Related Experiment Video
Updated: Mar 6, 2026

Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion
Published on: January 20, 2019
Application of a Framework to Implement Trauma-Informed Care Throughout a Pediatric Health Care Network
Danielle Weiss1, Nancy Kassam-Adams, Carol Murray
1Ms. Weiss: Research Assistant, Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, PA. Dr. Kassam-Adams: Research Associate Professor of Clinical Psychology in Pediatrics, Perelman School of Medicine, University of Pennsylvania, Associate Director for Behavioral Research, Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, PA, and Director of the Center for Pediatric Traumatic Stress; Past President, International Society for Traumatic Stress Studies. Ms. Murray: Training Manager, Violence Prevention Initiative, Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, PA. Ms. Kohser: Research Coordinator, Center for Injury Research and Prevention; Project Coordinator, Center for Pediatric Traumatic Stress, The Children's Hospital of Philadelphia, Philadelphia, PA. Dr. Fein: Professor of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Director, Violence Prevention Initiative, The Children's Hospital of Philadelphia, and Director of Advocacy & Health Policy, The Division of Emergency Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA. Dr. Winston: Professor of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Attending Physician, Founder and Scientific Director, Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, PA, and Director of the National Science Foundation Industry, University Cooperative Research Center, the Center for Child Injury Prevention Studies. Dr. Marsac: Assistant Professor of Pediatrics, College of Medicine, Kentucky University, and Kentucky Children's Hospital, Lexington, KY.
Introduction:
To evaluate the initial application of a recently published three-step framework for implementing trauma-informed care (TIC) in a pediatric health care network by applying Framework for Spread.
Methods:
In steps 1 and 2 of the framework, we established commitment from the health care network leadership and initial interest in TIC among clinical providers (step 1), set evidence-based training goals and created the associated TIC training content (step 2). In step 3, 440 health care professionals (from 27 health care teams) participated in single-session, 1-hour training that covered the psychological impact of injury- and illness-related trauma, identification of traumatic stress symptoms, and how to respond to children exposed to potentially traumatic events. A concomitant quality improvement project allowed us to assess potential changes in training participants' favorable attitudes toward the integration of TIC and confidence in delivering TIC.
Results:
Compared with pretraining, participants demonstrated increases in attitude toward TIC, t(293) = 5.8, P < .001, Cohen's d = 0.32, and confidence in delivering TIC, t(293) = 20.9, P < .001, Cohen's d = 1.09.
Discussion:
Trainings were effective in achieving proximal goals targeting attitudes and confidence, thereby demonstrating the feasibility and clinical relevance of TIC training when implemented according to the three-step framework. Future research should examine methods of training to reach wide audiences to promote systematic change and evaluate changes in patient outcomes associated with providers' implementation of TIC.
Related Concept Videos
Nursing Implementation
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.
Nursing Clinical Information System
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:
Interdisciplinary Care: The Health Care Team-I
Physicians
The physician's primary responsibility is to diagnose illness and direct the medical or surgical treatment of the condition. The authority to admit patients to a healthcare agency or institution and practice care within that setting is granted to physicians by the healthcare agency or institution...
Interdisciplinary Care: The Health Care Team-II
Physical Therapist
A physical therapist (PT) aims to restore function or prevent additional impairment in a patient following an injury or disease. Massage, heat, cold, water, sonar waves, exercises, and electrical stimulation are some treatments used by PTs to treat...
Aneurysm III: Interprofessional Care
Community Based Intervention
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...

