Understanding Trauma-Informed Care in the Emergency Department
“The funding made this research possible, and ultimately it is helping us create something that we hope will benefit both staff and patients.” – Olivia Miller
Developing Guidelines to Support Patients and Staff in Crisis:
When most people think about the emergency department ED), they imagine fast-paced medical decisions, lifesaving interventions, and a flurry of activity. What people tend to overlook is that these are high pressure environments for healthcare workers as well as patients who may be carrying invisible burdens, psychological trauma
That is what Olivia Miller the recipient of rethinking emergency medicine grant from the PA Research Foundation has been researching. With a background in psychology and a focus on trauma, her and her team are leading a pioneering project that explores how trauma informed care can be meaningfully integrated into emergency departments.
“Trauma-informed care might sound abstract, but it’s really about recognising that many patients entering the ED have experienced psychological trauma, this like sexual assault, war, or displacement. These experiences can influence how they interact with the medical system, and our goal is to make sure we don’t accidentally cause more harm.”
Trauma Isn’t always Visible – But its impact is
Previous traumatic experiences can deeply affect how a person responds to treatment, procedures, or even conversations in the ED. Something as routine as removing clothing for an exam or being touched unexpectedly can be triggering for survivors of trauma.
“We’re not just talking about psychological trauma coexisting with physical health issues, sometimes people might be presenting with headaches, chest pain that might not have any physical kind of explanation. It might be a result of prior traumatic experiences, so physical and mental health are very interlinked and tend to impact one another,” Olivia said.
Why the Emergency Department?
While trauma-informed care principles have been widely developed for contexts like disability services, substance use treatment, and general practice, there seemed to be a lack of publicly available guidelines tailored to emergency departments:
The ED presents unique challenges, it is fast paced, noisy, crowded and sometimes chaotic. Patients may arrive unconscious or in extreme distress. The injury or illness that brings them in might itself be a traumatic event.
Olivia notes “There’s added pressure on emergency clinicians, they’re often literally trying to save lives, but that doesn’t mean we can’t also be thinking about psychological safety alongside physical safety.”
Aims of the research:
The project, supported by the research grant, aims to develop practical, context specific guidelines for implementing trauma informed care in the emergency setting,
The study involves interviews with ED doctors and nurses to explore:
- How clinicians currently understand and practice trauma-informed care
- What challenges or barries they face in implementing it
- What kind of support or resources would help them feel more confident addressing patients’ psychological needs.
Interestingly, many or the clinicians Olivia interviewed said they weren’t sure what trauma-informed care was only to reveal through conversation, that they were already practicing many of its core principles.
“That’s been one of the lightbulb moments of this research. They’re doing it, they just don’t necessarily call it trauma informed care”
How the Funding has Helped:
The funding has allowed Olvia to:
- Hire a research assistant to help coordinate the project
- Provide small incentives for busy ED staff who volunteer their time
- Navigate logistical challenges of interview shift working clinicians in a fast-paced environment
“The funding made this research possible, and ultimately its helping us create something that we hope will benefit both staff and patients.
Olivia has the ultimate goal to provide clear, usable set of trauma informed care guidelines tailored specifically to the emergency department setting, something that is currently not that publicly available.
“We want clinicians to feel more confident and supported in delivering trauma informed care, and we want patients to feel safer and more understood when they come into the ED, even during incredibly difficult moments in their lives”, she said.
Help Olivia Expand the Conversation:
Olivia and her team are still recruiting emergency department nurses and doctors to participate in interviews. If you work in the ED and would like to contribute your perspective please contact Olivia at: o3.miller@qut.edu.au
