"Feeling seen, not judged": Stakeholder experiences during early implementation of a trauma collaborative care model for socially vulnerable survivors.

BACKGROUND

More than 95% of trauma patients survive their initial injury, and up to 50% experience persistent physical and psychosocial challenges that extend well beyond hospital discharge. Socially vulnerable patients, including those with limited social support, limited English proficiency (LEP), substance use disorders (SUD), and exposure to interpersonal violence, face these challenges disproportionately. While trauma collaborative care models (Trauma CCM) may address these gaps, how such models are experienced by providers and patients during the early implementation remains poorly understood.

PURPOSE: To examine stakeholders' experiences during the early implementation phase of what is, to our knowledge, the first trauma collaborative care model in New England designed specifically for socially vulnerable trauma survivors.

STUDY

DESIGN

We conducted a qualitative study informed by the Consolidated Framework for Implementation Research (CFIR) of the early implementation of the Transforming Recovery After Injury for the Long-term (TRAIL) Clinic at a single Level I trauma center. Semi-structured interviews were conducted with 23 stakeholders, including 15 patients, 6 clinic staff members, and 2 community partners.

RESULTS

We identified four interrelated themes: (1) Patients reported feeling seen and heard; (2) Engagement was facilitated through provider adaptation to patient needs; (3) Patients expressed a need for sustained, trauma-informed mental health support extending beyond short-term clinic engagement; and (4) Logistical and emotional challenges were identified during early implementation of the Trauma CCM.

CONCLUSIONS

Trauma CCM reframes post-injury recovery by addressing needs beyond surgical care. Experiences from stakeholders during early implementation emphasized flexible engagement strategies, integrated longitudinal trauma-informed mental health services, and institutional support for the trauma care workforce.