Sydney Timmer-Murillo

Millions of individuals sustain traumatic injuries each year, yet the emotional impact of hospitalization and acute medical care remains understudied. Trauma-informed care (TIC) offers a framework for reducing retraumatization and supporting both patients and providers, but little is known about how TIC is understood or applied in trauma centers. This qualitative study used a human-centered design approach to examine healthcare workers' experiences, perceptions, and training needs related to TIC within a Level 1 trauma center to inform development of a training on TIC. This study employed a qualitative approach guided by principles of Human-Centered Design (HCD) to explore healthcare workers' perceptions, experiences, and training needs related to trauma-informed care (TIC) within a high-acuity trauma setting. Healthcare workers, including nursing assistants, registered nurses, physical therapists, advanced practice providers, and physicians were included as key informants in defining the relevance, challenges, and applicability of trauma-informed practice at the trauma center. Participants were recruited from the Trauma and Acute Care Division and hospital unit serving predominantly traumatically injured patients. Using thematic reflexive analysis, semi-structured interviews (range: 10-25 min) with 20 multidisciplinary staff revealed three overarching themes: the emotional toll and burnout associated with trauma work; TIC-aligned practices (including empathetic communication and perspective taking); and training needs including format and content and skills needed to deliver TIC effectively. Participants emphasized the need for practical, hands-on training tailored to the realities of trauma care. Trauma-informed approaches have the potential to improve patient recovery, reduce psychological distress, and lessen strain on healthcare systems. Study findings can inform broader behavioral medicine practices by guiding the development of scalable TIC interventions that meet providers' identified needs which are adaptable to trauma centers, emergency care, and other high-acuity medical settings to enhance patient-centered care.

BACKGROUND: The field of trauma surgery has recognized the significant psychological distress and psychiatric comorbidity of trauma patients, and, increasingly, the critical role that psychological factors play in patients’ long-term adjustment to injury. Patients experiencing violence-related injuries are at added risk of poor mental health outcomes. The current study sought to better understand the association between contact with a psychology consultation service during hospitalization for violently injured patients and post-discharge health care utilization. METHODS: A retrospective cohort study from 2016 to 2022 of adults older than or equal to 18 years with traumatic injuries was conducted at a level I trauma center in the US Midwest from 2017 to 2022. Trauma Registry and Electronic Medical Record (EMR) data were pulled for injury characteristics (injury severity score, length of hospital stay), receipt of inpatient psychological consultation, the total time spent with psychology services during the hospitalization, hospital readmission, emergency department visits, and outpatient injury-related and mental health visits. Four analyses of covariance (ANCOVA) examined differences in health care utilization outcomes between patients who received psychology consultations and those who did not. Further, linear regressions examined if total amount of psychology service time was associated with outcomes. RESULTS: A total of 3,322 patients (M _age =34.55, SD=13.23) were admitted for a violence-related injury between 2016 and 2022. The results demonstrated that those with psychological consultations had more post-discharge injury-related appointments, mental health appointments, and ED visits, but not readmissions. Further, total time with inpatient mental health service predicted post-discharge injury-related and mental health service utilization. CONCLUSIONS: Results indicate that involvement with inpatient psychology services post-injury was associated with follow-up care attendance. With prior research showing patient engagement improving recovery outcomes, embedded psychological care may aid in reducing barriers to treatment both inpatient and post-discharge. ( J Trauma Acute Care Surg . 2026;00: 00–00. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved) LEVEL OF EVIDENCE: Level III.

Racism in policing continues to be a serious issue in the United States (U.S.). While most efforts to reduce racism, focus on changing implicit (i.e., nonconscious) racial biases, other factors may also influence behavior. Intergroup emotion theory posits that emotions, especially empathy, may play a powerful role in changing behavior. In this study, using community-based participatory research design we created and tested a virtual reality (VR) experience designed to reduce implicit racial bias through perspective taking and counter-stereotypical information. Fifty-six police officers from a large city took part in the study. They completed questionnaires and an implicit association task (IAT) before and after the VR experience to measure empathy and racial bias. After using the tool, officers showed a significant drop in implicit racial bias. The parts of the VR experience that included counterstereotypes increased empathy, as well as the components that encouraged officers to engage in perspective taking. Importantly, the empathy that officers reported during the VR experience was predictive of a stronger interest in working with community members through community building activities. This study shows that empathy, an emotion that can build connections, is a key factor to meaningful change in policing through bias reduction and empathy building.

