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Supporting Clinicians After Adverse Events

Development of a Clinician Peer Support Program

Lane, Michael A. MD*†; Newman, Brianne M. MD; Taylor, Mary Z. JD§; O'Neill, Meg BS; Ghetti, Chiara MD; Woltman, Robin M. BS, MIM§; Waterman, Amy D. PhD**††

doi: 10.1097/PTS.0000000000000508
Original Articles
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Background Many healthcare organizations have developed processes for supporting the emotional needs of patients and their families after medical errors or adverse events. However, the clinicians involved in such events may become “second victims” and frequently experience emotional harm that impacts their personal and professional lives. Many “second victims,” particularly physicians, do not receive adequate support by their organizations.

Methods A multidisciplinary team was assembled to create a clinician peer support program (PSP) at a large academic medical center including both adult and pediatric hospitals. A curriculum was developed to train clinicians to provide support to their peers based on research of clinician response to adverse events, utilization of various support resources, and clinician resiliency and ways to enhance natural resilience. Between April 2014 and January 2017, 165 individuals were referred to the program including 68 (41.2%) residents, 17 (10.3%) fellows, 70 (42.4%) faculty members, 6 (3.6%) nurse practitioners/physician assistants, and 4 (2.4%) certified registered nurse anesthetists. An average of 4.8 individuals were referred per month (range = 0–12). Of the 165 clinicians referred, 17 (10.3%) declined follow-up from the program. Individuals receiving support had a median of two interactions (range = 1–10). Among those receiving support from the clinician PSP, 16 (10.8%) required referral to a higher level of support.

Conclusions We describe the multiple steps necessary to create a successful PSP focused on physicians and midlevel providers. There is an unmet need to provide support to this group of healthcare providers after medical errors and adverse events.

From the *Infectious Diseases Division, Washington University School of Medicine;

Center for Clinical Excellence, BJC HealthCare;

Department of Psychiatry, Washington University School of Medicine;

§Washington University Faculty Practice Plan;

Washington University School of Medicine;

Department of Obstetrics and Gynecology, Washington University School of Medicine;

**Division of General Medical Sciences, Washington University School of Medicine, St. Louis, Missouri; and

††Division of Nephrology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, Terasaki Research Institute, Los Angeles, California.

Correspondence: Michael A. Lane, MD, MPHS, Infectious Diseases Division, Washington University School of Medicine, 660 S Euclid Ave, Campus Box 8051, St. Louis, MO 63110 (e-mail: lanem@wustl.edu).

M.A.L. has received career development support from the Washington University Institute of Clinical and Translational Sciences grant UL1TR000448, sub-award KL2TR000450, from the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH).

The content is solely the responsibility of the authors and does not necessarily represent the official view of the NIH.

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