Driving a Cultural Shift
Having strong training, policies and procedures, processes, and communication will help ensure effective, appropriate TIC; and it will take some of the guesswork and emotion out of the equation. As McDonald noted, “What is traumatizing to me may not be considered a trauma by someone else. It’s all about the individual, their experiences, and how their brain is wired. We can’t make assumptions or generalizations.” This means individualized plans built from consistent information, assessments, and processes.
Ultimately, said McLaughlin, “By putting trauma informed care in the requirements, it was an intentional way for CMS
to change the culture. There is potential harm caused by good-hearted people who unintentionally put residents in situations where they are re-traumatized.” By practicing TIC, care teams can have more positive interactions with residents and feel more confident that they are contributing to their safety and comfort.
Creating a trauma-informed culture will take time, McLaughlin stressed. She said, “Initially, people will find themselves checking the boxes, but they will quickly realize they need to do more. You can make this part of QAPI and say: This is what we think we’re doing. Let’s look at it and see what we need to change, do differently, and improve.”