Objective
Introduce principles and review strategies for supporting healthcare professionals impacted by adverse patient safety events. By the end of the session the participant will be able to:
1.Relate to the impact of a patient safety adverse event on the provider, based on a personal story provided by a healthcare professional.
2.Describe the potential impact of traumatic experiences on the health and well-being of healthcare professionals.
3.Identify key elements of an effective program for supporting caregiver coping with adverse patient safety events.
4.Explain how a just culture promotes peer to peer support of the second victim.
WATCH: http://bit.ly/1HxceIf
2. Do you have a formal program available to
support healthcare providers involved in a
Patient Safety Incident?
3. Dr. Katrina Hurley, MD, FRCPC, MHI, Emergency
Physician, IWK Health Centre
“As a physician and parent I have made lots
of mistakes! Although I would not consider
myself an ‘expert’in mistakes, I have
ruminated about it enough to provide
perspective on the impact to health care
practitioners.”
4. Do you partner with healthcare providers, in
your organization, who are willing to share
their stories of being involved in a Patient
Safety Incident?
12. Do you think the AHS Principles are
comprehensive enough to provide support
for a psychologically healthy culture?
13. Dr. Verna Yiu
Vice President, Quality and Chief Medical Officer
Alberta Health Services
14. When Caring Hurts
Helping Helpers Heal
Albert Wu, MD, MPH
Professorof Health Policy &
Management and Medicine
15. Financial Disclosures/Unapproved Use
• I have financial relationships with a commercial entity that is
relevant to the content of this presentation
– Maryland Patient Safety Center (grant funding)
– Josie King Foundation (grant funding)
• I will not reference unlabeled or unapproved uses of drugs or
other products.
18. Second Victim
• A health care provider involved in an unanticipated
adverse patient event and/or medical error who is
traumatized by the event
19. Short Term Symptom (Days – Weeks)
• Numbness, Confusion
• Detachment / Depersonalization
• Grief, depression, anxiety
• Withdrawal, agitation, sleep disturbance
• Re-experiencing of the event
• Physical symptoms
• Shame / guilt / self doubt
• Impairment in functioning
20. Post Traumatic Stress Disorder (PTSD)
• Re-experiencing the original trauma through flashbacks,
nightmares
• Avoidance of stimuli associated with the trauma
• Increased arousal: difficulty falling or staying asleep, anger,
hypervigilance
• Symptomslasting > one month
31. The RISE Team - Mission
“To provide timely peer support to
any employee who encounters a stressful,
patient-related event”
32. Psychological First Aid
• Compassionate, supportive practical assistance to
individuals recently exposed to serious stressors
• Involves non-intrusive, practical care and support
– Assessing needs and concerns
– Listening, but not pressuring people to talk
– Comforting people and helping them to feel calm
– Helping people Link to information, services and social supports
34. • VOLUNTARY
• Peers: Managers, nurse leaders, pastoral care, social
workers, physicians, surgeons, respiratory therapists,
pharmacy etc…
• Seek recruitment via organizational leaders
Pager: 410-283-3953
RISE Team Membership
35. RAPID Psychological First Aid
(Johns Hopkins Center for Public Health Preparedness)
Reflective Listening
Assessment of Needs
Prioritization
Intervention
Disposition
39. RISE Services
• Non-judgmental, safe, peer-to-peer support for employees
who have experienced a stressful patient related event
• No investigation
• No report back to a supervisor
• 24/7
• One to one or group support
Pager: 410-283-3953
40. Presented by Maryland Patient SafetyCenter in collaboration
with The JohnsHopkins Hospital RISE Program
44. Summary
• Second Victim: health care worker who suffers emotional
trauma from a patient adverse event
• When patients are seriously harmed by health care, there are
always “Second Victims”
• Extent of problem is large
• Individuals and organizations can increase awareness,
increase resilience and provide psychological first aid
44
49. References
Wu, AW. Medical Error: The Second Victim. The Doctor Who Makes the
Mistake Needs Help Too. BMJ 2000 320:726-727.
Pratt S, Kenney L, Scott SD, Wu AW. How to develop a second victim suppor
program: a toolkit for health care organizations. Jt Comm J Qual Patient
Saf.2012 May;38(5):235-40,
Wu AW, Steckelberg RC. Medical error, incident investigation and the second
victim: doing better but feeling worse? BMJ Qual Saf. 2012 Apr;21(4):267-70
Scott SD, Hirschinger LE, Cox KR, McCoig M, Hahn-Cover K, Epperly KM,
Phillips EC, Hall LW. Caring for our own: deploying a systemwide second
victim rapid response team. Jt Comm J Qual Patient Saf. 2010
May;36(5):233-40.
Scott SD, Hirschinger LE, Cox KR, McCoig M, Brandt J, Hall LW. The natural
history of recovery for the healthcare provider "second victim" after adverse
patient events. Qual Saf Health Care. 2009 Oct;18(5):325-30.
Seys D, Scott S, Wu A, Van Gerven E, Vleugels A, Euwema M, Panella M,
Conway J, Sermeus W, Vanhaecht K. Supporting involved health care
professionals (second victims) following an adverse health event: a literature
review. Int J Nurs Stud. 2013 May;50(5):678-87.
51. Do you think healthcare providers feel safer
discussing their involvement with a patient
safety incident today than when Dr. Wu first
started researching this topic in the 1990s?
51