Trent Maxine, Waldo Kimberly, Wehbe-Janek Hania, Williams Daniel, Hegefeld Wendy, Havens Lisa
Baylor Scott & White Health.
East Tyler Medical Center, Tyler, Texas.
J Healthc Risk Manag. 2016 Aug;36(2):27-34. doi: 10.1002/jhrm.21239.
Health care providers often experience traumatic events and adversity that can have negative emotional impacts on the profession and on patients. These impacts are typically multifaceted and can result from many different events, such as unanticipated outcomes, licensing board complaints, claims, and litigation. Because health care providers are exposed to diverse situations, they require adequate and timely support, imperative for provider resilience and patient safety. This study evaluated the success of an institution's second victim health care support program and best practices in responding to these traumatic experiences effectively.
Twenty faculty and medical residents who utilized the support program at a large hospital system located in Central Texas from 2001 to 2012 participated in 1 of 6 focus groups. Qualitative data were collected from these groups to describe program requirements for the adequate delivery of health care adversity support and necessary program improvements. Responses were first transcribed verbatim. Each research team member analyzed data using a thematic framework approach. This approach helped to characterize traumatic experiences and to design a support system.
The results revealed that (1) provider experiences are traumatic, (2) it is necessary to communicate an adverse event in a confidential and timely manner, preferably with a peer, (3) preemptive education regarding risk management and the legal process is helpful, and (4) there is a need for further support of the specific experience of a board complaint.
Focus group data indicated the complexity of the emotional impact of traumatic experiences. Specific program components are needed to create best practices for providers affected by health care adversity, including support when providers face board complaints. The program's unique combination of support and education allowed us to expand upon leading national health care adversity programs.
医疗保健提供者经常经历创伤性事件和逆境，这可能会对该职业以及患者产生负面情绪影响。这些影响通常是多方面的，可能由许多不同事件导致，例如意外结果、执照委员会投诉、索赔和诉讼。由于医疗保健提供者会接触到各种不同情况，他们需要充分且及时的支持，这对于提供者的恢复力和患者安全至关重要。本研究评估了一个机构的二级受害者医疗保健支持项目的成效以及有效应对这些创伤经历的最佳实践。
2001年至2012年期间，在德克萨斯州中部一家大型医院系统使用该支持项目的20名教职员工和住院医师参加了6个焦点小组中的1个。从这些小组收集定性数据，以描述充分提供医疗保健逆境支持所需的项目要求以及必要的项目改进。回答首先逐字转录。每个研究团队成员使用主题框架方法分析数据。这种方法有助于描述创伤经历并设计支持系统。
结果显示：（1）提供者的经历具有创伤性；（2）有必要以保密且及时的方式传达不良事件，最好是与同行；（3）关于风险管理和法律程序的预防性教育是有帮助的；（4）需要进一步支持应对执照委员会投诉的具体经历。
焦点小组数据表明创伤经历的情感影响具有复杂性。需要特定的项目组成部分来为受医疗保健逆境影响的提供者创建最佳实践，包括在提供者面临执照委员会投诉时提供支持。该项目独特的支持与教育相结合使我们能够在全国领先的医疗保健逆境项目基础上加以拓展。
