Health Leaders Media reported in an online article that due to the work of medical professionals like Albert Wu, MD, director of Johns Hopkins’ Center for Health Services and Outcomes Research, hospitals are finally changing the way they respond to the needs of healthcare providers affected by adverse events.
The Institute for Healthcare Improvement has suggested that when an adverse event occurs, a hospital has three basic priorities:
- To care for the patients and family members who are direct victims of the event;
- To care for the front-line healthcare workers involved; and
- To address the needs of the organization.
Every healthcare worker carries with him or her the risk of becoming a “second victim,” a term coined by Dr. Wu in an article written for the British Medical Journal in 2000.
Haunted by the repeat occurrences of bullying, gossip, and blame that for years he witnessed colleagues enduring in the wake of adverse events, Wu had a hard time comprehending the industry’s long-standing reluctance to address the emotional needs of staff linked to undesirable outcomes.
When we consistently punish each other for making mistakes, Wu explains, we are creating an environment where everyone is afraid to talk and where that silence just leads to repeated mistakes and more bad outcomes. On the contrary, Wu says errors need to be widely talked about so that true learning can happen.
According to Wu, hospitals not only have an ethical obligation to help personnel heal in these situations, but he alludes to the existence of a fiscal responsibility as well. Wu points out that having to replace a burned out second victim can be very expensive, sometimes costing a hospital in excess of $100,000.
Susan Scott, RN, patient safety officer at University of Missouri Healthcare discovered just how critical empathy and dialogue are when it comes to helping second victims cope. Inspired by Wu’s research and overwhelmed by the pain and defeat that she sensed over and over again in interviewing physicians following adverse events, Scott pioneered the hospital’s forYou Team, one of the first-ever organized systems for reaching out to emotionally distressed care givers.
Since Scott’s team’s establishment, the hospital has trained 99 volunteers to deliver “emotional first aid” to at least 639 second victims, and it’s important to note that many of the team’s volunteers have been second victims themselves. This fact is significant because one of the issues that Scott discovered in building her program is that second victims want to be able to talk to people who know what it’s like working in a hospital. This sort of empathy is exactly what makes this method so different from traditional employee assistance programs which typically are managed by outside professionals.
Scott also acknowledged that not all bad outcomes necessarily happen as a result of errors, but they could lead to errors down the road if not properly dealt with. The unexpected death of a patient or even a colleague can place tremendous stress on staff. In fact, she cited a devastating situation in which a young surgery technician experienced leg pain one morning, suffered a pulmonary embolism that afternoon and died the very next day, but sadly, the story did not end there. That young tech’s own team had the job of harvesting her organs for transplant. A story like this one can only reinforce the notion that helping second victims work through traumatic experiences with the potential for leaving an unhealthy psychological imprint is a key step in building a stronger healthcare system with fewer medical errors.
Under Wu’s leadership, Johns Hopkins launched a similar program in 2011 called the RISE (Resiliency In Stressful Events) Team. This team of about 30 volunteers was begun specifically for pediatric caregivers and was partially funded by the Josie King Foundation. Today, similar programs are in the works at hospitals including Brigham and Women’s Hospital and Beth Israel Deaconess Medical Center in Boston and at Stanford University Hospital in California.
To learn more about efforts to support second victims, click here.
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