Fierce exclusive: Healthcare professionals need more support in the wake of adverse events

By Anthony Vecchione

Patients aren't the only victims of an adverse event. Experts often refer to doctors, nurses, pharmacists and other healthcare workers who are implicated when a patient is harmed as "second victims."

While hospitals and health systems have increased their efforts to address the needs of employees who cause or witness an adverse event, some industry insiders assert that more has to be done. In addition, providing the right response is essential to helping employees cope and heal in the aftermath of the error. 

"First and foremost give them your support. They certainly didn't go into healthcare to hurt people," Michael Cohen, president of the Horsham, Pennsylvania-based Institute for Safe Medication Practices (ISMP), told FierceHealthcare in an exclusive interview. When healthcare workers are involved in a serious error that leads to patient harm, he said they are devastated and need psychological support.

Cohen said that most adverse events are systemic in nature, and not caused by an individual practitioner. "Organizations have to take a look at what could be changed with the medication system that wouldn't allow the error to occur in the first place," Cohen said.

He noted that most hospitals started to move in that direction a few years ago and they are getting better at it. "There are very few cases where someone is reckless in their behavior knowing that what they're doing could hurt somebody. Those kinds of things are very rare," said Cohen.

Hospital success stories

Hackensack University Medical Center in New Jersey has an integrated process where all of its leaders are knowledgeable and feel comfortable reaching out directly to the organization's employee assistance program--Care EAP, Suzanne Gallagher, administrative director, Center for Occupational Medicine/Employee Health, at the medical center, told FierceHealthcare.

"We can bring the EAP directly into the department that has had an adverse event. We have 24/7 service and our on-call contacts are the actual clinical providers we work with," said Gallagher.

When an event occurs, Gallagher said that contact is immediately made with Care EAP. "It is available to all employees and anyone living in their households. In addition to an organized system approach, individual employees are encouraged to reach out privately to the EAP for assistance should they or their household members need it," Gallagher said.

Another success story can be found at Greater Baltimore Medical Center, which has established the Caring for Caregivers initiative, where a team of trained peer responders lend an ear to caregivers coping with the aftermath of an error they've made or with some other clinically related stress, according to the Baltimore Sun.

More advocacy needed

Deb Pasko, director of medication safety and quality for the American Society of Health System Pharmacists (ASHP), told FierceHealthcare that most healthcare organizations don't have very robust processes in place to deal with second victims. And those that do have programs are just in the starting stages.

While awareness is becoming more prevalent, she said organizations in the past often just emphasized establishing a "just culture environment" to encourage people to speak up when they become aware of a medical errors. "But many of the people who are involved in these errors that we describe as the second victims, really do not feel like that they have had adequate organizational support after the error has happened," she said.  

The good news, Pasko said, is that many organizations such as the Joint Commission, The Institute for Healthcare Improvement (ISI), ISMP and ASHP, have started to advocate for these support system for second victims.

To learn more:
- here's the Baltimore Sun article

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