Second Victims in Healthcare

The Quality & Patient Safety team of the KU Leuven Institute for Healthcare Policy (Belgium) has more than 10 years of experience in research & support systems for healthcare professionals involved in serious adverse events, known as Second Victims. Our findings are published in peer reviewed journals and presented during international meeting. During the COVID-19 pandemic this experience and expertise was used to support our healthcare colleagues during this crisis.

In 1999, the » Institute of Medicine’s report “To Err is Human” estimated that errors cause 44,000 to 98,000 deaths annually in the United States, with a total cost of between $17 and $29 billion each year. Studies show that adverse events occur in one out of ten patients, and 50% of these events are highly preventable. Guilt, fear and frustration are among the best known reactions of the involved professionals. Off course the most important victim is the first victim: the patient & kin. But respectful management of adverse events, for both first and second victims, should be a high priority for hospital management.

10 years ago a white paper of the Institute for Healthcare Improvement stated that the organization has three specific priorities. The first priority is to care for the patient and his or her family members who are the direct victims of the adverse event. The second priority is to care for front-line health care workers involved in or exposed to the event. These individuals can be referred to as “second victims”, a term first introduced by professor Albert Wu in 2000.The third priority is to address the needs of the organization, which can also suffer a potential loss from the incident, becoming a third victim.

Every health care worker can become a second victim: nurses, physicians, pharmacists, social services, physiotherapists,… It is estimated that almost 50% of all health care providers are a second victim at least once in their career! This is a total underestimation and nearly every professional will be involved in adverse events and personal and professional reactions in the aftermath of the event are normal reactions. We may not underestimate the impact of this event and therefor take care of our colleagues. Second victims need to be supported through implementation of support systems on organizational level that result in constructive changes in practice.

The European international leadership regarding this subject lies with the European Research Network on Second and Third Victims. Our team is member of the management team of this network.