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Literature

Topic

Association between physician burnout and self-reported errors: Meta-analysis doi: 10.1097/PTS.0000000000000724

Owoc J, Mańczak M, Jabłońska M, Tombarkiewicz M, Olszewski R

(Jan 2022) Thirteen studies on 20,643 physicians and residents were included in this meta-analysis. The overall burnout among participants was associated with a significantly increased risk of self-reported errors. The authors write that, as self-reported errors may translate into different types of adverse events, this strong and unequivocal association should be of major concern to health care organizations. Read more

Meta-analysis • Moral injury, distress and burnout • Adverse event impact

COVID-19 pandemic and overall mental health of health care professionals globally: A meta-review of systematic reviews doi:10.3389/fpsyt.2021.804525

Chutiyami M, Cheong AMY, Salihu D, et al.

(Jan 2022) This meta-review aims to provide a comprehensive overview of the mental health of health care professionals during the COVID-19 pandemic. It was concluded that health care professionals have experienced various mental health issues during COVID-19 pandemic and recommends targeted interventions and health policies to support professionals during the duration of the COVID-19 pandemic and similar future health crises. Read more

COVID-19 • Meta-analysis

Healing our own: A randomized trial to assess benefits of peer support doi: 10.1097/PTS.0000000000000771

Rivera-Chiauzzi E, Smith H, Moore-Murray T, Lee C, Goffman, D, Bernstein, P, Chazotte, C

(Jan 2022) This study aimed to develop and evaluate a structured peer support program. In this pilot randomized controlled trial, participants were providers who experienced an obstetric-related adverse outcome. Fifty participants were enrolled and 42 completed the program. Researchers concluded that for supporting health care providers involved in adverse outcomes, structured peer support is a practicable intervention that can be initiated with limited resources. Read more

Programming and implementation • Randomized control trial

A transactional "second-victim" mode – Experiences of affected health care professionals in acute-somatic inpatient settings doi: 10.1097/PTS.0000000000000461

Schiess C, Schwappach D, Schwendimann R, Vanhaecht K, Burgstaller M, Senn B.

(Dec 2021) “Second victims” are health care professionals traumatized by involvement in significant adverse events. This study aims to identify, describe, and interpret these experiences. The authors' transactional model of second-victim experience provides a foundation for strategies to maintain and improve patient safety. Read more

Meta-analysis • Second victim

Support opportunities for second victims lessons learned: A qualitative study of the top 20 US News and World Report Honor Roll Hospitals doi: 10.1186/s12913-021-07315-1

Marr R, Goyal A, Quinn M, Chopra V

(Dec 2021) Researchers interviewed individuals representing second victim support programs from 20 US News and World Report (USNWR) Honor Roll Hospitals. Most reported that participants sought support voluntarily, and that poor participation due to the stigma associated with seeking support was a challenge. However, acceptance of the mission, growing recognition of the value of the program across hospital departments, and systematic safety enhancements were cited as key advantages. To ensure success, participants suggested training a variety of volunteers and incorporating the programs within quality improvement processes. Read more

Programming and implementation • Second victim

Validation of the second victim experience and support tool-revised in the neonatal intensive care unit doi: 10.1097/PTS.0000000000000659

Winning A, Merandi J, Rausch J, et al.

(Dec 2021) This study validated a revised version of the Second Victim Experience and Support Tool (SVEST-R), which was developed to measure the impact of medical errors and adverse events on providers and can help organizations evaluate the effectiveness of support resources. An SVEST-R was completed by 316 health care providers from seven neonatal intensive care units affiliated with a large, pediatric hospital. Read more

Programming and implementation • Second victim

COVID-19 and moral distress: A pediatric critical care survey doi:10.4037/ajcc2021999

Thomas T, Davis FD, Kumar S, Thammasitboon S, Rushton CH

(Nov 2021) The aim of this survey was to investigate whether pediatric critical care professionals are experiencing moral distress during the COVID-19 pandemic and, if so, for what reasons. A survey was conducted from April to May 2020. Overall, 85.8% of survey respondents reported moral distress, often related to challenges to professional integrity and lack of organizational support. Five themes were identified: psychological safety, expectations of leadership, connectedness through a moral community, professional identity challenges, and professional versus social responsibility. Read more

COVID-19 • Moral injury, distress and burnout

Let's embed peer-support groups into the medical curriculum for all doi:10.7861/fhj.2021-0041

