What is Informed Practice?
Trauma informed practice helps creating a better overall experience for the patient. It is important to remind ourselves that everyone has experienced trauma in their life.
To practice from an informed trauma care position benefits everyone.
In simple term, to practice from a trauma informed practice means that we provide patient centered care. It involves taking the time to have conversation with the patient, to allow them to have a say about their care. It gives the patient a perceived sense of control, autonomy and agency.
See them as a whole person.
It is important to see a patient as a whole person with life experiences that impact how they react and engage with the world around them. A person’s actions or behaviours might differ from what you feel is ‘normal’. Keeping this in mind, it is important to be curious about how we can support others when they come for dental support.
Having a clinic that understands the basics of trauma and adapt its practice accordingly will help patients have a better experience.
Create the environment
Calm and soothing office environment: this includes providing things like music & tv shows if available
Modify the Intake Form
When making an initial appointment with a new patient and on the intake form
- Dental assistant staff asking about level of anxiety for new patients when making an initial appointment and make a note for the Dental Professional to know
- Asking patients if there is anything that would be helpful for the clinic to know about their dental history
- Flagging previous dental trauma in the patient’s file
Be curious when anxiety is indicated
OHP will be curious when they see on the initial intake form that the patient experiences anxiety. Taking the time to ask in conversation “On a scale from 0 to 10, 0 not being anxious at all and 10 being the most anxious you can imagine, how anxious are you about the appointment today?” Also asking questions like “What could I do to support you today?” “What would make our time together easier for you?”
Notify them of changes
Letting people know ahead of time if there is a change of Dental Professional including Dentist. Offer to rebook if they are not comfortable working with a different person and waive any cancellation fee.
Offer a conversation
Prior to the oral procedure, offer to the patient to have a conversation before starting any dental work. If space allows, have a regular chair in the treatment room for the client to sit in during that conversation. If not, ask the patient if they would prefer to have the conversation while standing or if they are comfortable sitting in the treatment chair.
- Present a summary of the treatment
- Have some flexibility. Ask if there is anything that the patient needs to be looked at. If it takes precedence, adapt your treatment plan.
- Discuss the preferred pace for the procedure i.e. doing everything in one appointment or multiple appointment
- Allow the patient to ask questions
- Develop a simple non verbal communication code with the patient. For example: Are you good? Thumb up. If the treatment needs to stop raise the left hand.
- Let the patient know there will also be time available to ask questions afterward.
Patients who are anxious in the supine position may feel more comfortable if offered a pillow for their back.
Offer the option of a mirror to see procedures or examinations that are out of the patient’s visual field.
If patient’s nonverbal behaviour indicates a moderate level of anxiety, stop what you’re doing. Allow time for the patient to have a break. Ask what would be useful to the patient.
Make sure of indicating any special requirement for the patient on their chart, highly visible so another practitioner would easily notice it. Add details such as position of chair, gag reflex when xray at the back of their mouth, difficulty with the dental dam…
Remember that increasing the level of sense of control and agency for the patient increases their chances of feeling safer and have an overall more positive experience.
Tools and resources
a statement about the tools that we've got available etc...