By Megan Headley
Second victim programs are gaining ground, providing a network of support to acute care practitioners who may suffer emotionally following an adverse patient event or traumatic episode. Now Ob Hospitalist Group (OBHG) has launched a program for its network of more than 600 obstetricians and midwives who suffer from vicarious trauma—no matter where it takes place.
“We launched the CARE program because we recognize that the second victim scenario is a real issue for physicians and midwives,” explains Mark Simon, MD, MMM, CPE, chief medical officer for OBHG. “As OB hospitalists, we’re frequently put into positions where we’re taking care of patients in very high-acuity situations where sometimes, despite our best efforts, bad outcomes can occur. We wanted to make sure that we had a program in place that could help support those clinicians when those events occur, no matter where they occur across the country.”
OBHG’s clinicians serve in more than 120 partner hospitals across 31 states, which could have posed a problem in creating a program that relies on in-person support.
“I’ve seen a lot of second victim programs that are hospital-based, and they’re multidisciplinary, which is very appropriate for a hospital-based approach,” Simon says. “We had to develop something that could support clinicians wherever they might be.”
The group was led by a physician who had worked with a second victim program in a hospital setting prior to moving to OBHG. Together with Simon and a representative from the risk management team, the group began to determine the best approach for OBHG to support its clinicians.
The group began training physician and midwife volunteers through in-person educational sessions on how to best serve as peer support for clinicians should an event occur. In addition, they set up an infrastructure where a clinician can call or email a hotline in response to an event.
Most importantly, the group wanted to raise awareness about this program to their employees’ support team—in the hospital and at home.
“The clinicians themselves don’t have to be the ones to call the CARE program,” Simon explains.
“One of their colleagues could refer them, or their significant other could refer them. We intentionally sent informational materials about the program to the hospital to their breakroom to post there, but we also sent the same package to the home address of every physician and midwife who works for us, in very brightly colored packaging, with the hope that their spouse or significant others would see that so they too could refer someone if they thought something was wrong. We tried really hard to make it an easy referral process so we could maximize the potential of intervening or providing help should they need it.”
The group also uses information already being gathered on adverse patient events by risk management to reach out to clinicians who may not have considered reaching out themselves. In this event, or in the case of a referral, a member of the volunteer team will make contact and make sure the clinician is open to some sort of support. “They have to be open and willing to at least talk to someone,” Simon says.
Once in the system, a trained caregiver is expected to quickly reach out to the individual seeking help. “We want to have these conversations, and the sooner they start the better. We want things fresh in people’s minds, to make sure that they’re addressing their issues,” Simon says. Conversations can be held over phone or video conference to account for distance between volunteers and clinicians.
With the program in place, OBHG is working to broaden awareness around the new offering and normalize this process of reaching out for help.
“What I think has been really beneficial is that we’ve utilized our physicians as the lead to communicate this,” Simon explains. He says this peer-to-peer communication is helping to lessen any chance of stigma associated with seeking help. “We’ve used our team meetings and communication pathways to make this physician-to-physician and to normalize it.”
Simon adds, “We want to say, ‘There isn’t a stigma, this isn’t a bad thing: We’re OB hospitalists. We take care of emergency obstetrical patients every day. Sometimes bad things are going to happen. It’s not your fault. But you’re a human being and it has to affect you. That’s why this system is here.’ We’d rather address that and put it in the open, so to speak, and have the conversation rather than let it eat someone up inside.”
Although the program is just getting off the ground, Simon reports that feedback so far has been positive. “I think it demonstrates that care is not just about the patient, but also about the physician and midwife who are delivering that bedside care,” he says.
The group is watching metrics for improvement, such as the time it takes for a volunteer to reach out to a clinician in need of support. Over time, Simon hopes to watch data to see if this support could impact the rate of retirement or people who leave the profession.
“Long-term, I think that is one of the advantages of this type of program: keeping physicians and midwives and other care providers from leaving because they’ve had an adverse event occur.”
Megan Headley is a freelance writer and owner of ClearStory Publications. She has covered healthcare safety and operations for numerous publications. Headley can be reached at firstname.lastname@example.org.