‘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.

… to the use of organization support programs. … Edrees HH, Wu AW. Does one size fit all? Assessing the need for …

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.  

Individuals involved in adverse maternal events require support both physically and emotionally. This guidance combines readiness, recognition, response, and reporting and systems-learning steps to aid birthing facility nurses and management in providing standardized help for mothers, families, and care team members that experience care-related harm.  

… the safety and well-being of health care workers. … Wu AW, Sax H, Letaief M, et al. COVID-19: the dark side and …

… , promoting wellness, and showing gratitude for staff. … Wu AW, Buckle P, Haut ER, et al. Supporting the emotional …

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 effect refers to the emotional distress health care providers may experience after an adverse event or error. This systematic review found that mindfulness interventions have the potential to reduce stress and burnout among physicians. The authors suggest that further research regarding the impact of mindfulness on the second victim effect is needed.

… care workers after medical errors. A PSNet interview with Albert Wu , who coined the term second victim , discussed approaches …

Preventable harm can inflict lasting emotional damage on patients and families. Although many safety experts have examined how adverse events affect health care workers (second victims), patients' emotional experience of these events has garnered less scientific attention. The Agency for Healthcare Research and Quality convened diverse stakeholders, including patients, to identify research priorities to better elucidate how adverse events emotionally impact patients and families. They identified 4 priorities and delineated 20 steps organizations can take immediately to support those who experience adverse events, such as involving patients and families in developing solutions, incorporating emotional harm in organizational approaches to safety, and engaging patient advocates and leaders in improvement work. An Annual Perspective examined the shift toward a just culture in patient safety, which requires reckoning with the impact of errors on patients and families.

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.