Administering ACE questionnaire in a clinical setting

Readers may be interested in the results we unexpectedly attained when the ACE questions were routinely integrated into the general medical questionnaire we used as Step 1 in comprehensive medical evaluation of >400,000 adults over a multi-year period in one setting.  They are described starting on p211 of the attached overview of ACE Study findings.  Anyone may feel free to use the ACE Study questionnaire in their own work.  I'd certainly be interested in hearing what was learned.

Dr. Felitti, 

looking forward to meeting you here in Hagerstown in March. I work with Joan Gillece and Tonier Cain. 

We are excited to hear you.

David

Jane Stevens posted:

Hi, Everyone -- Here's an update about the upcoming chat. We decided to schedule it Tuesday, March 1, a few days after the launch of the ACEs in Primary Care group on Feb. 26. We'll also be restructuring and upgrading of the ACEs in Pediatrics group (to see the new interest-based group structure, check out the ACEs in Education group).

For the chat, I'm hoping to have someone from a primary care clinic that has  integrated the ACEs survey be the featured guest, so that we can get some information about how it's being implemented, and how it's working.

Thanks for your enthusiasm -- and your patience!

As soon as we have ID'd our featured guest, we'll announce time/date.
With the interest we see in this topic, we anticipate doing a chat every two or three weeks.

Cheers, Jane

When on Tuesday, Jane, and by what medium?  Having done this with 440,000 adult patients in one setting, I have some possibly useful ideas, but Tuesday is a busy day. 

Although I've been in touch with a person at the primary care clinic that I'd like to be our featured guest, I haven't received confirmation. To make sure we give everyone enough lead time, we'll try to schedule this the week of March 7. As soon as I know, you'll know!!
And once we get the first one organized, then we'll have a regular schedule for chats.
Thank you for your patience!!

Hello,

Did you all end up having a group phone call?  If not and you are still planning to talk, I would love to join!

thank you

rachel

Rachel Gilgoff posted:

Hello,

Did you all end up having a group phone call?  If not and you are still planning to talk, I would love to join!

thank you

rachel

I'm hoping Jane will follow up her previous comment  in this thread, otherwise it may be hard to find.

The person I was hoping would be our first guest wanted to wait three more months. I have another clinic in mind, and will keep everyone posted. We'll announce it well in advance, to make sure that people have enough lead time to get it on their calendars.
Thank you for your patience!Cheers, Jane

Many thanks, Jane. 

Responsive and prompt as usual :-) 

I'm either prompt, or take weeks to respond!  Doesn't seem as if there's much inbetween!  ;-))

Dr. Felitti, 

I appreciate the Chadwick Chapter 10 you posted. I am disappointed that I can not find the book Lost Lives by Dr. Helander. 

As noted earlier I work in an ER in Baltimore. My position was created to address 30 day readmissions.  The system has really improved services for common I illnesses such as COPD and CHF. Digging deeper leads one to the ACE's. Unfortunately my boss specifically forbid me to ask the ACE's in the ER citing that the context of the ER is inappropriate and we don't have the services they need. (I was mostly asking those with substance issues). 

I have backed it up a couple steps and am currently working on expanding the treatment resources in my state. I am fond of the work of Bessel Van der Kolk in forwarding our understanding of why we need to expand solutions beyond Cognitive Based Therapies such as the Creative Arts, Trauma Informed Yoga Therapy etc.

As a Case Manager I can only refer to practitioners who are recognized by the state which at this point is CBT and Art Therapist. I am trying to work to get more of the Creative Therapies recognized (http://www.nccata.org) in my state. The first goal is that Case Managers such as myself would be educated. My second goal is that patients would be educated so they could participate in picking a provider that most matches how they learn. Ideally Case Managers or a special 'Therapy gatekeeper' role would be created in Patient Navigation models whose role is to have an deep knowledge of the pros/cons of each therapy and do an initial screening of patients to point them to the provider most likely to facilitate permanent change. 

Once some sort of community referral system is in place I hope to revisit question of Acute Care Hospitals asking the ACE questions. 

You might write write to Dr. Helander to purchase a copy directly.  He is at <meghelander@netcabo.pt> and his web site is <www.EinarHelander.com>.  Alternatively a hospital library could probably find you a copy somewhere in the US for inter-library loan.  

The attached chapter, starting on p211 might be of interest re OPD and ER visits.  If you used the one-page version of the ACE Questionnaire, and if it caused a measurable reduction in subsequent visits, you'd have a publishable article, regardless of whether you could enter the information in your ER notes.