​​​​​Strategies for supporting “second victims," providers most directly involved in an adverse event, were highlighted in the January 22, 2018, issue of Quick Safety from the Joint Commission. When an adverse event occurs, providers may feel emotionally traumatized and have lasting effects that persist for as long as a year afterward, Joint Commission said. Nearly half of all healthcare providers could face a second-victim experience at least once during their careers, Joint Commission said. If untreated, being a second victim can harm the emotional and physical health of an individual and subsequently create a threat to patient safety. Second victims often suffer in silence, Joint Commission said. Hospital resources available to a provider who has had a second victim experience include the organization's clergy, psychiatric department, or an employee assistance program. Barriers to utilization of support services in these situations include the need to take time away from work, fears or doubts about confidentially, and fears of negative judgement from colleagues. Joint Commission recommends that healthcare organizations instill a culture of learning about system defects, engage all team members during the debriefing process after an adverse event to share lessons learned, provide guidance on how staff can support each other after an adverse event, and consider creating supplemental programs to support second victims. If an organization decides to create a second victim program, Joint Commission said, among other recommendations, that it should include a strong patient safety culture, buy-in from leadership, and be developed using evidence-based guidelines. In related news, a February 5, 2018, article from MinnPost discussed a peer support program for providers who have had a second victim experience. “Physicians are asked to be perfect in an imperfect world," said the program's physician leader. “There is no way a physician can practice medicine and not be a witness to, a cause of or a part of something going wrong at least once in their career."

HRC Recommends: Healthcare organizations should develop programs to support healthcare personnel who have been involved in an event that leads to patient harm. Personnel may need care and support from the time they learn of the event until months, or even years, later. The organization may have to transform its culture and change its policies to support second victims.