CHCO Peer Support Program

July 2020

Background

Healthcare workers are exposed to a variety of emotionally and physically difficult situations. As a result, healthcare workers are at risk for traumatization following an unanticipated adverse event. This traumatization, when unsupported, can lead to difficulty sleeping, anxiety, isolation, leaving the workforce, and other physical symptoms (Scott, 2009; Wu, 2000).

Because of the direct impact on the team members involved in adverse medical events, the effort to support team members immediately and thereafter is crucial to their own personal success, emotional safety, and patient safety.

Purpose

The purpose of the Peer Support program is to respond to team members affected by adverse events in a standardized way, modeled after successful programs at other institutions.

Program Vision

Peer Supporters will be available to all team members by training selected providers and leaders to serve as immediate peer supporters, following adverse clinical events, and specific trigger events within each section. Trigger events include but aren’t limited to:

  • Unexpected death
  • Difficult diagnoses
  • Serious Safety Events
  • Quality/Safety Events resulting in additional investigation (Root Cause Analysis or Apparent Cause Analysis)
  • Provider Review Team (PRT) referral

Program Structure

  • Peer Support Program is operated under the CHCO Faculty Well-being Advisory Committee (link to FWBAC Charter)
  • As feasible, each section or department has one or more designated Peer Supporters.
  • Each section completes a Peer Support Program Description specific to their section, including the following information:
    • who are peer supporters
    • what are trigger events that should result in a peer support reaching out to impacted providers
    • what are means of peer supporters being notified of adverse events/trigger events
    • what are means of communication for peer supporters reaching out to affected providers (email, call, text, etc.)
  • Each section’s Peer Support Program leader(s) presents the overview of the program to their section members, and ensures that section leadership is aware of and endorsing the program

Criteria for Peer Supporters

  • Must be a faculty member or medical staff provider in good standing (no ongoing professionalism or practice concerns)
  • Participation in program must be endorsed by section head, and /or other section leaders
  • Peer Supporters may be nominated by anyone in their section or other sections
  • Must be a trusted peer among faculty (someone that peers are likely to be comfortable talking to)
  • Must uphold the expectations of the Faculty Well-being Advisory Committee including
    • Attend meetings as able
    • Participate in program education, curriculum offerings
    • Participate in program development and execution as feasible
    • Solicit input from their section members
    • Convey information to their section members
    • Participate in and attend national committees related to well-being as appropriate (e.g. AAP, APA, national specialty organizations)
    • Foster an environment consistent with a “safe space” where faculty are comfortable sharing their concerns and questions
    • Embrace diversity and inclusion

Foundational education for all Peer Supporters

  • All Peer Supporters attend a 2-hour training focusing on Peer Support and Coaching conversation, facilitated by Jenny Reese, Scott Markowitz and/or their designees, and follow-up skill-building and check in sessions as feasible.
  • Training includes best practices endorsed by legal affairs and risk management to mitigate “risk” of these conversations being discoverable or useful if litigation of an event occurs
  • Training includes criteria for mandatory reporting, and resources for referral if concerning situations arise
  • Fundamentals of training optimize confidentiality and psychological safety for providers receiving support

Outcome Measures and Reporting Plan

  • Over time the program will track volume of peer support conversations, while maintaining confidentiality and not tracking any names, case details, etc.
  • Ongoing Medical Staff Survey data will track well-being measures, which are likely affected by peer support programs; and may include questions specific to peer support utilization in the future
  • Peer Support Program outcomes will be reported to CMO and Medical Executive Committee Annually or as requested

References:

Scott, S.D. et al. (2010) Caring for our Own: Deployment of a Second Victim Rapid Response System.   The Joint Commission Journal on Quality and Patient Safety. 36(5):233-240.

Scott, S.D.  Second Victim Support: Implications for Patient Safety Attitudes and Perceptions. Scott. WWW.PSQH.COM Sept/Oct 2015

Burlison et al.  The Effects of the Second Victim Phenomenon on Work-Related Outcomes: Connecting Self-Reported Caregiver Distress to Turnover Intentions and Absenteeism.  J Patient Saf