‘Second victim’ is controversial term used to describe health care professionals who experience continuing psychological harm after involvement in a medical error or adverse event. In this study, an expert panel reviewed existing definitions of ‘second victim’ in the literature and proposed a new consensus-based definition.

… as one key component of good quality care. … Hannawa AF, Wu AW, Kolyada A, et al. The aspects of healthcare quality …

… learning format. … Gleason KT, Commodore-Mensah Y, Wu AW, et al. Massive open online course (MOOC) learning …

… these practitioners to provide the safest care possible. … Wu AW, Vincent C, Shapiro DW, et al. Mitigating the July …

Clinicians involved in unexpected patient outcomes can experience negative emotions and frequently need access to second victim support programs. This systematic review describing 12 second victim support programs identifies staff benefits, implementation challenges, and experiences of peer supporters. Affected staff and peer supporters reported the benefits of the programs. Challenges included blame culture, limited awareness of program existence, and lack of financial resources. Findings indicate a need for implementing new second victim support programs, promoting current programs, and monitoring peer supporters’ well-being.

Unanticipated adverse events harm not only patients, but also have the potential to cause psychological harm to the healthcare providers involved in the incident. This study investigated how Maryland hospitals currently support “second victims.” Even though all study participants agreed that organizations should offer support programs to second victims, they stated that several barriers exist, including stigma. Future research efforts should involve second victims themselves in order to identify barriers and facilitators, such as safety culture, to the use of organization support programs.

The Resilience in Stressful Events (RISE) program provides peer support for healthcare workers who are involved in an adverse event. RISE program volunteers surveyed in this study reported positive perceptions of program participation and personal empowerment.  

In this editorial, patient safety experts discuss threats to healthcare safety and quality due to the COVID-19 pandemic (e.g., failures in infection prevention and control, diagnostic errors, issues with laboratory testing) and highlight positive changes and opportunities, such as improved care coordination, supply chain innovations, accelerated learning, expansion of telemedicine, and prioritizing the safety and well-being of health care workers.

This editorial discusses priority areas for maintaining and promoting the well-being of the healthcare workforce during the COVID-19 pandemic. The authors discuss the importance of providing adequate personal protective equipment (PPE), supporting basic daily needs (e.g., provision of in-hospital food stores), ensuring frequent and visible communication, supporting mental and emotional well-being, addressing ethical concerns, promoting wellness, and showing gratitude for staff.

This study randomized primary care practices across ten health care systems to evaluate the effectiveness of a multifactorial intervention to prevent falls with injury, which included risk assessment and individualized plans administered by specially trained nurses. The intervention did not result in a significantly lower rate of serious fall injury compared to usual care.

In this literature review, the authors identified patient-, clinician-, and institutional-level barriers to patient involvement in patient safety investigations. Potential strategies for overcoming barriers are also discussed, such as adopting a blame-free climate and enhancing clinician training in error disclosure and communication.

To address the negative psychological impacts faced by healthcare workers during the COVID-19 crisis, the authors of this commentary recommend three strategic principles for healthcare institutions responding to the pandemic: Encourage leadership to focus on resilience  Ensure that crisis communication provides both information and empowerment Create a continuum of staff support within the organization to address a surge in mental health concerns among healthcare workers.

… (4) directed leadership to implement successful change. … Wu AW, Dzau VJ. What can patient safety teach us about …

Adverse events can have significant psychological impacts on the providers involved and involvement in medical errors can increase risk of burnout among second victims. This study describes the nurse utilization of the Resilience in Stressful Events (RISE) peer support program. The authors found high awareness of the program among nurses, but low utilization. Nurses who had used the program reported greater resilience, but more burnout than those who had not.

Root cause analysis is a fundamental approach to understanding how failures occur, but some have questioned its effectiveness in health care. This review highlights alternative approaches to incident analysis that address some of the concerns with root cause analysis, such as time commitment and lack of follow up.

The second victim phenomenon refers to the emotional impact adverse events and patient harm can have on health care team members, including physicians and nurses. This meta-analysis sought to quantify psychological and psychosomatic symptoms experienced by second victims. Researchers identified 18 studies and found that embarrassment, guilt, regret, self-recrimination, anxiety, fear of future errors, reliving the incident, and difficulty sleeping were the most common symptoms. These results underscore how involvement in errors can have detrimental consequences for provider well-being. The authors recommend both preventive programs and postevent support for health care workers after medical errors. A PSNet interview with Albert Wu, who coined the term second victim, discussed approaches to address this safety issue.

Disclosing medical errors to patients and families is considered essential for maintaining a therapeutic relationship and a core tenet of medical professionalism, but less is known about the impact of disclosure on malpractice claims and compensation. In this study, researchers sought to understand the effect of state legislation requiring disclosure of serious events to patients. Using data from a single, large health care system, they found that although the number of serious event disclosures increased between May 2002—the year the legislation was enacted—and June 2011, the rate of malpractice claims remained stable. Claims that were disclosed and claims that involved greater harm were associated with increased compensation. An accompanying editorial highlights some of the advantages of comprehensive disclosure programs.

After being involved in adverse events, health care workers can experience burnout and reduced job satisfaction. Researchers evaluated a second victim support program for nurses and found the initiative to be well-liked and effective in promoting a more robust culture of safety.

Word choice can impact buy-in for programs and integrating concepts across an organization. This review examines the term "second victim" as a label for health professionals involved in adverse events. The authors explore both constructive and negative reactions to the term and suggest that context and culture affect the appropriateness of its use.

The need to improve patient safety is an international concern. This commentary discusses the importance of partnership in reaching the overall goals of global patient safety and highlights experiences in Africa that demonstrate how high-income health care systems can learn from low-income hospitals.