Skip to main content

Main menu

  • Latest content
    • Latest content
  • Archive
  • About the journal
    • About the journal
    • Editorial board
    • Information for authors
    • FAQs
    • Thank you to our reviewers
    • The American Association for the Surgery of Trauma
  • Submit a paper
    • Online submission site
    • Information for authors
  • Email alerts
    • Email alerts
  • Help
    • Contact us
    • Feedback form
    • Reprints
    • Permissions
    • Advertising
  • BMJ Journals

User menu

  • Login

Search

  • Advanced search
  • BMJ Journals
  • Login
  • Facebook
  • Twitter
TSACO

Advanced Search

  • Latest content
    • Latest content
  • Archive
  • About the journal
    • About the journal
    • Editorial board
    • Information for authors
    • FAQs
    • Thank you to our reviewers
    • The American Association for the Surgery of Trauma
  • Submit a paper
    • Online submission site
    • Information for authors
  • Email alerts
    • Email alerts
  • Help
    • Contact us
    • Feedback form
    • Reprints
    • Permissions
    • Advertising
Open Access

Implementing psychosocial programming at a level 1 trauma center: results from a 5-year period

Natasha M Simske, Trenton Rivera, Mary A Breslin, Sarah B Hendrickson, Megen Simpson, Mark Kalina, Vanessa P Ho, Heather A Vallier
DOI: 10.1136/tsaco-2019-000363 Published 21 January 2020
Natasha M Simske
Orthopaedic Surgery, MetroHealth System, Cleveland, Ohio, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Trenton Rivera
Orthopaedic Surgery, MetroHealth System, Cleveland, Ohio, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Mary A Breslin
Orthopaedic Surgery, MetroHealth System, Cleveland, Ohio, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Sarah B Hendrickson
Orthopaedic Surgery, MetroHealth System, Cleveland, Ohio, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Megen Simpson
Orthopaedic Surgery, MetroHealth System, Cleveland, Ohio, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Mark Kalina
Orthopaedic Surgery, MetroHealth System, Cleveland, Ohio, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Vanessa P Ho
Orthopaedic Surgery, MetroHealth System, Cleveland, Ohio, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Heather A Vallier
Orthopaedic Surgery, MetroHealth System, Cleveland, Ohio, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Heather A Vallier
  • Article
  • Figures & Data
  • eLetters
  • Info & Metrics
  • PDF
Loading

Article Figures & Data

Figures

  • Tables
  • Figure 1
    • Download figure
    • Open in new tab
    • Download powerpoint
    Figure 1

    Total number of discrete peer visits and number of peers with more than one visit from 2013 to 2018.

  • Figure 2
    • Download figure
    • Open in new tab
    • Download powerpoint
    Figure 2

    Total number of patients attending support groups from 2013 to 2018, along with the number of patients attending >1 support group. *Support group data were unavailable for 2015 and 2016.

Tables

  • Figures
  • Table 1

    Overview of services offered through Trauma Recovery Services

    ServiceBrief description of servicePersonnel involvedProgram initiationSource
    Educational materialsPatients are provided a copy of the TSN Handbook and/or instructions for TSN website access.Peer volunteer or TRS coach2013TSN (for TCCS)
    TRS AppPatients are provided information about TRS App that includes information about injuries, hospitalization and recovery.Peer volunteer, TRS coach or research assistant2017Novel
    CoachingLicensed counselor provides emotional support and other counseling as needed to patients and/or family members.TRS coach2013
    Family classesHelp prepare family members to assume a caregiving role after discharge.TRS coach2013 (discontinued in 2015)TSN (for TCCS)
    Support groupsAllowed patients and/or family members to engage in open discussion about their injuries and recovery.TRS coach2013TSN (for TCCS)
    NextSteps classesSelf-management classes for patients after hospital discharge.TRS coach2013 (discontinued in 2015)TSN (for TCCS)
    Peer mentorshipA trauma survivor who can share their story and offer support.Peer volunteers2013TSN (for TCCS)
    Comfort bagsBags containing hygiene products, socks, blankets and other items donated by trauma survivors.Peer volunteers2014Novel
    PTSD screeningPCL-5 administered at postdischarge clinic visits.Clinical providers2017Novel
    VOCARPVictim advocacy, educational resources, and referral to internal or external resources for patients with violence-related activations.Social workers2017Novel
    • PCL-5, PTSD checklist for Diagnostic and Statistical Manual for Mental Illness, Fifth Edition; PTSD, post-traumatic stress disorder;TCCS, Trauma Collaborative Care Study; TRS, Trauma Recovery Services;TSN, Trauma Survivors Network; VOCARP, Victims of Crime Advocacy and Recovery Program.

