Remembering the Second Victim (Part 1 of 3)

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Having open and transparent lines of communication between the leadership and staff at a healthcare organization is vitally important. To create a culture in which physicians, nurses, and housekeepers are afraid to report when something has gone wrong not only jeopardizes patient safety, but also impacts the overall quality of the organization’s care.

This is why it is so important that healthcare leaders remember the second victims after a mistake has occurred, no matter how serious, Tami Swartz asserts in the February 2013 issue of Patient Safety Monitor and reprinted on the HealthLeaders Media site.

“The first victim, of course, is the patient and family ­affected by a patient-care mistake,” Swartz writes. “…In recent years, attention has also turned toward these second victims–providers involved in the ­adverse event, who are also the hospital’s responsibility. Evidence suggests these second victims, if not given the correct ­support, can contribute to further patient safety problems; and, of course, each person in a work system affects culture.”

If these second victims are not cared for, she adds, their “intense emotional distress” could lead to more mistakes. Furthermore, “how this second victim is treated will be noted by other ­providers and staff who contribute to patient care,” especially if the second victims are “penalized, punished, or simply ignored.”

Instead, research suggests that providing emotional support as soon as the event occurs for these second victims will help them avoid errors in the future.

A recent study co-authored by Kris Vanhaecht, M.D., R.N., MSc, Ph.D., leader of Health Services Research Group, School of Public Health, KU Leuven, ­University of ­Leuven, Belgium, compiled 21 research articles and 10 non-research articles on the subject of second victims and concluded “that a hospital should have a plan in place for–addressing the needs of second victims and should ­identify the organization as a whole as a third victim.”

Titled “Supporting involved healthcare professionals (second victims) following an adverse health event: A literature review,” the report cited one study that concluded, “When healthcare institutions do not support their people, they will lose all the trust and respect and in the long term it will harm the culture of the organization.”

So, how does an organization connect with the second victims, understanding their perspective enough to provide the needed emotional support?

We’ll look at that subject in our next posting.

-by Pete Fernbaugh

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