Implementation of a trauma-informed care initiative at FQHCs in Texas

Trauma-informed care recognizes the high prevalence and impact of trauma across the healthcare continuum, and its implementation across healthcare settings has varied. We describe the development and implementation of a trauma-informed care initiative at community health centers across Texas.

Using an inquiry-based learning approach, a train-the-trainer model disseminated trauma-informed principles across participating health centers. This approach was evaluated using formative, summative, and organizational assessments as well as qualitative interviews with trained staff.

34 health centers participated in the trauma-informed care initiative. We observed significant improvements in organizational assessment subdomains and an average score of 73.9% in summative assessments. Trained staff shared difficulties related to learner engagement, time, leadership buy-in, and self-efficacy to train others, however, successes included enhanced cross-departmental collaboration and incorporation of trauma-informed principles in everyday practice.

Trauma-informed care has the potential to transform healthcare delivery to ensure staff, patient, and organizational wellbeing. We describe a novel approach to implementing trauma-informed care at health centers that shows promise for organizational transformation. Future programs should consider pre-post knowledge assessments, leadership engagement, and sustainability methods such as certifications or continuing education.