Pete Soto dedicated his life to public service. A former army medic, he was a police officer for nearly 20 years.
In 2010, as he responded to a report of domestic violence, a truck hit his motorcycle, pinning him underneath and shattering his pelvis. Soto had less than a 5 percent chance to live.
For two weeks, he was in a medically induced coma in the intensive care unit at The MetroHealth System, an America’s Essential Hospitals member in Cleveland.
His recovery, a lengthy process that included 15 surgeries and years of rehab, was difficult and left him feeling like a burden on his family — so much so, that “I’m sorry” were his first words to his wife when she rushed to the hospital after the accident, his police chief has told him.
Soto felt frustrated with the pace of his healing and struggled to accept a future that looked different from the one he had imagined — one that didn’t include returning to work in the field.
“I had lofty expectations, thinking that, ‘oh, I’m going to get back to work.’ I was a big runner, I was training for a marathon when I got hurt,” he says. It took a “crushing” conversation with his tough-love physician, Heather Vallier, MD, to begin his journey toward a “new normal.”
Soto’s experience is common among trauma survivors. Further, the struggle to adapt to a new normal can be compounded by social risk factors, including food insecurity, housing instability, or lack of transportation. As the longest-operating level I trauma center in one of the top 10 cities for severe traumas, MetroHealth aimed to confront those social risk factors by joining the Trauma Survivors Network (TSN), an American Trauma Society program built to connect and support trauma survivors and caregivers through the continuum of care.
“We do a great job of putting bones back together, expert surgeon care, and yet our patients aren’t recovering. They aren’t getting back to their lives and they aren’t reporting satisfaction with their journey,” says MetroHealth Community Trauma Institute Director Sarah Hendrickson, MEd. “So many feel like this is a life-ending vs. life-changing event. We really have to make sure that we don’t lose people that were [physically] saved by a great care system.”
In times of crisis, patients and caregivers can struggle to recall information providers share, so the TSN works to give them additional opportunities to engage clinical and support staff. Before launching the TSN, “it was common for patients and families to only interact with emergent physicians and the care team, and it was often intermittent interaction,” Hendrickson says. “The expectation of recovery was addressed at discharge or in rehab, or not at all.”
To increase touchpoints and bolster communication among patients, caregivers, and staff, MetroHealth worked to increase engagements and connections during the patient’s stay. A trauma recovery coach works alongside social workers, case managers, and the care team to educate and support patients and their families.
In 2015, the health system enlisted the trauma recovery coaches to make follow-up phone calls to every person discharged within an eight-week period in the peak of “trauma season.” Accounting for injury type, patient demographic, and hospital volume, the health system saw a nearly 85 percent increase in follow-up at its trauma, orthopedic, and plastic surgery clinics compared with the same period in 2014.
While coaches don’t provide medical advice, they work to empower patients and families to ask questions, connect them with resources, and provide hope.
“We often say that we’re providing not false hope or empty hope, but the right kind of hope for the situation,” Hendrickson says. “Hope is paramount to recovery.”
Sometimes, other survivors are the best channel for sharing that hope. The heart of MetroHealth’s TSN is its Peer Survivor Program, which pairs trauma patients with trained survivors, who meet with them weekly to share support. Often, patients disclose more to a peer than they might to a physician, Hendrickson says.
“To talk with someone about how your identity shifts after you’ve been through something traumatic and help you feel comfortable with being vulnerable is a huge part of healing,” Hendrickson says. “We wholeheartedly believe that peer mentorship is a clinical intervention.”
Program leaders strive to pair patients with survivors with similar injury profiles and experiences. Their aid helps transition patients out of crisis mode, both physically and emotionally. Some trauma survivors who develop depression and post-traumatic stress disorder struggle to engage the part of their brain responsible for preparing for the future. Peer mentors can help them activate that part of their brain and manage their expectations, perspectives, and goals.
When recruiting volunteers for the program, Hendrickson knew right away whom to call.
“Pete is one of the most loving, compassionate, dedicated people I’ve ever met in my life,” she says.
Soto had previously helped a struggling trauma patient open his mind to therapy, an experience he found fulfilling.
“I’ve always had the bug for helping and trying to fix things, so when I got injured and had — I felt — nothing to give, it’s like I was seeking and looking for a purpose, and this fell in my lap and gave me a little bit of purpose — just trying to help my community.” He shares an especially close bond with Kim Jaworski, another trauma survivor who suffered a violent injury and now volunteers with the program himself. “He said, ‘you got me through this.’”
Even though Soto recently moved to Tennessee to help care for his infant granddaughter, he still makes it to the hospital almost every time he visits home.
“It’s cathartic for me,” says Soto, who wishes he’d had a mentor during his own recovery. “You take the good with the bad, and find the silver lining in everything, and this is definitely a silver lining.”
The peer support program has grown to 21 mentors and more than 5,000 visits to date. It’s just part of a network of services MetroHealth provides to help trauma survivors receive proper care, despite the social risk factors they might face. The health system provides transportation to follow-up appointments, referrals to trauma-focused counseling, and resources for post-traumatic stress disorder. The TSN runs a “We’ve Got You Covered” campaign to fund care packages with blankets, tote bags, and toiletries to deliver to survivors’ families.
“We try to bring dignity, regardless of where you are in your socioeconomic status or where you are in the severity of injury — to everyone involved,” Hendrickson says. Regular support groups and events help build community among survivors.
MetroHealth’s model is inspiring other hospitals around the country. Kim Nasby, RN, a trauma injury prevention coordinator at essential hospital SUNY Upstate University Hospital, in Syracuse, N.Y., recently attended a regional training at MetroHealth to learn how to start a program at her own hospital. She thinks a robust trauma survivors network can contribute to a holistic care model.
“It makes us better to make sure that when [survivors] get discharged from the hospital, they are cared for and they have the resources available to live a productive life,” Nasby says. “We don’t want them to continue to tap into the health care system because we didn’t care for them fully or wholly as we could have when they were here.”
Hendrickson agrees. “As an essential hospital, to say we’re going to invest in an unconventional way to take care of trauma and conventional health issues, it’s a real nod to the … fighting passion to make things better with limited resources.”