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Outcomes are important. When ever you try something new in you agency, you have to as confident as you can that the change will make a measurable difference. Here is the difference TRC made in one agency Aldridge Palay worked with to implement TRC.
Here are some of the outcomes measured by a large, urban-based provider of services to people with intellectual and other developmental disabilities such as autism. These outcomes, measured over an 18 month project, reflect the story of TRC in one agency. They are impressive and reflect the great work of strong leadership and dedicated staff, implementing TRC with Aldridge Palay. Here are some of the outcomes:
Trauma Responsive Care Outcomes: Measuring the difference.
Overwhelming positive reactions to the training. The overall evaluation on a 5-point scale averaged 4.46.
Measured improvements in staff’s level of knowledge of trauma and Trauma Responsive Care. Using a pre-test/post-test model, we measured a 3.15% increase in knowledge base through the pre-test post-test evaluation. One class showed a 5.97% increase. Given that the agency had been training on and discussed some key elements of Trauma Informed Care with all staff before the initiative started, this result is impressive.
Significant organizational improvements on two scales measuring preparedness for trauma informed and responsive care. The agency improved their score on the Creative Cultures of Trauma Informed Care (CCTIC) Fidelity scale from 2.21 to 4.67. This represents an improvement of 114%. On a separate scale, the APG Organizational Assessment, developed for use in Medicaid Waiver services, the agency jumped from a pre TRC score of 5.17 to 13.06 at the end of the project on a 15-point scale. This 7.89-point increase represents an improvement of 153%.
Measured improvement staff retention by 20%. In 2015, the baseline year, turnover at the agency was 70.6. In 2016, the year of implementation, turnover dropped to 48.25, a decrease of 31.66%. There are many factors that contribute to this impressive improvement in turnover, including a change in leadership in 2015. However, this reduction occurred amid rapid expansion, which makes it all the more impressive. TRC is only one of many factors, but is in indicative of improved job satisfaction and improved retention.
Measured decrease in Unusual Incidents (UI) and Major Unusual Incidents (MUI). The agency reported a 38% drop in incidences of aggressive or self-injurious behavior. Most striking, however, is the overall drop in UI’s and MUI’s following the implementation of the CALMER Approach. (See graph). The sharp decline starting in the 3rd quarter of 2016 coincides with the training of all agency staff in that same quarter. This downward trend has persisted for a year. This decline in UI’s and MUI’s was also accompanied by a 43% decrease in the use of restraints and a 29% decrease in the use of emergency services, a key Medicaid metric.
Increase occurrences of positive interaction. The agency also measured, through sampled observation, an increase in positive staff interactions of 37% over the course of the initiative.