  • Table 2

    Patient demographics for all who had resource utilization beyond educational materials, coaching, or VOCARP (n=2324 of 4977). Frequency (%) is based on the number of patients with available data

    All patients (n=2324)
    Age, years; mean (SD)45.4 (18.5)
    Male1453 (64.1%)
    Race and ethnic background
     Caucasian1555 (69.0%)
     African-American605 (26.9%)
     Hispanic93 (4.1%)
     Other race82 (3.6%)
    Marital status
     Single1100 (48.8%)
     Married/significant other862 (38.3%)
     Divorced191 (8.5%)
     Widowed100 (4.4%)
    Emergency contact
     Spouse/significant other717 (31.8%)
     Parent/grandparent769 (34.1%)
     Child/grandchild275 (12.2%)
     Sibling201 (8.9%)
     Friend101 (4.5%)
     Other162 (7.2%)
     None27 (1.2%)
    Employment
     Employed*915 (40.7%)
     Not employed903 (40.2%)
     Retired354 (15.7%)
     Student77 (3.4%)
    Insurance
     Medicare370 (18.2%)
     Medicaid794 (39.1%)
     Uninsured170 (8.4%)
     Managed care359 (17.7%)
     Commercial232 (11.4%)
     BWC100 (4.9%)
    Mechanism of injury
     Assault36 (1.6%)
     ATV/dirt bike/snowmobile40 (1.8%)
     Burn15 (0.7%)
     Crush77 (3.4%)
     Fall569 (25.3%)
     Motor vehicle collision717 (31.8%)
     Motorcycle collision270 (12.0%)
     Other40 (1.8%)
     Pedestrian struck127 (5.6%)
     Penetrating (GSW or stab)314 (13.9%)
     Sport related48 (2.1%)
    Injuries
     Head/neck429 (19.1%)
     Face204 (9.1%)
     Chest555 (24.7%)
     Spine339 (15.1%)
     Abdomen322 (14.3%)
     Pelvis207 (9.2%)
     Upper extremity457 (20.4%)
     Lower extremity891 (39.7%)
     ≥1 orthopedic injury†1519 (67.7%)
    • *Includes four patients who were currently active duty in the US military.

    • †Includes injuries to the spine, pelvis and/or extremities.

    • ATV, all-terrain vehicle; BWC, Bureau of Worker’s Compensation; GSW, gunshot wound; VOCARP, Victims of Crime Advocacy and Recovery Program.

  • Table 3

    Summary of services used from 2013 to 2018

    201320142015201620172018Total
    Direct contact2095746746016835763317
    Peer visit192753404234143561827
    Support group1211N/AN/A5633114
    Comfort bag349N/A6431147
    PTSD screening  263219482
    VOCARP  244730974
    • Blank cells indicate services that were not rolled out in the listed year.

    • N/A, not available; PTSD, post-traumatic stress disorder; VOCARP, Victims of Crime Advocacy and Recovery Program.

  • Table 4

    Breakdown of patient demographics and injury patterns for different services used. Frequency (%) is based on the number of patients with available data

