Division of Hospital Medicine, Michigan Medicine, University of Michigan, MI, Ann Arbor, USA.
School of Public Health, University of Michigan, MI, Ann Arbor, USA.
BMC Health Serv Res. 2021 Dec 11;21(1):1330. doi: 10.1186/s12913-021-07315-1.
Second Victim Programs (SVPs) provide support for healthcare providers involved in a near-miss, medical error, or adverse patient outcomes. Little is known about existence and structure of SVPs in top performing US hospitals.
We performed a prospective study and interviewed individuals representing SVPs from 20 US News and World Report (USNWR) Honor Roll Hospitals. Telephone interviews were recorded, transcribed, and de-identified. To allow identification of both quantitative and qualitative themes that unified or distinguished programs with SVPs from each other, a content analysis approach was used.
Of the Top 20 UNSWR hospitals, nineteen individuals with knowledge of or involvement in SVPs were identified. One individual represented two hospital systems for the same institution. Thirteen representatives agreed to participate, 12 declined, and 5 did not respond. One individual who initially agreed to participate did not attend the interview. Among twelve representatives interviewed, 10 reported establishment of SVPs at their hospitals between 2011 and 2016. Most program representatives reported that participants sought support voluntarily. Four domains were identified in the qualitative analysis: (a) identification of need for Second Victim Program (SVP); (b) challenges to program viability; (c) structural changes following SVP creation, and (d) insights for success. Driving SVP creation was the need support medical providers following a traumatic patient event. Poor physician participation due to the stigma associated with seeking support was commonly reported as a challenge. However, acceptance of the mission of SVPs, growing recognition of the value of the program across hospital departments, and systematic safety enhancements were cited as key advantages. To ensure success, participants suggested training a variety of volunteers and incorporating SVPs within quality improvement processes.
In this convenience sample, programs for healthcare providers that experience psychosocial or emotional trauma from clinical care were uncommon. Variation in structure, performance, and measures of success among SVPs was observed. A systematic approach to evaluating SVPs is needed to help inform institutions of how to best serve their second victims.
第二受害者计划（SVPs）为参与险些发生的医疗失误、医疗差错或患者不良结局的医疗保健提供者提供支持。目前，人们对美国顶尖医院中 SVPs 的存在和结构知之甚少。
我们进行了一项前瞻性研究，采访了来自 20 家美国新闻与世界报道（USNWR）荣誉榜医院的 SVP 代表。电话访谈进行了录音、转录和去识别处理。为了识别具有 SVP 的程序之间统一或区分的定量和定性主题，我们采用了内容分析方法。
在 20 家 USNWR 顶级医院中，确定了 19 名具有 SVP 知识或参与其中的个人。有 1 人代表了两家医院系统中的同一家机构。13 名代表同意参加，12 名拒绝参加，5 名没有回复。1 名最初同意参加的代表没有参加访谈。在接受采访的 12 名代表中，有 10 人报告称他们的医院在 2011 年至 2016 年期间建立了 SVPs。大多数项目代表报告说，参与者自愿寻求支持。定性分析中确定了四个领域：（a）确定第二受害者计划（SVP）的需求；（b）对计划可行性的挑战；（c）SVP 创建后的结构变化；（d）成功的见解。推动 SVP 创建的是在发生创伤性患者事件后为医疗提供者提供支持的需求。由于寻求支持相关的耻辱感，医生参与度低，这是一个常见的挑战。然而，接受 SVP 的使命、跨医院部门对该计划价值的日益认可以及系统的安全增强被认为是关键优势。为了确保成功，参与者建议培训各种志愿者，并将 SVP 纳入质量改进流程。
在这个方便的样本中，为经历临床护理带来的心理社会或情感创伤的医疗保健提供者提供的计划并不常见。SVPs 的结构、绩效和成功衡量标准存在差异。需要采用系统的方法来评估 SVPs，以帮助机构了解如何为其第二受害者提供最佳服务。
