1. Building a Trauma-Informed UI Health

2. Increasing life expectancy Reducing obesity
Reducing preventable hospitalizations
Reducing discrimination
Improving overall health
Reducing economic hardship
Increasing opportunities for children to live healthy lives
Institutionalizing a Health in All Policies approach
BECOMING A TRAUMA-INFORMED CITY
AMY
Becoming a trauma-informed city is priority for CDPH and for the City of Chicago. UI Health is working collaboratively with CDPH and other hospitals in Chicago to support the development of trauma-informed hospitals.

3. Trauma-Informed Hospitals Workgroup
16 Participating hospitals including:
UI Health
Northwestern
University of Chicago
Rush
Presence
Advocate
Mercy
AMY

4. Defining trauma
“Individual trauma results from an event, series of events, or set of circumstances that is experiences by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.”
AUDREY
Source: Substance Abuse and Mental Health Administration; Health Management Associates Trauma Informed Care Webinar

6. Neurodevelopment and Attachment
Around the same time period as the collection of the ACE Study data, there was an explosion of sophisticated neuroscience research from , the Decade of the Brain .
We’re going to do a crash course in normal neurodevelopment and attachment to better understand how experience can cause disease, disability and death. For the sake of simplicity, our brain is composed of three parts, the brainstem or survival brain, the midbrain or emotional brain, and the cortex or thinking brain. Our brain develops in response to our experiences and our environment from the bottom up from the survival brain to the cortex, starting prenatally and continuing until about age 24. This responsiveness of the brain is called neuroplasticity. Also important to note is that there are critical and sensitive periods for development. For example, if we remain in a dark room during the critical period for development of vision, we will be blind.
Attachment is the special emotional relationship that involves an exchange of comfort, care, and pleasure. Early attachment styles are established in childhood through the infant/caregiver relationship. Attunement is the perception and understanding of the wants and needs of others.
Stress and trauma can disrupt attachment, derail the optimal growth and development of the brain and autonomic nervous system, its signaling to all of the other body systems, and our overall physiology . Secure attachments and attunement protect and heal from later stress, distress and trauma.
Sources: Bruce Perry, MD PhD; Daniel Siegel, MD

7. Brain Regulates Body through Autonomic Nervous System
Thoughts or reactions to memories
(am I safe? am I loved?)
are transmitted from brain to body in less than a second

9. Hospitals as a Traumatized Community
Both staff and patients carry the burden and stress of their own individual ACEs and traumas.
In addition, healthcare workers carry the ADDITIONAL secondary traumatic stress of exposure to their patients’ ACEs and traumas and the stress of their workplace, which often is high demand and inadequately resourced.
AUDREY
Source: Illinois ACE Response Collaborative Group, The Center for Childhood Resilience – Lurie Children’s Hospital;

10. What does trauma mean for UI Health staff?
Impact of chronic worker stress
Increased chronic pain, fatigue, diabetes, heart disease
Increased healthcare costs and worker’s comp costs (on job injuries)
Increased worker turnover
Takes ~10 months for organizations to recover if leadership leaves
Costs $3.5K to replace an $8/hr employee (recruitment, training)
Increased tardiness and absenteeism
Caused by burnout, low moral and engagement
Costs organizations $84 billion annually ($2.6-$3.5K/employee/ year)
Decreased presenteesim, not functioning to full capacity
60% of workers reported decreased productivity due to workplace stress
Leads to increased likelihood of mistakes, poor quality, increased time for tasks
Costs organizations $168 billion annually in lost productivity
AUDREY
Source: Anda, Robert F et al. “Childhood Abuse, Household Dysfunction, and Indicators of Impaired Adult Worker Performance.” The Permanente Journal 8.1 (2004): 30–38; Health Management Associates Trauma Informed Care Webinar

11. What does trauma really mean for ui health staff?
RANI and AUDREY to share stories of how trauma has impacted team members in the last year.

12. SAMHSA’s Concept of a Trauma-Informed Approach

16. What can UI Health do?
We can START WITH OUR STAFF by following SAMSHA or other guidelines for Trauma-Informed Institutions to support staff through trauma-informed:
Developing leaders and champions
Policies
Hiring Practices
Staff Training and Support
Content of Care
Physical Environment
CREATE A CULTURE OF SAFETY and CONNECTION that SUPPORTS SELF-REGULATION
AUDREY
Source: Illinois ACE Response Collaborative Group, The Center for Childhood Resilience – Lurie Children’s Hospital

17. The continuum of change
Trauma-Aware
Staff understand the term “trauma” and how it can change the way they view and interact with others.
Workplace safety is a priority and the workplace considers both physical and mental health.
Trauma-Sensitive
The organization values a trauma-informed lens and identifies trauma and resilience in policies.
Trauma training is institutionalized for all staff.
Staff feel supported and understood in the workplace.
Trauma-Responsive
Staff applies knowledge of trauma and resilience in work.
Staff utilizes language that supports safety, choice, collaboration, trustworthiness, and empowerment.
Trauma-Informed
The entire staff is skilled in using trauma-informed practices.
Individuals outside the organization understand that trauma and resilience are at the center of our mission.
AUDREY
Implementing change takes time.
Becoming a trauma-informed hospital is a multi-year process that starts with a shift in staff knowledge, perspectives, attitudes, and skills.
Source: This framework was adapted by the Philadelphia ACE Task Force from the Missouri Model: A Development Framework for Trauma Informed

18. Why this, why now? Harness momentum Leverage existing resources
Chicago-wide effort
Staff stories
Leverage existing resources
Staff expertise
TeamSTEPPS
Align with KRAs
Increase employee engagement
Increase physician engagement
ANNA

19. What’s Already HapPENING In OUR INSTITUTION

20. What exisiting Programs Can We Align With

21. Which EXISITNG ORGANIZATIONAL MEASURES WILL BENEFIT FROM THIS WORK

22. EXISTING employee resources
Can we do more to support staff and address burnout?
ANNA

23. Potential next steps
Define how does becoming trauma-informed support the goals of our organization?
Assemble a core team and specific recommendations/next steps