2. OSU: Harding-Hospital Huge System with Expanding Opportunities Inpatient Units (53-adult beds, 20-adolescent beds) Inpatient Units (53-adult beds, 20-adolescent beds) ED Annex (16-bed behavioral crisis unit) ED Annex (16-bed behavioral crisis unit) CALM (8-bed observation unit) CALM (8-bed observation unit) Psych Consultation Team Psych Consultation Team Inpatient Units (53-adult beds, 20-adolescent beds) Inpatient Units (53-adult beds, 20-adolescent beds) ED Annex (16-bed behavioral crisis unit) ED Annex (16-bed behavioral crisis unit) CALM (8-bed observation unit) CALM (8-bed observation unit) Psych Consultation Team Psych Consultation Team ECT/TMS Clinics ECT/TMS Clinics IOP & Partial Hospitalization Units IOP & Partial Hospitalization Units Talbot Hall (Off-Campus) Talbot Hall (Off-Campus) Brain Spine Hospital 2016 Brain Spine Hospital 2016 Med-Psych Unit (15-bed) Med-Psych Unit (15-bed) ECT/TMS Clinics ECT/TMS Clinics IOP & Partial Hospitalization Units IOP & Partial Hospitalization Units Talbot Hall (Off-Campus) Talbot Hall (Off-Campus) Brain Spine Hospital 2016 Brain Spine Hospital 2016 Med-Psych Unit (15-bed) Med-Psych Unit (15-bed) 2 The Ohio State University Wexner Medical Center., n.d.

3. 3 Needs Assessment Typical non-trauma sensitive environments – High use of rules to manage safety – High use of Seclusion/Restraint – High rates of injury (patients and staff) – Low satisfaction (patients and staff) – Poorly defined Processes Typical non-trauma sensitive environments – High use of rules to manage safety – High use of Seclusion/Restraint – High rates of injury (patients and staff) – Low satisfaction (patients and staff) – Poorly defined Processes

4. 4 TIC Enculturation Plan

5. Leadership Commitment 5 Core Strategy 1 Become Trauma-Informed Improve QA Resources Review each S/R Event Become Trauma-Informed Improve QA Resources Review each S/R Event

6. Meaningful Data 6 Core Strategy 2 DefineMeasureAnalyzeImproveControlDefineMeasureAnalyzeImproveControl

7. Workforce Development 7 Core Strategy 3 TIC Consult (Huckshorn) - February 2013 TIC Consult (Huckshorn) - February 2013 Initial Training (NCTIC) - August 2013 Initial Training (NCTIC) - August 2013 Supplemental Training Supplemental Training Annual Digital Trainer (OSU) Annual Digital Trainer (OSU) New Hire Orientation (Harding) New Hire Orientation (Harding) Formal Quality Reviews of S/R Episodes Formal Quality Reviews of S/R Episodes Recruiter Screen for Trauma Sensitive Candidates Recruiter Screen for Trauma Sensitive Candidates TIC Consult (Huckshorn) - February 2013 TIC Consult (Huckshorn) - February 2013 Initial Training (NCTIC) - August 2013 Initial Training (NCTIC) - August 2013 Supplemental Training Supplemental Training Annual Digital Trainer (OSU) Annual Digital Trainer (OSU) New Hire Orientation (Harding) New Hire Orientation (Harding) Formal Quality Reviews of S/R Episodes Formal Quality Reviews of S/R Episodes Recruiter Screen for Trauma Sensitive Candidates Recruiter Screen for Trauma Sensitive Candidates

8. Core Strategy 4 January 2014 S AFETY G UIDELINES FOR T RAUMA -I NFORMED A PPROACHES AND P ATIENT D IRECTED S UPPORT - January 2014 TIC Overview TIC Overview P4 Comfort Plan P4 Comfort Plan Comfort Boxes Comfort Boxes Behavioral Support Teams Behavioral Support Teams Ekahau Safety Badges Ekahau Safety Badges January 2014 S AFETY G UIDELINES FOR T RAUMA -I NFORMED A PPROACHES AND P ATIENT D IRECTED S UPPORT - January 2014 TIC Overview TIC Overview P4 Comfort Plan P4 Comfort Plan Comfort Boxes Comfort Boxes Behavioral Support Teams Behavioral Support Teams Ekahau Safety Badges Ekahau Safety Badges 8 Prevention Tools

9. Core Strategy 4 New Furniture (Adolescent Unit) New Furniture (Adolescent Unit) Sensory Room Project (Adolescent Unit) Sensory Room Project (Adolescent Unit) Personalized Comfort Box & WRAP Plans Personalized Comfort Box & WRAP Plans Level of care Initiative Level of care Initiative ICU/Step Down ICU/Step Down General Psych General Psych New Furniture (Adolescent Unit) New Furniture (Adolescent Unit) Sensory Room Project (Adolescent Unit) Sensory Room Project (Adolescent Unit) Personalized Comfort Box & WRAP Plans Personalized Comfort Box & WRAP Plans Level of care Initiative Level of care Initiative ICU/Step Down ICU/Step Down General Psych General Psych 9 Prevention Tools (Continued)

10. Core Strategy 5 Patient Experience Council Patient Experience Council Parent Partner Initiative (NCH) Parent Partner Initiative (NCH) Patient Experience Council Patient Experience Council Parent Partner Initiative (NCH) Parent Partner Initiative (NCH) 10 Peer Support

11. Core Strategy 6 3-Step Process 1.Patient 2.Staff 3.Team 3-Step Process 1.Patient 2.Staff 3.Team 11 Debriefing Tools

12. Areas of Needs 1.Training 2.P&P Revision 3.Champions 4.System reassessment 1.Training 2.P&P Revision 3.Champions 4.System reassessment 12

13. References The Ohio State University Wexner Medical Center. (n.d.). OSU Harding Hospital. Retrieved from http://wexnermedical.osu.edu/patient-care/locations-and- parking/osu-harding-hospital http://wexnermedical.osu.edu/patient-care/locations-and- parking/osu-harding-hospital University of South Florida. (n.d.). Creating trauma-informed care environments: Organizational self-assessment for trauma-informed care practices in youth residential settings. Retrieved from http://www.cfbhn.org/assets/TIC/youthresidentialself%20assess% 20Fillable%20FORM%20%282%29.pdf http://www.cfbhn.org/assets/TIC/youthresidentialself%20assess% 20Fillable%20FORM%20%282%29.pdf 13