Overcrowding in Emergency Departments (ED) is a pervasive issue in many healthcare systems, and UF Health Shands is no exception (Cistola, A. S, 2020). This intervention program will expand the University of Florida Health Shands Emergency Department's capacity to manage patients with complex social and medical needs to reduce the overuse of emergency services. The Trauma-informed team will include an interdisciplinary team of health care professionals; two nurse practitioners or physician assistants who will review the patient's medical discharge plan with a patient navigator and case manager who will then assist patients in understanding and implementing their care plan. In addition, the case manager will address and implement any social services that may impede patients' ability to meet their needs.
The four principles of trauma-informed care emphasized throughout this intervention will include Safety, Collaboration/ Mutuality, Empowerment, and Trustworthiness (SAMHSA, 2014). These principles are crucial to the structure and practice of this intervention because this intervention will help build protective factors such as self-management and increase capacity and resilience that would encourage health-promoting behaviors and enable patients to manage what's directly within their control. In addition, this interdisciplinary team will link patients to resources and health information critical to their care. Communicating this information in a safe and trusted space where patients are empowered to make health decisions with their provider's guidance is essential.
This intervention will use the McLeroy Social Ecological Model to address two levels of health promotion at the intrapersonal and institutional levels (McLeroy et al., 1988). First, at the institutional level, we will address health promotion by providing trauma-informed training to the interdisciplinary team to create a trauma-informed space for the patients. This intervention program will focus on secondary and tertiary prevention by reducing the disease burden of chronic conditions by focusing on two types of rehabilitation: medical and social (Celentano, 2019). The combined and coordinated care provided by this intervention can significantly reduce the progression of chronic conditions and the number of exacerbations, which could ultimately improve patient outcomes by helping them retain a better quality of life for as long as possible(Celentano, 2019).
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