A pilot program that prescribes a trip to the produce aisle has been a success in Idaho. The Nebraska-based Gretchen Swanson Center for Nutrition evaluated the Idaho Hunger Relief Task Force's (IHRTF) Prescription for Fresh Fruits and Vegetables program, which offers vouchers to food-insecure patients with diabetes and prediabetes. It found significant improvements in participants' health; Julie Walker, manager of diabetes...
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Lauren Brumley
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