In the USA, traumatic injury results in a significant financial burden, which is unevenly distributed in our society. In this paper, we will highlight some of the data around the costs of injury associated with a focus on socially vulnerable and historically resilient groups at risk for disparate outcomes. We delve into the concept of economic return on investment from multiple perspectives: the patient perspective, the community perspective and from a national and policy perspective. Targeted policy changes and dedicated efforts towards minimizing gaps in trauma care and enhancing survivorship can yield substantial economic benefits. This paper also describes several national funding agencies and their current priorities related to funding in equity and trauma research. This manuscript will demonstrate that reducing disparities in trauma care not only serves a moral imperative but also a necessary and financially sound strategy with a good economic return on investment.

Despite remarkable advances in clinical care, injury remains a leading cause of death in the USA. Recent studies in the care of the injured patient have begun to unearth the crucial influence of health disparities and health inequity on outcomes after injury. Importantly, it is known that there are strikingly disparate outcomes following injury based on demographic backgrounds, with racial and ethnic minoritized groups having a higher risk of death from traumatic injury. This paper highlights the problem of health inequity after injury by addressing health and health care disparities in trauma with a focus on the proceedings from the Summit on the Advancement of Focused Equity Research in Trauma organized by Coalition for National Trauma Research’s Equity, Diversity and Inclusion Committee. Included in this work is an assessment of the structural determinants of health inequities and the evidence for widespread inequities across the continuum of trauma care; with an emphasis on five vital, actionable steps towards health equity that can be taken now by the trauma community, including firearm injury prevention, Medicaid expansion, trauma-informed care, equity measurement and benchmarking, and improving trauma survivorship. Ultimately, to move towards improved quality of care for all injured patients, we must eliminate health care disparities in trauma care across the continuum and work towards more equitable care for all.

Trauma research is an expansive discipline that informs injury prevention, best practices in care, and novel interventions. However, implicit bias, or the unconscious stereotypical beliefs about groups of people, can have profound implications for traumatic injury research. Several forms of implicit bias can emerge in trauma research, which deepens existing disparities based on race or ethnicity, sex, ability status, socioeconomic status, and other factors. This paper reviews how implicit bias affects the development of research and the application of findings, potentially leading to suboptimal care and misdirected preventive strategies in trauma. We present the recent dialogue and progress on implicit bias in research at the Summit on the Advancement of Focused Equity Research in Trauma (SAFER-Trauma) conference, an Agency for Healthcare Research and Quality-funded assembly of multiple disciplines which was convened to tackle the challenges involved in addressing disparities in traumatic injury. Through this review, we seek to generate momentum for action toward reducing implicit bias and establishing comprehensive equity-focused standards of trauma research and practice.

On August 2–3, 2023, the Summit on the Advancement of Focused Equity Research in Trauma (SAFER-Trauma) convened to discuss strategies to support research to eliminate disparities in trauma care. An ongoing challenge for performing high-quality equity-based research is the uncomfortable recognition that implicit bias and structural racism are deeply ingrained in our society and culture and are therefore often unrecognized in medicine and research practices. Throughout SAFER-Trauma, several examples of strategies to overcome these challenges were presented. In this article, we will relate a diverse array of examples through three distinct angles. The first focuses on innovations that harness existing data in novel and groundbreaking ways, uncovering fresh insights and applications from information already at our disposal. The second examines innovations that arise from traditional healthcare systems and research methods, showing how research in the healthcare sphere can adapt to meet modern needs. The third will explore projects that emerged from communities, driven by the pressing needs and aspirations of the people they serve.