Higham A, Behrman S, Vlachos H, Lightfoot H, Stevens R, Stegen G

(Nov 2021) Group-based peer support and regular reflective practice are interventions known to reduce clinician burnout and optimize wellbeing. The NHS Staff and Learners' Mental Wellbeing Commission report advocates establishing explicit peer support mechanisms and the use of peer support as part of the first line of psychological first aid. Because junior doctors are the most likely of all medical groups to be at a high risk of burnout, authors recommend that regular peer-support reflective groups are provided during protected time for all trainees. Read more

Programming and implementation

The role of perceived organizational support in mental health of health care workers during the COVID-19 pandemic: A cross-sectional study doi:10.3389/fpsyt.2021.707293

Chatzittofis A, Constantinidou A, Artemiadis A, Michailidou K, Karanikola MNK

(Nov 2021) The study assessed the association between perceived organizational support and mental distress in health care workers during the COVID-19 pandemic. This was an online cross-sectional study in 424 health care workers, with data collected during the first wave of the pandemic. Researchers found that self-perceived organizational support was significantly associated with workers’ self-assessed mental status during the pandemic. Read more

COVID-19 • Moral injury, distress and burnout

Understanding and mitigating moral injury in nurses doi:10.7748/ns.2021.e11703

Rowlands SL

(Nov 2021) The concept of moral injury has its origins in the context of military personnel encountering ethically challenging decisions during armed conflict. The term has been applied to health care and is increasingly acknowledged to be a challenge for health care professionals. Nurses across all specialties and settings are frequently required to make or witness ethically challenging decisions about patient care. This article discusses the manifestations of moral injury and its associated risk factors, including the effects of the COVID-19 pandemic. It also outlines various strategies that can be used to mitigate and/or prevent moral injury in nurses. Read more

COVID-19 • Moral injury, distress and burnout

Moral distress in frontline health care workers in the initial epicenter of the COVID-19 pandemic in the United States: Relationship to PTSD symptoms, burnout, and psychosocial functioning doi:10.1002/da.23205

Norman S, Feingold J, Kaye-Kauderer H, et al.

(Oct 2021) Authors examine moral distress in frontline health care workers caring for COVID-19 patients during the height of the spring 2020 pandemic surge in New York City. The analysis revealed three dimensions of COVID-19 moral distress: negative impact on family, fear of infecting others, and work-related concerns. All three factors were significantly associated with severity and positive screen for COVID-19-related PTSD symptoms, burnout, and work and interpersonal difficulties. Read more

COVID-19 • Moral injury, distress and burnout

Peer assessment after clinical exposure (PACE): An evaluation of structured peer support for staff in emergency care doi:10.12968/bjon.2021.30.19.1132

Sillitoe K, Kimbya N, Milliken J, Bennett P

(Oct 2021) Peer Assessment After Clinical Exposure (PACE) is a structured program designed to support staff following traumatic or chronic work-related stressful exposure. This study aims to explore the thoughts and experiences of the staff who used PACE support services in one emergency department. Overall, PACE was well received by the majority of staff (11/12). There was a positive association with the one-to-one element and the educational component helped to reduce the stigma associated with stress reactions after work-related exposure. Read more

Programming and implementation

Implementation of a second victim peer support program in a large anesthesia department

Finney R, Jacob A, Johnson J, Messner H, Pulos B, Sviggum H

(Jun 2021) This article describes the implementation of a second victim peer support program in a large academic anesthesiology practice, with the goal of augmenting emotional support for anesthesia providers. A total of 130 peer support encounters were documented. Trained peer supporters were able to provide helpful support to affected colleagues nearly all (98.8%) of the time. Nearly 97% of second victims reported the support as extremely or very beneficial, and 96.8% would recommend the program to colleagues. Read more

Programming and implementation • Second victim

The second victim requires more than Medice Cura Te Ipsum doi:10.5489/cuaj.7229

Koyle M, Chua M, Kherani T, Pereira N, Heiss K

(Jun 2021) Second victim syndrome, a consequence of an unforeseen adverse event, often precipitated by an error, can lead to a post-traumatic stress-like reaction, that is unique to health care workers. Often, the second victim suffers in silence, forced to rely on resilience. Peer support has been demonstrated to be beneficial in assisting health care workers in recovering from both burnout and second victim syndrome. The authors of this article advocate for institutions and organizations to be more responsive in supporting physicians and other health care workers in need. Read more

Programming and implementation • Second victim

Preventing clinician suicide: A call to action during the COVID-19 pandemic and beyond doi:10.1097/ACM.0000000000003972

Moutier CY, Myers MF, Feist JB, Feist JC, Zisook S.

