Start: December 2015

Funder: Robert Wood Johnson Foundation

Health policymakers and practitioners across the country increasingly recognize the destructive effects of trauma on the health status of children and adults. Trauma — including physical, emotional, or sexual abuse; neglect; discrimination; and violence — increases an individual’s long-term risk of serious physical and behavioral health problems, often leading to costly health care utilization. Adopting trauma-informed approaches to care can potentially improve patient engagement, enhance outcomes, and reduce avoidable care and excess costs for both the health care sector and social service systems.

Advancing Trauma-Informed Care, led by the Center for Health Care Strategies (CHCS) through support from the Robert Wood Johnson Foundation, is a national initiative aimed at understanding how trauma-informed approaches can be practically implemented across the health care sector. CHCS is overseeing a multi-site pilot demonstration including six competitively selected health care organizations committed to improving care for individuals with a history of trauma. The pilot efforts, representing a range of delivery systems and populations, are designed to expand and enhance trauma-informed approaches with a focus on improving patient outcomes, decreasing costs, and increasing staff resiliency. The pilot sites are:

  • Center for Youth Wellness, San Francisco, CA, will implement adverse childhood experiences (ACE) screening, care coordination, and data management strategies to further its integrated care approach for addressing the physical and behavioral health needs of families with ACE exposure.
  • Greater Newark Healthcare Coalition, Newark, NJ, will establish care coordination, trauma screening and treatment, professional development, and data integration practices.
  • Montefiore Medical Group, Bronx, NY, will train all staff within its 22-practice outpatient ambulatory care network in trauma-informed approaches to care using a multi-disciplinary train-the-trainer model including patient representatives.
  • San Francisco Department of Public Health, San Francisco, CA, will develop a leadership model, learning community, and collaborative work group that will infuse trauma-informed systems’ principles and practices into public health and other child-, youth-, and family-serving agencies.
  • Stephen and Sandra Sheller 11th Street Family Health Services, Philadelphia, PA, will train all staff to adopt a standard approach to collective mindfulness practice and use an integrated mind-body treatment model in working with patients who have experienced trauma.
  • Women’s HIV Program at the University of California, San Francisco, CA, will develop a formal service integration partnership with the Trauma Recovery Center at San Francisco General Hospital to address the effects of lifetime trauma on adults.

Participants in the demonstration are receiving extensive technical assistance and participating in a learning collaborative designed to foster ongoing exchange between pilot sites, leading national experts, and other relevant stakeholders. Emerging best practices and case studies from these innovative programs will be shared in an “evolving” online toolbox of strategies for fostering trauma-informed approaches to care.