Mistakes happen. In fact, as many as seven out of 100 hospital inpatients experience a significant medication error, according to Don Berwick, MD, former administrator of the Centers for Medicare and Medicaid Services1, and one in seven Medicare patients experience a medical error in the hospital.2
Humans are prone to making mistakes—regardless of their training—so it’s not a matter of asking if errors will occur, but when. Thinking about your own care setting, how would you and your facility support a coworker if an adverse event occurred today?
Some settings and specialties carry higher risk: intensive care units, operating rooms, code teams, emergency medicine, pediatrics, obstetrics, oncology, and palliative care. But adverse events are not limited to these environments.
When an event occurs, the clinicians who are involved typically respond in three ways. For some, a first instinct is to drop out of the profession. Others survive the event and cope, but may be haunted with sadness and thoughts about the event or even resort to addictive behaviors to cope. Others choose to thrive. They do so by practicing self-care, by maintaining a good work/life balance, and by gaining wisdom from the experience. They realize they needn’t define their practice or career by the single event. Some clinicians recover by advocating for patient-safety initiatives.
ORGANIZATIONS AND PEERS CAN HELP
Coworkers and organizational leaders can support clinicians by knowing how to respond when an error occurs. Here are some ways department leaders and medical colleagues can help:
- Reach out to the affected clinician, demonstrating a caring attitude and conveying faith in the provider’s clinical skills.
- Actively listen to what the affected clinician wants to express.
- Swap “war stories” to provide an outlet for stress.
- Offer the clinician flexible scheduling as needed.
- Brief the clinician on any investigation that may occur.
- Be visible and transparent to all staff on the unit.
- Deploy multidisciplinary rapidresponse teams, especially in high-risk areas, to reach out to clinicians as part of a formal provider support program. These employees should be specially trained to monitor colleagues for second-victim signs and provide support.
Develop external referral networks, which might include employee assistance programs, social workers, chaplains, and clinical psychologists. After a serious event, one health professional in five will require counseling or other form of support. A provider who lived through an event referred to the experience as “an emotional tsunami.” Another described it as “the darkest hour of my life.” As health care professionals and organizations, we have a responsibility to protect and heal the clinicians on our team.
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PHYSICIANS INSURANCE PEER SUPPORT PROGRAM
Many of your peers have dealt with the aftermath of unanticipated outcomes of patient care. They know how helpful it is to share the experience with someone who has already walked this path.
Our peer consultants are volunteer member physicians. They understand the impact on your personal and professional life, and have been trained to reach out to colleagues following an unanticipated outcome. This support is confidential and meant to help you process the effects of an unanticipated outcome.
Learn more at
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1. Donald Berwick, Escape Fire: Lessons for the Future of Health Care (New York: The Commonwealth Fund, 2002): 20, http://www.commonwealthfund.org/usr_doc/berwick_
escapefire_563.pdf.
2. Agency for Healthcare Research and Quality, “20 Tips to Help Prevent Medical Errors: Patient Fact Sheet” (September 2011), http://www.ahrq.gov/consumer/20tips.htm.