![](http://inclusionhealth.ie/wp-content/uploads/2023/11/TCD_Frederique_Vallieres-1024x956.png)
Dr Frédérique Vallières
Associate Professor, Global Health and Psychology, and Director, Trinity Centre for Global Health
Psychological trauma results from exposure to a single event or a series of events that are experienced as emotionally or physically harmful. Single traumatic events (i.e., an accident, house fire or assault), or repeat traumatic events (i.e., childhood abuse, domestic violence, war, homelessness, poverty, mental health conditions, racism, or ableism) can all result in psychological trauma that may lead to life-altering consequences. Psychological trauma may overwhelm a person’s coping capacity and perpetuate detrimental long-term effects on physical and mental health and well-being. As 70% of the adult population report experiences of psychological trauma (Benjet, et. al., 2016), it is highly likely that hospital staff encounter patients with psychological trauma histories every day, with challenging interactions between patients and staff that place patients at increased risk of avoidable patient safety events and poorer health outcomes. Recognising the prevalence and potentially injurious effects of psychological trauma among healthcare workers and patients alike is considered important to ensure patient engagement, quality of care, positive health outcomes, as well as improved staff wellness, and more resilient health systems.
Underpinning the Institute for Healthcare Improvement (IHI) Model for Improvement, we are using the novel approach of translational simulation (TS), a simulation methodology that aims to improve patient care and health systems. It uses a team-based, in-situ simulation of challenging scenarios to improve patient care and healthcare systems. The focus of TS in this project is on team behaviours and systems-level learning and change rather than on individual knowledge. Using TS approaches, we are currently co-designing and implementing a trauma-informed care (TIC) improvement programme for use in acute hospital settings.
Stages of implementing translational simulation have been reproduced with permission from Brazil, V. (2017)
Adapted from the Institute for Health Improvement (IHI) model for improvement
The co-development and subsequent evaluation of the programme is being achieved using a mixed-methods, collaborative approach through a combination of TS with the IHI Model for Improvement and Demming’s PDSA cycles. This process entails the co-development of translational simulation for trauma-informed care (TS4TIC) improvement programme [Plan], carrying out the TS4TIC training and improvements [Do], observing and learning from the processes and outcomes of TS4TIC [Study], and determining what modifications are to be made in the next iteration of the TS4TIC improvement programme [Act].
The TS scenarios have been developed with input from service user representatives and staff. Debrief sessions following simulations are also being conducted which provide an opportunity to explore learning and focus on the use of trauma-informed skills such as establishing trust, offering choice, empowering patients, active listening, showing cultural sensitivity, improving trauma awareness, as well as seeking guidance from staff on how the hospital could support more of the use of these skills in frontline practice. Six simulations have been completed to date, with 42 participants from catering, healthcare assistance, nursing, occupational therapy, physiotherapy and security taking part. Staff from all areas are encouraged to take part. The simulations have received appreciation through positive feedback from participants.
References:
An open-access TS4TIC Toolkit is underway that consists of TS scenarios and other resources to support other acute settings (both nationally and internationally) to develop a similar programme that focuses on TS as a methodology to explore aspects of TIC delivery. We envision that the outputs of this project, particularly the findings and resulting toolkit will considerably impact the work environment for healthcare workers, along with improving quality of care and patient experiences among all those accessing services. Apart from this, we foresee an impact on curriculum development within our partner academic teaching hospitals, while also impacting existing methods and theory, towards the advancement of new approaches to achieve system change.
Resources: You can access the study protocol here for more details.
Stay tuned for a suite of open-access resources to promote trauma-informed care in your respective acute contexts.
We are a group of people consisting of: people with lived experiences of psychological trauma; front-line and executive hospital staff including doctors, nurses, security staff and other health and social care professionals; and researchers with extensive experience in psychological trauma. Together, we understand first-hand the impact that psychological trauma has in healthcare settings, the effects of which have been worsened by the COVID-19 pandemic.