B1. The Second Victim phenomenon (4 Articles)
When an adverse event occurs, there is a domino effect with healthcare professionals (named second victims of these events) suffering from the knowledge of having harmed their patients (first victims).
European studies indicate that around 72% of health care providers in hospitals and 62% in primary care reported having suffered the second victim experience in the previous five years. An alarming 86% of these professionals reported that they received no counselling and 56% no institutional support. Of these, 24% required time off work and 25% transferred to a different department/centre.
Frequently, SVs feel personally responsible for the unexpected patient outcomes, and suffer doubts about their clinical skills and knowledge base. 1 Also, they are afraid of the legal, economic, and professional consequences.2 This SV phenomenon increases the likelihood of further errors and suboptimal care as consequences of emotional disturbances in the hours/days following the occurrence of an AE. Therefore, if not alleviated or treated, the SV phenomenon can harm the emotional and physical health of care providers and subsequently compromise patient safety. Evidence-based interventions to address the SV phenomenon increase patient safety by reducing AEs; promote staff and team wellbeing, engagement morale and retention, public engagement, and trust in healthcare; and reduce the costs of financial compensation.3
- Heiss K, Clifton M. The unmeasured quality metric: Burn out and the second victim syndrome in healthcare. Semin Pediatr Surg [Internet]. 2019;28(3):189–94. Available from: https://doi.org/10.1053/j.sempedsurg.2019.04.011
- Wu AW, Shapiro J, Harrison R, Scott SD, Connors C, Kenney L, et al. The impact of adverse events on clinicians: What’s in a name? J Patient Saf. 2017;65–72.
- Schiess C, Schwappach D, Schwendimann R, Vanhaecht K, Burgstaller M, Senn B. A transactional “second-victim” model—experiences of affected healthcare professionals in acute-somatic inpatient settings: A qualitative metasynthesis. J Patient Saf. 2018;
B3. What is being done in Europe (1 Article)
EU patient safety policy has, inter alia, the following targets: protecting patients from preventable harm, mapping national patient safety policies to provide a basis for mutual sharing of knowledge, establishing effective reporting and learning systems through a blame-free culture to avoid AEs, and developing redress mechanisms, including fair compensation to patients. The impact of organisational and patient safety culture, leadership styles, gender differences in the stress reactivity and responses, work climate, or well-being at work as included in the Quadruple Aim scheme -effectiveness, efficiency, patient experience and caring for the care provider- are recognised requisites to achieve these objectives.
Now and since the past two decades different interventions are being implemented in Europe to enhance the resilience of healthcare professionals in stressful situations for addressing this problem. However, the number of proved interventions in progress is scarce.
The worries and shame experimented with these events are some of the barriers that make it difficult to tackle this phenomenon, as well as preventing from engaging more actively in putting up barriers, speaking up or reporting adverse events, finally the patients are the biggest affected. In addition to very different legal schemes coexist, barriers to speak-up about errors, mistakes, and mishaps and blame and shame cultures.