Short summary

Healthcare professionals involved in traumatic incidents at work may experience feelings of guilt, psychological distress, fear and loss of self-esteem following an adverse event, which may lead to secondary traumatic stress, PTSD or burnout. The purpose of this study is to develop and implement a support programme for healthcare professionals in the aftermath of an adverse or traumatic incident. The overall study aim is to develop and evaluate a peer support programme for healthcare professionals after an adverse clinical event. The study design is mixed methods study generating data from both questionnaires, qualitative interviews and observational studies. 

Rationale

Second victims are healthcare professionals who are involved in an unanticipated adverse patient event, in a medical error and/or a patient related injury, and become victimised in the sense that the provider is traumatised by the event. Second victims may experience psychological distress, fear, loss of self-esteem, feelings of guilt, anger, frustration, fear of continued practice and even post-traumatic stress disorder. 

Personal distress of physicians and self-reported error involvement are related in a reciprocal cycle, where feelings of responsibility for a serious medical error enters a vicious cycle by provoking burn-out, depression and reduced empathy. This may result in suboptimal patient care and a greater risk of future errors. Although the greatest assets of any healthcare system are the individuals who deliver care, little investment is placed on the health and well-being of the care providers. This lack of support may impair their health, reduce job satisfaction, and compromise their ability to provide safe, compassionate, and high-quality care.

Globally, supporting second victims and addressing their needs has become a major concern for healthcare organizations.  There has been increased evidence on the prevalence of second victims and on the impact of medical error and adverse events. Several studies in the USA, UK, Belgium, Switzerland, Sweden, Italy and Denmark have acknowledged the second victim concept, and have suggested methods to support healthcare professionals following an adverse event. An increasing numbers of hospitals have implemented a second victim support program. They provide a hospital-wide support team with well-trained peer supporters to help second victims with their recovery after adverse events. However, a recent study has explored physicians' support needs after adverse events and found that most respondents preferred forms of support organised in their direct working environment over a hospital-wide support team. 

The ability to have private, unguarded conversations with colleagues, in which healthcare professionals can discuss incidents of adverse events and their own role in, and emotions concerning these incidents, appears to be the most important factor in the clinicians' ability to recover. An empathic, non-judgmental and reliable colleague is regarded as the best supporter, and 'the buddy study' aims to facilitate and qualify this intercollegiate communication about adverse events. The emphasis on the close relations in the direct working environment is the fundament of this study, which will investigate how clinical peers can constitute a mutual support system in a hospital department.

The overall study aim is to develop and evaluate a peer support programme for healthcare profes-sionals after an adverse clinical event. 

Research questions

1. What are the second victim experiences of the staff in two selected departments at Odense University Hospital and what is the quality of existing support resources? 

2. Does a compulsory, inhouse seminar contribute to a more supportive and compassionate intercollegiate communication about adverse events?

3. How does the staff perceive the effectiveness of the implemented support programme?

Description of the cohort

Midwives and nurses at the Department of Obstetrics and Gynaecology (OUH) and doctors at the Emergency Department (OUH Svendborg). 

Data and biological material

Questionnaires 

Collaborating researchers and departments

Department of Obstetrics and Gynaecology, OUH

• Professor, Ellen Aagard Nøhr
• Professor Jan Stener Jørgensen

Emergency Department (FAM), OUH Svendborg

• Head of the department, Consultant, Mette Worsøe

Research Unit for General Practice, SDU

• Professor Niels Christian Hvidt
• Assistant professor Elisabeth Assing Hvidt
• Professor Jens Søndergaard