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• W4386002641 abstract "In their recent publication, Dr. Lewis-O'Connor and colleagues’ findings offer a nuanced consideration of the challenges and great opportunities for trauma-informed care (TIC) models in emergency departments.1 We applaud their efforts and the editors for highlighting a strong example of qualitative research that offers actionable guidance for supporting victims of trauma, whether these victims are patients or staff. Although TIC is traditionally considered for its benefits to patients, the authors rightfully point out the ubiquity of secondary trauma experienced by emergency department (ED) staff working with high-risk patients. This trauma comes from witnessing death and injury, suffering verbal and physical assaults, and experiencing moral distress from repeated encounters with patients confronting homelessness and systemic discrimination. The authors describe staff's encounters with racism, sexism, homophobia, and other discrimination toward patients; we must recognize that our colleagues’ experiences are affected by such abuse as well. Lewis-O'Connor et al’s findings prompt consideration of models to address secondary trauma and foster workforce resilience. Since March 2020, Denver Health has operated Resilience and Equity through Support and Training for Organizational Renewal (RESTORE), a multimodal program that offers non-judgmental, trauma-informed services for health care staff. Founded on principles of caregiver support programs,2 RESTORE has grown to encompass a suite of services including no-cost group support sessions, a drop-in center, educational programming, and individual peer-delivered emotional support and psychological first aid. To date, RESTORE's 7 full-time staff have provided over 300,000 staff touches in our safety net health system—testament to the current findings that describe a desire to respond “both individually and on an organizational level to trauma.” Of staff providing departmental data, 31% work in the ED—a disproportionate share of the organization's over 6,000 employees—and ED staff are among the most common users of our drop-in support center. As does the present publication, our experience demonstrates the demand for trauma-informed services to directly support ED staff. Although the authors put less focus on application of their findings, we found their research helpful for envisioning how to design staff support programs to support TIC in EDs. Frequently cited barriers to implementing TIC interventions—such as guided debriefs of difficult care episodes, education on the impacts of trauma, and protected space to consider external influences and social determinants on patients’ care—include constraints of time, expertise, and cost.3 These can be directly overcome via staffing of programs like RESTORE. Moreover, leadership engagement is a critical factor in the success of TIC programs. Investment in support programs offers leaders a cost-effective approach to disseminating TIC practices.4 Medicine has long underrecognized the complex sequelae of trauma in patients’ medical and psychology recovery. And for longer still has the impact of trauma on our health care colleagues been neglected. We hope this research and our own experience hearten health care leaders and policymakers that the urgently needed solutions are practical, effective, and at hand. The authors have nothing to report. This work has not been presented or published previously." @default.
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• W4386002641 date "2023-08-01" @default.
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• W4386002641 title "Realizing the promise of trauma‐informed care through hospital staff support programs" @default.
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• W4386002641 doi "https://doi.org/10.1002/emp2.13029" @default.
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