Becoming a “second victim” in health care: Pathway of recovery after adverse event

Rinaldi, Carmela; Leigheb, Fabrizio; Vanhaecht, Kris; Donnarumma, Chiara; Panella, Massimiliano

doi:10.1016/j.cali.2016.05.001

Cited by 50 publications

(112 citation statements)

References 23 publications

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“…Health-care facilities without emotional support for staff need to consider the implementation of a second victim peer support program and evaluate its effectiveness. 27 …”

Section: Discussionmentioning

confidence: 99%

Deployment of a Second Victim Peer Support Program: A Replication Study

Merandi

Liao

Lewe

et al. 2017

Pediatric Quality &Amp; Safety

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Background:The second victim phenomenon occurs when health-care providers experience significant professional distress (compassion dissatisfaction, burnout, secondary traumatic stress) and psychological distress (shame, anxiety, and depression) as a result of medical errors or adverse patient outcomes. Few hospitals have institution-wide systems in place to assist employees through the recovery process.Methods:At Nationwide Children’s Hospital (NCH), a peer-based support program called “YOU Matter” was executed and spread hospital-wide. The program emulated the framework and execution strategy designed by University of Missouri Health Care’s (MUHC) “forYOU” Team. Strategic elements of the program’s structure were reviewed and adapted for NCH with system-wide deployment and enhancement to include electronic peer support reporting. This article summarizes program implementation, management, and sustainment over the past 2 years.Results:By following University of Missouri Health Care’s model, we successfully deployed an institution-wide second victim program. Since the November 2013 initiation, we have documented 232 peer and 21 group encounters. High-risk clinical areas for second victimization at NCH included the emergency department (ED), pediatric intensive care unit (PICU), cardiothoracic intensive care unit (CTICU), and pharmacy department. Registered nurses (RNs) and licensed practical nurses (LPNs) have had the highest number of encounters necessitating second victim support (32%). Supported staff reported improved emotional state and improved return-to-work metrics.Conclusions:An organization’s culture of patient safety can be enhanced by ensuring staff psychological safety. Programs like “YOU Matter” and the “forYOU” Team are essential building blocks to improve the overall safety culture and quality of care. Implementation of “YOU Matter” at NCH validates the MUHC program and demonstrates its generalizability to other health-care institutions.

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“…Health-care facilities without emotional support for staff need to consider the implementation of a second victim peer support program and evaluate its effectiveness. 27 …”

Section: Discussionmentioning

confidence: 99%

Deployment of a Second Victim Peer Support Program: A Replication Study

Merandi

Liao

Lewe

et al. 2017

Pediatric Quality &Amp; Safety

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“…It exposes patients to the risk of receiving unnecessary examinations or of being excluded from treatments; and increases the costs of care. Interconnected with medical errors and defensive medicine, is the concept of the ‘second victim’, a healthcare worker involved in an adverse event, error and/or injury, who is traumatized by the event. Being a second victim is the strongest predictor of practising defensive medicine.…”

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confidence: 99%

“…Being a second victim is the strongest predictor of practising defensive medicine. The pathway of recovery for second victims might differ from that occurring after traumas, with most feeling that the support received is inadequate. The last postevent phase, career outcome, can result in healthcare workers who: (1) consider leaving their position, (2) continue and cope without forgetting, and (3) thrive by reviewing events and participating in enhancing care delivery for future patients.…”

mentioning

confidence: 99%

“…The pathway of recovery for second victims might differ from that occurring after traumas, with most feeling that the support received is inadequate. The last postevent phase, career outcome, can result in healthcare workers who: (1) consider leaving their position, (2) continue and cope without forgetting, and (3) thrive by reviewing events and participating in enhancing care delivery for future patients. We must make sure that errors are prevented, but there is a crying need for the ‘humanization’ of doctors, which is different from the historical paternalistic approach, and can only be possible with the input of authorities/entities at a global level; and we must be able to become better surgeons after committing errors.…”

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confidence: 99%

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Deaths, errors and second victims in surgery: an underestimated problem

Pellino

Pellino²

2020

Journal of British Surgery

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“…A vicious cycle starts when doctors are involved in an unexpected adverse event, mistake, and/or patient related harm; then are sued by the patient or relatives; next the (sometimes huge) trauma related to the event leads to physical, cognitive, and behavioral symptoms, including the practice of defensive medicine[ 29 , 30 ]. Support obtained by these physicians in their institutions is poor and inefficient[ 31 ]. Adequate support is necessary to help interrupt this negative series of events.…”

Section: Introductionmentioning

confidence: 99%

Defensive medicine: It is time to finally slow down an epidemic

Vento¹,

Cainelli²,

Vallone³

2018

WJCC

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Defensive medicine is widespread and practiced the world over, with serious consequences for patients, doctors, and healthcare costs. Even students and residents are exposed to defensive medicine practices and taught to take malpractice liability into consideration when making clinical decisions. Defensive medicine is generally thought to stem from physicians’ perception that they can easily be sued by patients or their relatives who seek compensation for presumed medical errors. However, in our view the growth of defensive medicine should be seen in the context of larger changes in the conception of medicine that have taken place in the last few decades, undermining the patient–physician trust, which has traditionally been the main source of professional satisfaction for physicians. These changes include the following: time directly spent with patients has been overtaken by time devoted to electronic health records and desk work; family doctors have played a progressively less central role; clinical reasoning is being replaced by guidelines and algorithms; the public at large and a number of young physicians tend to believe that medicine is a perfect science rather than an imperfect art, as it continues to be; and modern societies do not tolerate the inevitable morbidity and mortality. To finally reduce the increasing defensive behavior of doctors around the world, the decriminalization of medical errors and the assurance that they can be dealt with in civil courts or by medical organizations in all countries could help but it would not suffice. Physicians and surgeons should be allowed to spend the time they need with their patients and should give clinical reasoning the importance it deserves. The institutions should support the doctors who have experienced adverse patient events, and the media should stop reporting with excessive evidence presumed medical errors and subject physicians to “public trials” before they are eventually judged in court.

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Becoming a “second victim” in health care: Pathway of recovery after adverse event

Cited by 50 publications

References 23 publications

Deployment of a Second Victim Peer Support Program: A Replication Study

Deployment of a Second Victim Peer Support Program: A Replication Study

Deaths, errors and second victims in surgery: an underestimated problem

Defensive medicine: It is time to finally slow down an epidemic

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