SECOND VICTIMS & PEER SUPPORT PROGRAMS IN MARYLAND HOSPITALS: A STUDY OF PERCEIVED NEED FOR ORGANIZATIONAL LEADERS
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Problem Statement: Second victims are healthcare providers who are emotionally traumatized after experiencing an unanticipated adverse event. To support second victims, organizations can provide a dedicated support program for their employees. The scope of this study will include the perceptions of organization patient safety leaders of the concept of second victims and on developing a support program to assist their colleagues and caregivers in their organization. Methods: A literature review was conducted on second victims, the need for support programs in healthcare, policy implications, the Malcolm Baldrige Criteria for Performance Excellence, stress disorder, examples of second victim support programs in healthcare settings and in non-healthcare settings. In-depth, semi-structured interviews were conducted with 43 patient safety representatives from 38 acute hospitals in Maryland. Descriptive statistics were generated for both hospital and participant characteristics. Data were analyzed in the QSR NVivo10 software using a mixed-methods approach to generate codes and extract themes from the interviews Results: The response rate was 83%. All participants believed that they and their executives were aware that the second victim problem exists. Although participants varied in their perceptions of whether a second victim program would be helpful, all of the participants agreed that hospitals should offer organizational support programs for their own staff that become second victims. Although some organizations are attempting to promote a ‘just culture’ in responding to events, there continues to be stigma attached with: (1) speaking up during an RCA and (2) accessing support if it was offered to employees. There continue to be gaps in organizational services that are provided regards timeliness of intervention. Also, there is a need for peer support for both the second victim and for the individuals who provide that support. Approximately 18% of the Maryland hospitals offer a second victim support program. Details on the structure, accessibility, and outcomes for these programs are described. Conclusions: The second victim problem is recognized in all hospitals in Maryland. However, healthcare providers face barriers in accessing them. Future efforts should assess the need for second victim programs from the perspectives of second victims themselves to identify barriers and improve access to needed support. Future research should focus on developing tools to evaluate the effectiveness of second victim programs.