From the Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
J Patient Saf. 2022 Jan 1;18(1):e308-e314. doi: 10.1097/PTS.0000000000000771.
This study aimed to develop and evaluate a structured peer support program to address the needs of providers involved in obstetric adverse outcomes.
In this pilot randomized controlled trial, participants were providers who experienced an obstetric-related adverse outcome. Providers were randomly assigned to routine support (no further follow-up) or enhanced support (follow-up with a trained peer supporter). Participants completed surveys at baseline, 3 months, and 6 months. The primary outcome was the use of resources and the perception of their helpfulness. Secondary outcomes were the effect on the recovery stages and the duration of use of peer support.
Fifty participants were enrolled and randomly assigned 1:1 to each group; 42 completed the program (enhanced, 23; routine, 19). The 2 groups were not significantly different with respect to event type, demographics, or baseline stage; in both groups, most participants started at the stage 6 thriving path. Most participants required less than 3 months of support: 65.2% did not need follow-up after the first contact, and 91.3% did not need follow-up after the second contact. Participants who transitioned from an early stage of recovery (stages 1-3) to the stage 6 thriving path reported that they most often sought support from peers (P = 0.02) and departmental leadership (P = 0.07). Those in the enhanced support group were significantly more likely to consider departmental leadership as one of the most helpful resources (P = 0.02).
For supporting health care providers involved in adverse outcomes, structured peer support is a practicable intervention that can be initiated with limited resources.
本研究旨在开发和评估一种结构化的同行支持计划,以满足参与产科不良结局的提供者的需求。
在这项试点随机对照试验中,参与者为经历产科相关不良结局的提供者。将参与者随机分配至常规支持(无进一步随访)或强化支持(接受经过培训的同行支持者随访)。参与者在基线、3 个月和 6 个月时完成调查。主要结局是资源的使用情况及其对资源的感知。次要结局是对恢复阶段的影响和同行支持的使用持续时间。
共纳入 50 名参与者并随机分为 1:1 两组,每组 23 名和 19 名参与者完成了该计划。两组在事件类型、人口统计学特征或基线阶段方面无显著差异;两组中大多数参与者都从第 6 阶段蓬勃发展的路径开始。大多数参与者需要的支持时间不到 3 个月:65.2%的参与者在首次接触后不需要随访,91.3%的参与者在第二次接触后不需要随访。从恢复早期阶段(第 1-3 阶段)过渡到第 6 阶段蓬勃发展路径的参与者报告说,他们最常从同行(P=0.02)和部门领导(P=0.07)寻求支持。强化支持组的参与者更有可能将部门领导视为最有帮助的资源之一(P=0.02)。
对于支持参与不良结局的医疗保健提供者,结构化的同行支持是一种可行的干预措施,可以在有限的资源下启动。