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New Advisory from The Joint Commission on Supporting Second Victims in Health Care

Safety actions for health care professionals involved in adverse events

January 30, 2018
By: Katie Looze Bronk, Corporate Communications

(OAKBROOK TERRACE, Illinois – January 30, 2018) – After a patient suffers an adverse event, the health care providers directly involved can suffer from difficulty sleeping, reduced job satisfaction, guilt and anxiety, as well as other emotional and physical harm. In addition, recurrent memories can contribute to more serious consequences such as burnout, depression, post-traumatic stress disorder and suicidal ideation—all of which affect medical judgement. This is called “second victim” syndrome, and it is estimated that nearly half of health care providers experience the impact as a second victim at least once in their careers. 

A new Quick Safety advisory from The Joint Commission provides health care organizations with research, recommendations and resources on how to address and support second victims. The Quick Safety offers several safety actions for health care organizations to consider, including: 

  • Instilling a just culture for learning from system defects and communicating lessons learned.

  • Engaging all team members in the debriefing process and sharing of the lessons learned from the event analysis.

  • Providing guidance on how staff can support each other during an adverse event (i.e., how to offer immediate peer-to-peer emotional support or buddy programs).

  • If the employee assistance program (EAP) is the sole source of support for second victims, consider creating supplemental programs after evaluating the EAP’s structure and performance.

“If not treated, a second victim experience can bring emotional and physical harm to our health care providers who work so hard to treat and care for patients,” says Ana Pujols McKee, MD, executive vice president and chief medical officer, The Joint Commission. “Unfortunately, many second victims find themselves in need of support and care that many health care organizations are not prepared to provide. This emphasizes the importance of establishing second victim programs which play a critical role in strengthening safety culture, as well as reducing stigma and biases.”

Resources from the University of Missouri Health Care; Beth Israel Deaconess Medical Center, Boston; Johns Hopkins Hospital, Baltimore, Maryland; and others are highlighted in the advisory. John’s Hopkins’ second victims program also was featured in a blog post, based on a study from the September 2017 issue of The Joint Commission Journal on Quality and Patient Safety.  

The Quick Safety is available on The Joint Commission website. It may be reproduced if credited to The Joint Commission. 

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The Joint Commission
Founded in 1951, The Joint Commission seeks to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. The Joint Commission accredits and certifies more than 21,000 health care organizations and programs in the United States. An independent, nonprofit organization, The Joint Commission is the nation’s oldest and largest standards-setting and accrediting body in health care. Learn more about The Joint Commission at www.jointcommission.org.

1Seys D, et al. Health care professionals as second victims after adverse events: A systematic review. Evaluation & The Health Professions. 2012;36(2):135-162.
2Edrees HH, et al. Do hospitals support second victims? Collective insights from patient safety leaders in Maryland. The Joint Commission Journal on Quality and Patient Safety, 2017;43:471-483.

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