Physician Support After Adverse Patient Events Women s Leadership Forum Massachusetts Medical Society September 30, 2016
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1 Physician Support After Adverse Patient Events Women s Leadership Forum Massachusetts Medical Society September 30, 2016 Carol Mostow LICSW Associate Director, Psychosocial Training Department of Family Medicine, Boston Medical Center Assistant Professor of Family Medicine Boston University School of Medicine Catherine Lanteri, MD, FAPA Lanteri Coaching and Communication Certified Physician Development Coach Carol Mostow LICSW Associate Director, Psychosocial Training Department of Family Medicine Jane M. Liebschutz, MD, MPH Director of the Combined Family Medicine- General Internal Medicine- General Pediatrics Fellowship Programs and BMC Wellness Director Diane Hanley, MS, RN-BC, EJD Sr. Director for Professional Practice, Nursing Quality and Education Scott Friedman, JD, RPh Director Insurance, Risk and Claims
2 Care for the Caregivers Compassionate and timely support for caregivers who are involved in a stressful patient event 2 The Need Second Victim - PTSD 3
3 Silent Sufferers Health care providers are reluctant to seek help 4 The Aftermath of No Support* * U of Missouri 5
4 Natural history of recovery for second victim after adverse patient events Scott et al OUR STORIES - What helps? 7
5 PAIR/ SHARE : what helps or prevents us getting needed support Reflect on an adverse or other stressful pt-related event that caused you significant anxiety, depression or concern about your ability to do your job. Did you seek or receive support? Why or why not? What was helpful? What were less helpful responses? What if anything, has helped you recover since then? Share with your neighbor for 4 minutes per person Pairs report out themes to small group 5 min 8 WHAT DID WE LEARN? WHAT HELPS US? - to seek or receive support? - What feels supportive? - What helps us recover? WHAT MAKES IT HARD to get help? ( internalized as well as external factors) What is not helpful?
6 What Second Victims Want WISDOM IN MEDICINE: What Helps Physicians After Medical Error? Plews-Ogan et al 2016 Talking about it Disclosure& apology Forgiveness A moral context Dealing with imperfection Learning/becoming an expert Preventing recurrences, improving teamwork Helping others/teaching 11
7 Emulating successful programs 12 Support impacts safety culture scores * Sue Scott/U of Missour 13
8 Three-Tiered Intervention Model * * Sue Scott/U of Missouri 14 What can you do? Set an intention and share with your neighbor What can you do to help any of the following recover from stressful patient related events? you a colleague supervisee your team 2 1/2 minutes per person 15
9 WRAP-UP Take homes and action steps Questions/ discussion THANK YOUS! SPECIAL THANKS TO: Linda Kenney MITSS Sue Scott PhD, RN, CPP Scott Friedman JD, RPh For permission to use many of these materials
10 EXTRAS about BMC Peer Connections Program Healing the Healer 19
11 Inclusive model ENTIRE Boston Medical Center staff Lessons from Boston Marathon Schwartz Center Rounds BMC STRONGer TOGETHER!!! 20 Selection Process Peer Supporters Selected by Peers 21
12 RESOURCES: see Medically Induced Trauma Support Services for helpand training resources for individual patients and clinicians as well as organizations REFERENCES: Hilfiker, D. (1984, January 12). Facing our mistakes. New England Journal of Medicine, 310(2), DOI: /NEJM Hu YH, FixML, Hevelone ND, Lipsitz SR, Greenberg CC, Weissman JS, Shapiro J. ( 2012 March) Physicians Needs in Coping with Emotional Stressors: The Case for Peer Support. Arch Surg ; 147(3): Institute of Medicine. Committee on Quality of Health Care in America. (2000). To err is human: Building a safer health system. L. T. Kohn, J. M. Corrigan, & M. S. Donaldson [Eds.). Washington, DC: National Academy Press *Plews-Ogan M, May N, Owens J, Ardelt M, Shapiro J, Bell, S. Wisdom in Medicine: What Helps Physicians After a Medical Error. (2016, February) Academic Medicine What_Helps_Physicians_After_a.29.aspx *Scott SD, Hirschinger LE, Cox KR, McCoig M, Brandt J, Hall LW. ( 2009, October) The natural history of recovery for the healthcare provider "second victim" after adverse patient events. Qual Saf Health Care 2009 Oct;18(5): ; doi: /qshc Scott SD (2015, October)Second Victim Support:Implications for Patient Safety Attitudes and Perceptions. Patient Safety and Quality Healthcare. Van Pelt, F. (2008). Peer support: Healthcare professional supporting each other after adverse medical events. Quality and Safety in Health Care, 17, Waterman, A.,GarbuttJ,Hazel E et al. The Emotional Impact of Medical Errors on Practicing Physicians in the United States and Canada. The Joint Commission Journal on Quality and Patient Safety August :8pp Wu, A. (2000, March 18). Medical error: The second victim. BMJ, 320,
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