The World Health Organization reports that patient harm causes as many deaths as tuberculosis and that 1 in 10 patients is harmed by a hospital stay. How then, do you improve patient safety in your medical organization without leaving your healthcare providers behind?
Who is The Second Victim?
The second victims are defined as "healthcare providers who are involved in an unanticipated adverse patient event, in a medical error, and/or a patient related injury and become victimized in the sense that the provider is traumatized by the event” (Scott et al. 2009)." Studies on previous crisis situations such as the SARS pandemic of 2003 report that up to half of the clinicians who treated SARS patients showed acute psychological distress, burnout or post‐traumatic stress disorder (Tam et al. 2004).
Healthcare Provider Safety is Patient Safety
It's never been more apparent that the safety of providers goes hand in hand with the safety of their patients. The COVID-19 pandemic has shown us that without the proper PPE, risk for the spread of infection becomes exponentially higher. Provider safety goes beyond basic PPE however, since providers are at risk of second victim trauma, it's equally important that providers are reinforced with mindfulness training along with access to mental health providers in order to diagnosis and treat these traumas.
In April of 2020, Dr. Laura Breen, an emergency medicine doctor treating COVID-19 patients in New York City died by suicide. Her father believes that the city and the hospital she worked in are to blame. He told CNN, "She went down in the trenches and was killed by the enemy on the frontline. She loved New York and wouldn't hear about living anywhere else. She loved her coworkers and did what she could for them."
It is often reinforced that a patient dying should be seen as a failure during medical training. Healthcare providers dealing with this deadly disease are feeling an immense responsibility to keep their patients alive.
Second victim traumatization can lead to:
Reduced professional confidence
Feelings of guilt, isolation, depression
Medication and/or alcohol consumption
Managing Provider Safety
In 2019, a program at Massachusetts General Hospital (MGH), Boston was created to help surgeons deal with the trauma of complications during surgery. To do this, they provided opportunities for surgeons to offer and receive support from fellow surgeons who directly understood their experience. This peer support program was developed at MGH with the goal of helping surgeons and surgical trainees deal with not only adverse events that happen during an operation, but also catastrophic patient outcomes and long-term litigation cases. The success of this program was reported in the Journal of the American College of Surgeons.
"A lot of times surgeons suffer alone. We have a perception that surgeons can deal with anything, that we're made of steel. We continue on without taking time to reflect on our own emotions."
—Haytham Kaafarani, MD, MPH, FACS, study co-author & Director of the Center for Outcomes and Patient Safety in Surgery (COMPASS), MGH
When a major adverse event and the team involved was identified, the peer support group members would reach out to affected peers and follow a four-step strategy:
Introduce the process: Emphasize the confidentiality of the conversation and stress that he or she does not know the details of the adverse event and that his or her role is to listen and help, not to investigate.
Non-judgmental listening: Acknowledge the second victim's difficult experience rather than trying to resolve any issues. Avoid trivializing an event or feeling. Peer supporters should be encouraged to offer empathy and to share personal experiences when appropriate.
Review common symptoms & feelings: After an adverse event, ask if the affected peer is experiencing any of these emotions.
Create a plan: Discuss a plan of action with the affected peer by reinforcing useful coping strategies and inquiring about existing support systems. The potential need for continued support is discussed.
Through a peer-support program, healthcare organizations can help providers be more resilient during these exceptional times by creating a safer environment for both patient and provider.
After addressing issues involved with patient safety and how it can improve your providers' mental health as well as the efficiency of your organization, the entire patient experience can be taken into consideration. Patient experience ranks among one of the top five priorities of both new and returning patients when it comes to choosing—and staying with—a medical practice. InSync Healthcare Solutions has identified 9 easy ways to enhance the patient experience within a medical practice. You can download this quick read for free when you click on the banner below.