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With troubled patients, a team approach helps

Trauma-informed care response, or TICR, huddles ensure the safety of both patient and staff.


It’s easy to feel alone or ill-equipped when working with complex patients and unstable or dangerous behaviors. To help both staff members and patients, Asante recently adopted a trauma-informed care response, or TICR, huddle.

A TICR huddle pulls in nursing leadership (such as a charge nurse), house supervisor, security officer and patient-assigned primary nurse or CNA to evaluate the patient’s circumstances and develop an appropriate safety response. The huddle may also include providers, rehab services, pharmacy, resource management or the patient themselves.

A TICR huddle saved the day when a patient was in a crisis and unable to redirect. Within a few minutes of calling the huddle, the team learned that not only was the patient escalated due to mental health needs, the patient was also worried about a loved one who was admitted as an inpatient.

Once the team understood what was contributing to the patient’s crisis, they were able to create a safety plan that reassured the patient about their loved one. With this information, the team motivated the patient to focus on their own health care treatment so they could be stabilized and reconnect with their loved one faster.

As an added preventive measure, Security increased rounding and checked in with staff about this patient more frequently. The staff shared that having this extra support and knowing how to effectively interact with words that worked for the patient was helpful and impactful.

Consider using the TICR huddle as a tool to prevent code grays for patients with a history of unstable behaviors. Or it can also be used as a debriefing tool after a code gray.

This procedure was optimized for the hospital setting. For additional information, or requests to adapt the procedure in your unique department, email WP*@as****.org. Click here for the procedure Trauma Informed Care Response Huddle 400-PCS-NURS-0964 .

To learn more about this and other workplace violence prevention efforts, visit the Asante’s Workplace Violence Prevention Program page.

Tags: Behavioral Health, huddle, multidisciplinary, safety, TICR, trauma-informed care response
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