Brenda Bursch PhD (is Professor, Department of Psychiatry and Biobehavioral Sciences, and Department of Pediatrics, David Geffen School of Medicine at UCLA.), Keren Ziv MD (is Clinical Professor, Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA.), Shevaughn Marchese (is Faculty Development and Career Advancement Program Manager, Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA.), Hilary Aralis PhD (is Professor, Department of Biostatistics, UCLA Fielding School of Public Health.), Teresa Bufford PhD (formerly Graduate Student Researcher and Biostatistician, Department of Biostatistics, UCLA Fielding School of Public Health, is Principal Statistician GSK, Wynnewood, Pennsylvania.), Patricia Lester MD (is Professor, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA. Please address correspondence to Brenda Bursch)
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Abstract
Background
Most anesthesia providers experience an adverse event during their training or career. Limited evidence suggests skilled peer support programs (SPSPs) reduce initial distress and support adaptive functioning and coping. This study evaluated second victim perceptions of a voluntary SPSP.
Methods
An SPSP was developed and implemented for all clinical and administrative personnel in the Department of Anesthesiology and Perioperative Medicine in three hospitals and six outpatient surgery centers in December 2017. The program incorporated the Scott Three-Tiered Interventional Model of Second Victim Support. Surveys were offered to clinicians in the department prior to implementation of the SPSP and again 18 months after implementation. Among the subset of respondents who experienced a serious adverse patient event, the authors used multiple logistic regression models that adjusted for role and number of night shifts per month to examine differences in perceived resource availability and post-event support received following implementation of the program.
Results
There were 94 surveys (83 complete; 11 partially complete) collected prior to implementation and 84 surveys (67 complete; 17 partially complete) collected after implementation. A total of 25 individuals took the survey at both pre and post (19 complete). After implementation, 62.5% of respondents indicated that institutional support had improved since the occurrence of their serious adverse patient event. Statistical models identified a significant improvement in the probability that a clinician agreed with the statement “I think that the organization learned from the event and took appropriate steps to reduce the chance of it happening again” at post vs. pre (adjusted odds ratio [aOR] 3.9, 95% confidence interval [CI] 1.01–15.1. A statistically significant increase from pre to post in the perceived availability of formal emotional support was identified (aOR 5.2, 95% CI 1.9–22.5).
Conclusion
Implementation of a skilled peer support program within a large department of anesthesiology can improve institutional-based emotional support.
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