(May 2021) In this commentary, the authors offer a call to action in the long-standing fight to prevent clinicians from dying by suicide. In April 2020, the nation was shocked by the suicide of New York City emergency physician Dr. Lorna Breen, who died while recovering from COVID-19. She joins an unknown number of clinicians who have taken their lives over the past year. The authors sort through the science of clinician distress; critique how the COVID-19 pandemic is affecting the lives of clinicians; and describe existing national initiatives to address clinician stress, burnout, and suicide. Finally, they recommend evidence-based actions to prevent clinician suicide. Read more

COVID-19 • Moral injury, distress and burnout

Promoting the psychological well-being of health care providers facing the burden of adverse events: A systematic review of second victim support resources doi:10.3390/ijerph18105080

Martina Busch I, Moretti F, Campagna I, Benoni R, Tardivo S, Wu A, Rimondini M

(May 2021) This study aims to describe the types of support resources available in health care organizations, their benefits for second victims, peer supporters’ experiences, and implementation challenges. The 16 included studies described 12 second victim support resources, implemented between 2006 and 2017. Preliminary data indicated beneficial effects not only for the affected staff but also for the peer responders who considered their role to be challenging but gratifying. Challenges during program implementation included persistent blame culture, limited awareness of program availability, and lack of financial resources. Read more

Meta-analysis • Programming and implementation • Second victim

Fear of COVID-19, psychological distress, work satisfaction and turnover intention among frontline nurses doi:10.1111/jonm.13168

Labrague LJ, de Los Santos JAA

(Apr 2021) This study examines the relative influence of fear of COVID-19 on nurses' psychological distress, work satisfaction and intent to leave their organisation and the profession. This is a cross-sectional research design involving 261 frontline nurses in the Philippines. Five standardized scales were used for data collection. Frontline nurses who reported not having attended COVID-19-related training and those who held part-time job roles reported increased fears of COVID-19. Addressing the fear of COVID-19 may result in improved job outcomes in frontline nurses, such as increased job satisfaction, decreased stress levels and lower intent to leave the organisation and the profession. Read more

COVID-19 • Moral injury, distress and burnout

Clinician mental health, nursing shortages and the COVID-19 pandemic: Crises within crises doi:10.1111/inr.12674

Turale S, Nantsupawat A.

(Mar 2021) Before the COVID-19 pandemic, the nursing profession was struggling to be adequately respected and compensated despite the vital role they play in the health care system. The nursing profession has been dealing with a shortage crisis that will potentially become worse/exacerbated by the COVID-19 pandemic. During the pandemic, nurses were inundated with frontline health care delivery while not being cared for by the very institutions that rely on their expertise. Read more

COVID-19 • Moral injury, distress and burnout

COVID-19-related occupational burnout and moral distress among nurses: A rapid scoping review doi:10.12927/cjnl.2021.26459

Sriharan A, West KJ, Almost J, Hamza A

(Mar 2021) This paper aims to synthesize existing literature on COVID-19-related burnout and moral distress among nurses and identify recommendations for nurse leaders to support the psychological needs of nursing staff. Thematic analysis of selected studies suggests that nurses are at an increased risk for stress, burnout and depression during the ongoing COVID-19 pandemic. Younger female nurses with less clinical experience are more vulnerable to adverse mental health outcomes. Read more

COVID-19 • Meta-analysis • Moral injury, distress and burnout

Mental health and COVID-19: The psychological implications of a pandemic for nurses doi:10.1188/21.CJON.69-75

Shah M, Roggenkamp M, Ferrer L, Burger V, Brassil KJ

(Feb 2021) The aim of this article is to explore the potential psychological sequelae of nursing during a pandemic and to provide recommendations to support a psychologically healthy work environment. Highlights from the literature on psychological sequelae, symptoms, and outcomes related to COVID-19 and prior pandemics is presented, along with insight from the experiences of oncology nurses caring for patients with COVID-19. Hospital administrators must develop proactive wellness plans for the triage and management of mental and emotional health needs during a pandemic that prioritize transparent communication, resources for health care providers within and beyond the clinical setting, and training. Read more

COVID-19 • Moral injury, distress and burnout

Self-care strategies in response to nurses’ moral injury during COVID-19 pandemic doi:10.1177/0969733020961825

