This month we are featuring a series about sustaining trauma-informed care through goal setting, data collection, monitoring, responding to regression, and communicating and celebrating success.

Each of these topics is explored in more detail in Making It Real, the team-based on line course for child-serving teams. In the course you get videos, planning guides and resources which guide your team through an implementation plan in each one of these areas. Check it out here.

Implementing trauma-informed care is difficult. Sustaining it is even more difficult. Collecting data that will demonstrate the effects of the changes that you are making is the key to sustainable change. When staff, stakeholders, funders and consumers see the results, the effort you are making becomes worth while, and backsliding decreases.

What data should you collect? The first step is to consider your goals in implementing trauma-informed care.What are your current concerns about your programs? What do you hope to change by implementing trauma-informed care?

Programs often express concerns about the number of negative discharges, police calls and hospitalizations. They wish to decrease the use of restraints and seclusions. They are worried about the number of runaways. Furthermore, programs express concerns about their staff. They hope for less turn over and fewer injuries. They would like to decrease over use of sick time.

All of these represent areas that should be affected positively by a successful implementation of trauma-informed care.

Also, consider what you are proudest of about your programs. What do you do best? You can monitor these areas to make sure they are not negatively effected by the changes.

Many programs do a self-evaluation to hone in on their goals for change. Others already have clear areas of needed change. In some cases, an external regulatory body may be establishing standards of change. In every case, the team should discuss the goals of the initiative near the beginning, and be as specific as possible. It is helpful to look at what data the program already collects for other reasons. Rather than adding something new, do any of these measures reflect successful change?

Make a written plan, known to all team members:

We would like the following numbers to go down:
(Examples: restraints, seclusions, police calls, runaways, staff and client injuries, unplanned negative discharges, workforce turnover)
We would like the following numbers to go up:
(Examples: Discharges to a lower level of care, positive satisfaction surveys and positive responses on follow up surveys, workforce retention, scores on standardized testing)
Check those you collect regularly for other requirements.
Check those you have at least one year’s data prior to TIC intervention.
Create three goal statements: Be specific with dates and target numbers.
Examples:
By… (date) our restraints and seclusions will reduce by 25%.
By… (date) our Ohio scale scores in the area of acting out behaviors will show an average decrease of …
Focus on goals to that you hope to change by implementing trauma-informed care. Choosing data that you already have to collect will make the process more likely to be successful. You might also want to use a standardized measure, such as the ARTIC (Traumatic Stress Institute) or the ProQOL (http://www.proqol.org/ProQol_Test.html)
Click here for a worksheet for your team to use in goal setting.

The Results Based Accountability system provides a helpful framework for setting measurable goals.

How Well Measures
This data reflects how well we provide services in key ways that we believe impact results. They include both client and staff measures. They measure our treatment processes. Examples would be: number of restraints, police calls, staff turnover, staff and client injuries, amount of therapy provided and satisfaction surveys.
Better Off Measures
This data reflects whether any one is better off because of what we do. They are generally client measures, although staff measures of growth would be interesting. Examples would be: discharges to a lower level of care, reduction in unplanned negative discharges, positive results enduring over six months post discharge and scores on standardized tests.
Language adapted from Results-Based Accountability™ Trying Hard Is Not Good Enough by Mark Friedman (PARSE Publishing (March 8, 2015)

Working with your team to establish specific, data-driven goals and measures will help your implementation of trauma-informed care be more focused and sustainable.

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