Division of Adolescent Medicine, Department of Pediatrics, University of Illinois - Chicago (M McNamara and A Schwartz).
Johns Hopkins University (R Cane), Baltimore, MD.
Acad Pediatr. 2021 Jan-Feb;21(1):158-164. doi: 10.1016/j.acap.2020.05.019. Epub 2020 May 31.
Trauma-informed care (TIC) and violence intervention programs (VIPs) facilitate psychosocial healing and reduce injury recidivism for children and families affected by community violence. To integrate a VIP into 2 Level 1 Pediatric Trauma Centers, an educational initiative was developed and co-taught by pediatricians and former patients. The primary aim was to increase provider-driven patient referrals to the VIP. A secondary aim was to improve all participants' comfort levels in 5 areas of TIC.
Referrals to the VIP from 2014 to 2018 were tracked and analyzed. A curriculum based on Five Points of TIC was developed and offered to interprofessional groups of hospital employees. Pediatricians and former patients recovering from violent injury facilitated the workshops. Twenty-two workshops were attended by 318 providers and hospital staff members from 2015 to 2018. Pre- and postworkshop surveys asked participants to rate their comfort levels with 5 areas of TIC.
Provider-driven patient identification increased from 34.8% to 86.8% over the study period. For the entire cohort, participants' self-assessment of comfort levels with TIC improved by 21% (P < .001), with medical students' scores improving the most (24%). Residents were less likely to complete the workshop than fellows or attendings (P = .03).
This novel curriculum was associated with a change in practice patterns, as well as a closer relationship between the VIP and pediatric hospital systems. All professional groups experienced an improvement in comfort levels with the Five Points of TIC. Future study on information retention and other patient care-related outcomes is needed.
创伤知情护理（TIC）和暴力干预计划（VIP）有助于儿童和受社区暴力影响的家庭的心理社会康复，并减少伤害复发。为了将 VIP 整合到 2 个 1 级儿科创伤中心，开发了一项教育计划，并由儿科医生和前患者共同授课。主要目的是增加提供者驱动的患者向 VIP 的转介。次要目标是提高所有参与者在 TIC 的 5 个领域的舒适度。
跟踪和分析 2014 年至 2018 年向 VIP 的转介情况。根据 TIC 的五个要点制定了一个课程，并提供给医院员工的跨专业小组。儿科医生和从前暴力伤害中康复的患者促进了研讨会。2015 年至 2018 年，有 22 个工作坊吸引了 318 名提供者和医院工作人员参加。预-和课后调查要求参与者评估他们在 TIC 的 5 个领域的舒适度。
在研究期间，提供者驱动的患者识别从 34.8%增加到 86.8%。对于整个队列，参与者对 TIC 的舒适度自我评估提高了 21%（P<.001），医学生的分数提高最多（24%）。住院医师比研究员或主治医生更不可能完成研讨会（P=.03）。
这种新颖的课程与实践模式的改变以及 VIP 和儿科医院系统之间的更紧密关系相关。所有专业群体在 TIC 的五个要点方面的舒适度都有所提高。需要进一步研究信息保留和其他与患者护理相关的结果。
