Background: The trauma-informed care programme at the Tees, Esk and Wear Valleys Foundation NHS Trust identified a need to evaluate the ongoing service-wide trauma-informed care implementation effort. An absence of staff, service user and system-related outcomes specific to trauma-informed care presented barriers to monitoring the adoption of trauma-informed approaches and progress over time across the Tees, Esk and Wear Valleys Foundation NHS Trust. This paper describes the co-production of a new self-assessment tool, Roots, a discussion-based framework that facilitates learning and improvement by reflecting on positive or negative examples of trauma-informed services. Methods: Using secondary data obtained from an affiliated national trauma summit and instruments found in literature, domains and items were co-produced with the help of trauma-informed care leads, NHS staff and service users. The research design consisted of community-based co-production methods such as surveys, focus groups, and expert consultations. Results: Adopting trauma-informed care requires enthusiasm and commitment from all members of the organisation. Services must adapt to meet the dynamic needs of staff and service users to ensure they remain trauma-informed; this must be done as a community. Conclusions: Following an extensive co-production process, the Roots framework was published open-access and accompanied by a user manual. Roots can provide both qualitative and quantitative insights on trauma-informed care implementation by provoking the sharing of experience across services.
Trauma Informed Care (TIC) is an approach to human services based on the understanding that most people in contact with services are more likely to have experienced some level of trauma, adversity and loss and this understanding needs to be held by those involved so that it is may permeate service relationships and delivery. This article reviews TIC literature and introduces a case example outlining the successes and challenges of TIC implementation in practice, i.e. staff awareness, knowledge and skills, communication and quality of human interaction, wellbeing and resilience, organisational structures and artefact, measurement and monitoring for success. Insights from complexity and interpersonal neurobiology are interpreted in the context of facilitating TIC implementation, i.e. parallel safe-to-fail interventions, managing constraints and boundary conditions, monitoring change through trusted sensor networks, maintaining awareness development practices.
This article takes an ecological perspective that views management systems and information systems as dimensions of the overall business platform. The concepts of double-loop learning and knowledge creation are found to be useful in contemplating, explaining and evaluating the role of Information Systems in organisations. It is argued that the role of information systems is to support, facilitate and improve the knowledge creation and knowledge implementation processes in the organisation the skills of awareness and reflection need to be enacted within the communication processes of organizations. Dialogue is considered fundamental to learning and creativity.
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