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Working with Leadership to Improve Clinician Support for Second Victim Syndrome

Series: Second Victim Syndrome

Organizational awareness of second victim syndrome and an institutional response plan for it are critical to minimizing its stress on a clinician. Clinician support must become a predictable and required part of the health care operational response to stressful clinical events. Leadership engagement and a strong infrastructure for clinician support are essential to effectively address second victim syndrome, which can lead to physician burnout.

Promoting Organizational Awareness

Physicians can work within their organizations to promote organizational awareness of the value of second victim support.

On-Demand: The Three Victims of Medical Errors: How Supporting the Second can Help the Third and First is a one hour on-demand webinar that shows the positive effects of addressing organizational support to enhance patient safety, as well as the negative impact of not focusing on this issue.

Customizing an Institutional Response Plan

Organizations should begin providing support immediately after an unanticipated event and should continue providing it for as long as necessary. Information about the available support options should be widely distributed so clinicians know how to access help when they experience an unanticipated outcome. Support services should be flexible. For example, institutions can offer in-person or telephone counseling with therapists or other physicians who have coped with patient-care errors. In addition, services can be offered both during and outside of work hours.

Leadership Response to a Sentinel Event: Respectful, Effective Crisis Management
There are support tools available to help customize an institutional response plan in the event of adverse outcomes. The Institute for Healthcare Improvement has assembled several resources to help organizations manage serious events.

Supporting Clinicians Involved in Errors and Adverse Events

The commitment for a culture of safety and support encompasses six key elements:

1. Effective accident response.

Distracted clinicians feel internal and external turmoil. University of Missouri School of Medicine in Columbia addresses the trauma that providers may experience, including potential harm to the provider.

2. Help with intrusive reflections.

Repeatedly replaying the events mentally may intrude on a clinician’s thoughts and increase self-doubt. Ruminating over medical errors may result in anguish, sadness, and concern.

3. Restoring personal integrity.

In “The Natural History of Recovery for the Healthcare Provider ‘Second Victim’ after Adverse Patient Events,” interview participants provide insight into the type and quality of peer and institutional support they received to restore personal integrity.

4. Help with coping with the investigation.

Clinicians may be required to participate in an institutional investigation in the aftermath of a serious event. Although this in-depth case review is an important part of the quality improvement process, it carries an emotional impact. Clinicians may need help coping with the process.

5. Obtaining emotional first aid.

Clinicians feel isolated after a serious event. It is important to seek personal support from family, friends, and colleagues, as well as professional support as needed.

6. A how-to for moving on.

This article provides a case study involving a physician using a checklist to review the adverse event with her team, allowing the team to move on while balancing a no-blame approach with personal accountability.