391 - Trust-Based Relational Intervention® Principles in Inpatient Pediatrics and Medical Education: A Trauma-Informed Approach to Patient Care

Poster Number: 391
Publication Number: 391.310

Background: Trust Based Relational Intervention® (TBRI®) is a model of trauma-informed care that utilizes principles of connecting, empowering, and correcting to care for children with histories of complex developmental trauma. These principles can be used by medical caregivers when interacting with patients with histories of acute or chronic trauma and abuse. Previously, this trauma-informed approach to communication with patients was not standard at Children’s Memorial Hermann Hospital (CMHH) or in the McGovern Medical School (MMS) curriculum.

Objective: This project aims to equip interdisciplinary caregivers at CMHH and MMS with the background and tools needed to optimally care for patients with histories of complex developmental trauma.

Design/Methods: Two courses were designed by TBRI® Practitioners at CMHH and MMS. A one-day 8-hour course is given to CMHH hospital employees, residents, and faculty once or twice monthly. An elective was designed for medical students as a 6-part series of one-hour lectures given in a virtual format. The Attitudes Related to Trauma-Informed Care (ARTIC-35) survey is used to measure participants’ attitudes and understanding of trauma-informed care principles as well as confidence in implementing the presented principles and strategies. The medical students are surveyed prior to course, midpoint, and after completing the course. Employees and medical staff at CMHH are surveyed prior to the course, at one-month, and six months following course completion.

Results: Total average ARTIC-35 scores increased across the medical student’s surveys given before, midpoint, and conclusion of the TBRI® training. Average ARTIC-35 scores increased across all categories for hospital employees and medical staff from baseline to one-month post training but decreased at six-month point. Further analysis showed 48% of medical students participated in the final survey given at completion but only 10% of employee participants completed their final survey given after six-months.

Conclusion(s): Educational interventions providing TBRI® training improved attitudes and confidence levels related to trauma-informed care across hospital employees, residents, faculty, and medical students. Future QI efforts focus on continuing education for all students, residents, medical staff, and hospital employees. TBRI® training is also provided to all appropriate employee new hires at CMHH. We are implementing an additional PDSA cycle with plans to improve participation in surveys.