Trauma Informed Care: Improving Appointment Adherence in an Outpatient Behavioral Health Setting

Abstract

Exposure to a traumatic life event can lead to lifestyle practices that adversely affect one's health. Nearly three-fourths of Americans have experienced a traumatic life event. The purpose of this quality improvement project was to decrease no-show appointments by facilitating the adoption and integration of trauma informed care (TIC) in an outpatient behavioral health setting. All staff were offered an instructor led class introducing trauma informed care. Lewin's Change Theory served as the theoretical framework. Risking Connection and the Substance Abuse and Mental Health Service Administration, were used to establish training content. Two work aids, a TIC pocket reference card and an electronic reminder were developed to supplement staff education. The number of no-show appointments decreased from 30.1% to 23.4% over a 4-month time period. The majority of staff believed trauma informed care was beneficial to patient outcomes, and 76.9% requested additional training. This quality improvement project demonstrated a positive relationship between no-show appointments and TIC. It also supports a need for further exploration of the relationship between TIC and patient outcomes such as no-show appointments.