    >1 peer visit (n=489) (21%)Support group (n=114) (4.9%)VOC (n=140) (6.0%)PTSD screening (n=482) (20.7%)P value*
    Age, years; mean (SD)43.9 (18.2)43.6 (16.1)32.6 (12.1)43.6 (17.6)<0.001
    Male307 (62%)36 (61%)107 (78%)312 (65%)0.014
    Race/ethnicity
     Caucasian355 (73%)37 (66%)41 (30%)287 (60%)<0.001
     African-American105 (22%)16 (29%)89 (64%)174 (36%)<0.001
     Hispanic/other race29 (6%)3 (5.4%)9 (6.5%)21 (4.4%)0.60
    Marital status
     Single235 (48%)23 (42%)105 (76%)266 (55%)<0.001
     Married/significant other193 (40%)31 (56%)27 (20%)154 (32%)<0.001
     Divorced/widowed61 (13%)1 (1.8%)6 (4.3%)62 (13%)0.003
    Employment
     Employed222 (45%)27 (52%)36 (26%)174 (36%)<0.001
     Not employed183 (37%)14 (27%)87 (63%)227 (47%)<0.001
     Retired65 (13%)8 (15%)4 (3%)56 (12%)0.006
     Student19 (4%)3 (6%)11 (8%)25 (5%)0.15
    Hospital LOS, days; mean (SD)16.7 (14.9)12.4 (12.4)9.4 (12.1)4.9 (6.1)<0.001
    Mechanism of injury
     Assault0 (0)0 (0)5 (3.6%)14 (2.9%)–
     ATV/dirt bike/snowmobile10 (2.0%)1 (1.9%)0 (0)16 (3.3%)–
     Burn2 (0.4%)1 (1.9%)1 (0.7%)6 (1.2%)0.44
     Crush22 (4.5%)4 (7.5%)0 (0)13 (2.7%)–
     Fall80 (16%)7 (13.2%)1 (0.7%)157 (33%)<0.001
     Motor vehicle collision184 (37%)18 (34%)11 (8.0%)98 (20%)<0.001
     Motorcycle collision92 (19%)8 (15%)4 (2.9%)43 (9%)<0.001
     Other9 (1.8%)2 (3.8%)2 (1.4%)8 (1.7%)0.73
     Pedestrian struck28 (5.7%)4 (7.5%)7 (5.1%)22 (4.6%)0.74
     Penetrating (GSW/stab)53 (11%)7 (13.2%)107 (78%)99 (21%)<0.001
     Sports related9 (1.8%)1 (1.9%)0 (0)6 (1.2%)–
    Injuries
     Head/neck102 (21%)9 (19%)17 (12%)29 (6%)<0.001
     Face49 (10%)4 (8.3%)18 (13%)32 (6.6%)0.081
     Chest117 (24%)15 (31%)27 (20%)78 (16%)0.006
     Spine90 (18%)5 (10%)8 (5.8%)41 (8.5%)<0.001
     Abdomen87 (18%)11 (23%)45 (33%)62 (13%)<0.001
     Pelvis64 (13%)6 (13%)8 (5.8%)40 (8.3%)0.023
     Upper extremity121 (25%)19 (40%)25 (18%)107 (22%)0.019
     Lower extremity200 (41%)29 (60%)57 (41%)316 (66%)<0.001
    • Bold type denotes statistical significance.

    • *P values represent comparisons between all groups.

    • ATV, all-terrain vehicle; GSW, gunshot wound; LOS, length of stay; PTSD, post-traumatic stress disorder; VOC, victims of crime.

  • Table 5

    Breakdown of patient demographics and injury patterns by number of peer visits. Frequency (%) is based on the number of patients in a given column with available data

    1 Peer visit (n=1334) (73%)2 Peer visits (n=326) (17.8%)3+ Peer visits (n=168) (9.2%)P value*
    Demographics
    Age, years; mean (SD)46.6±18.745.3±18.641.2±17.10.002
    Male873 (65%)194 (60%)113 (68%)0.099
    Race/ethnicity
     Caucasian952 (72%)236 (73%)119 (72%)0.914
     African-American324 (25%)71 (22%)34 (21%)0.370
     Hispanic/other race49 (3.7%)16 (5%)13 (7.8%)0.040
    Marital status
     Single624 (47%)153 (47%)82 (49%)0.882
     Married/significant other531 (40%)126 (39%)67 (40%)0.928
     Divorced111 (8.4%)32 (9.9%)12 (7.2%)0.554
     Widowed61 (4.6%)12 (3.7%)5 (3%)0.532
    Employment
     Employed546 (41%)140 (43%)82 (49%)0.139
     Not employed515 (39%)120 (37%)63 (38%)0.823
     Retired229 (17%)50 (16%)15 (9%)0.022
     Student36 (2.7%)13 (4%)6 (3.6%)0.430
    Insurance
     Medicare/Medicaid785 (59%)166 (51%)89 (54%)0.020
     Uninsured102 (7.7%)26 (8.0%)11 (6.6%)0.848
     BWC52 (3.9%)20 (6.2%)14 (8.4%)0.015
     Managed care/commercial386 (29%)111 (34%)52 (31%)0.189
    Injurycharacteristics
    Mechanism of injury
     Assault24 (1.8%)0 (0%)0 (0%)–
     ATV/dirt bike/snowmobile17 (1.3%)7 (2.2%)3 (1.8%)0.474
     Burn6 (0.5%)2 (0.6%)0 (0%)–
     Crush39 (2.9%)12 (3.7%)10 (6%)0.111
     Fall335 (25.2%)66 (20%)14 (8.4%)<0.001
     Motor vehicle collision454 (34.2%)123 (38%)61 (37%)0.419
     Motorcycle collision154 (11.6%)53 (16%)39 (24%)<0.001
     Other23 (1.7%)5 (1.5%)4 (2.4%)0.787
     Pedestrian struck76 (5.7%)16 (5%)12 (7.2%)0.577
     Penetrating (GSW/stab)167 (12.6%)32 (9.9%)21 (12.7%)0.397
     Sports related34 (2.6%)7 (2.2%)2 (1.2%)0.557
    Hospital LOS, days; mean (SD)9.2±9.613.5±11.323±17.7<0.001
    • *P values represent comparisons between all groups.

