ACEs QI Project Evaluation October, 2018 Tatiana Popovitskaia, Project Coordinator

QI Project Evaluation Goal To evaluate the acceptability and feasibility of ACES for maternity healthcare providers and their patients in select maternity health practices across the province

QI Project Evaluation Expected Result Report on ACEs feasibility and acceptability for maternity healthcare providers and their patients and increase knowledge to develop recommendations on ACEs implementation in BC

ACEs Evaluation Principles Trauma informed and culturally safe care provided Promote resilience and strength based approach to care ACEs is not a screening test, but a history taking tool ACEs score is a starting point for a discussion between patient and provider It is not formal research, but program evaluation “Potential harm is in response, not the asking” - Bridget McBride, Kaiser Permanente Photo credit: ACEs Scotland Forum

QI Project Evaluation Timeline Lit review Resources development Evaluation design Face to Face meeting Orientation meetings May - Sept, 2018 Data collection Additional educational resources and support Oct, 18 - Feb , 2019 Data analysis Reporting Results dissemination March, 2019 Data collection Peer – support Additional education

Evaluation questions What is the knowledge level of maternity care providers in regards to ACEs, resiliency and trauma-informed care (self-reported)? To what extent is the ACEs questionnaire feasible for maternity healthcare providers? To what extent is the ACEs questionnaire acceptable for women as a history taking tool? What are the experiences of participating women with the ACEs questionnaire? What is the ACEs score of participating women? What is the outcome of the ACEs questionnaire as a history taking tool? Does the ACEs questionnaire affect work flow in maternity health practices?

Evaluation Instruments Pre- and post- test for providers on ACES, trauma informed care and resilience Patient exit survey In-depth patient phone interview Survey for MOAs/office staff Example – providers How would you rate your Knowledge about the impact of ACEs on patient Health Shared Services BC about to Discuss ACEs with patients Ability to educate patients about potential impact of CEAs on their health and wellbeing Ability to create safe environment for patients to discuss ACEs Your knowledge about trauma – informed care Your skill on providing trauma informed care You knowledge on resilience Your knowledge on additional resource on ACEs Concerns about ACEs enquire with your patient Example – patient How comfortable were answering the questions? How comfortable was it for to talk about these childhood experiences with your doctor? What’s your option on this questionnaire to be use in your clinics? Suggestions Pre- post intervention online survey for MoA and office staff

PSBC Support Patient Package Provider Package ACEs orientation meeting Data collection and analysis Report development Results dissemination ACEs evidence one pager ACEs and resiliency questionnaires Information letter Script for physician and MOA on ACEs discussion with patients Additional educational and informational resources on ACEs, TIC, and resilience Office workflow: Medical Office Assistant: Introduce the evaluation Provide ACEs package, collect questionnaire Medical Provider: Acknowledge and thank patient Review the ACEs and resiliency questionnaires when appropriate Give resource handout and make referrals

Thank you!