    • ATV, all-terrain vehicle; BWC, Bureau of Worker’s Compensation; GSW, gunshot wound; LOS, length of stay.

PreviousNext
Back to top
Email

Thank you for your interest in spreading the word on TSACO.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Implementing psychosocial programming at a level 1 trauma center: results from a 5-year period
(Your Name) has sent you a message from TSACO
(Your Name) thought you would like to see the TSACO web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Print
Alerts
Sign In to Email Alerts with your Email Address
Citation Tools
Implementing psychosocial programming at a level 1 trauma center: results from a 5-year period
Natasha M Simske, Trenton Rivera, Mary A Breslin, Sarah B Hendrickson, Megen Simpson, Mark Kalina, Vanessa P Ho, Heather A Vallier
Trauma Surg Acute Care Open Jan 2020, 5 (1) e000363; DOI: 10.1136/tsaco-2019-000363

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Cite This
  • APA
  • Chicago
  • Endnote
  • MLA
Loading
Implementing psychosocial programming at a level 1 trauma center: results from a 5-year period
Natasha M Simske, Trenton Rivera, Mary A Breslin, Sarah B Hendrickson, Megen Simpson, Mark Kalina, Vanessa P Ho, Heather A Vallier
Trauma Surg Acute Care Open Jan 2020, 5 (1) e000363; DOI: 10.1136/tsaco-2019-000363
Download PDF

Share
Implementing psychosocial programming at a level 1 trauma center: results from a 5-year period
Natasha M Simske, Trenton Rivera, Mary A Breslin, Sarah B Hendrickson, Megen Simpson, Mark Kalina, Vanessa P Ho, Heather A Vallier
Trauma Surgery & Acute Care Open Jan 2020, 5 (1) e000363; DOI: 10.1136/tsaco-2019-000363
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
Respond to this article
  • Tweet Widget
  • Facebook Like
  • Google Plus One
  • Article
    • Abstract
    • Background
    • Methods
    • Results
    • Discussion
    • Acknowledgments
    • Footnotes
    • References
  • Figures & Data
  • eLetters
  • Info & Metrics
  • PDF

Related Articles

Cited By...

More in this TOC Section

  • Building trauma capability: using geospatial analysis to consider military treatment facilities for trauma center development
  • A decade of hospital costs for firearm injuries in the United States by region, 2005–2015: government healthcare costs and firearm policies
  • Variability in opioid pain medication prescribing for adolescent trauma patients in a sample of US pediatric trauma centers
Show more Original research

Similar Articles

 
 

CONTENT

  • Latest content
  • Archive
  • eLetters
  • Sign up for email alerts
  • RSS

JOURNAL

  • About the journal
  • Editorial board
  • Thank you to our reviewers
  • The American Association for the Surgery of Trauma

AUTHORS

  • Information for authors
  • Submit a paper
  • Track your article
  • Open Access at BMJ

HELP

  • Contact us
  • Reprints
  • Permissions
  • Advertising
  • Feedback form

©Copyright 2022 The American Association for the Surgery of Trauma