Hossain F, Clatty A

(Feb 2021) This article aims to investigate moral distress and offer tools and recommendations to support health care nurses as they respond to this crisis and its aftermath. As most health care workers are passionate nursing professionals, frustration and often a sense of powerlessness occur when they find themselves unable to provide needed care to their patients. For nurses, the experience of this significant event can inflict ongoing moral injury. Nurses affected by this trauma require education, coping tools, and therapy to help avoid or alleviate the adverse effects on their well-being. Read more

COVID-19 • Moral injury, distress and burnout

What we have learned from two decades of epidemics and pandemics: A systematic review and meta-analysis of the psychological burden of frontline health care workers doi:10.1159/000513733

Busch IM, Moretti F, Mazzi M, Wu AW, Rimondini M

(Feb 2021) This study aimed to synthesize and quantify the psychological and psychosomatic symptoms among frontline medical staff. Studies reporting psychological and/or psychosomatic symptoms of health care workers caring for patients with severe acute respiratory syndrome, H1N1, Ebola, Middle East respiratory syndrome, or COVID-19 were eligible for inclusion. Frontline staff showed a wide range of symptoms, including concern about transmitting the virus to the family, perceived stress, concerns about own health, sleeping difficulties, burnout, symptoms of depression, anxiety, PTSD, mental health issues, and somatization. Read more

COVID-19 • Meta-analysis

PSST! I need help! Development of a peer support program for clinicians having serious illness conversations during COVID-19 doi: 10.1007/s11606-020-06565-9

Greenwald JL, Abrams AN, Park ER, Nguyen PH, Jacobsen J.

(Jan 2021) This article describes development and implementation of the Peer SIC Support Team (PSST), a program to offer real-time assistance to frontline clinicians who needed extra support conducting serious illness conversations during the pandemic. Read more

COVID-19 • Programming and implementation

Rate of suicide among women nurses compared with women in the general population before the COVID-19 global pandemic doi: 10.1001/jamapsychiatry.2021.0141

Guille C.

(Jan 2021) Findings from this large retrospective cohort study indicate that suicide rates among nurses exceed those of people in the general population and that female nurses are at twice the risk for suicide compared with women in the general population. Read more

COVID-19 • Meta-analysis

"I wish they had asked:" A qualitative study of emotional distress and peer support during internship doi: 10.1007/s11606-020-05803-4

Moore KA, O'Brien BC, Thomas LR.

(Dec 2020) Given the substantial role peer learning plays in intern development, senior residents can impact their interns by normalizing emotions, allowing vulnerability, and highlighting the importance of self-care. Authors propose a model illustrating key points at which near-peers can make an impact in reducing interns’ distress. Read more

Moral injury, distress and burnout • Programming and implementation

Supporting clinicians during COVID-19 and beyond — Learning from past failures and envisioning new strategies doi: 10.1056/NEJMp2024834

Shapiro J, McDonald TB.

(Dec 2020) Authors discus several strategies that medical institutions could use to design emotional support programs that clinicians will embrace. This includes funding peer support programs, developing systems for offering support to clinicians rather than relying on self-referral, and providing easily accessible and psychologically safe “reach-in” services for clinicians requesting help. Read more

COVID-19 • Programming and implementation

Peer support and crisis-focused psychological interventions designed to mitigate post-traumatic stress injuries among public safety and frontline health care personnel: A systematic review doi: 10.3390/ijerph17207645

Anderson GS, Di Nota PM, Groll D, Carleton RN.

(Oct 2020) This is a systematic review of studies investigating the effectiveness of organizational peer support and crisis-focused psychological interventions designed to mitigate post-traumatic stress injuries among health care workers. The review included 14 eligible studies (n = 18,849 participants) that were synthesized with qualitative narrative analyses. Read more

Meta-analysis • Moral injury, distress and burnout

Peer support for junior doctors: A positive outcome of the COVID-19 pandemic? doi: 10.7861/fhj.2020-0069

Behrman S, Baruch N, Stegen G.

(Oct 2020) Authors describe a peer support initiative to support medical trainees during the COVID-19 pandemic, discuss the barriers to the success of such schemes, and reflect on the value of grass-roots peer support initiatives. Read more

COVID-19 • Programming and implementation

Second victim support: Nurses’ perspectives of organizational support after an adverse event doi: 10.1097/NNA.0000000000000928

Stone M.

(Oct 2020) The purpose of this study was to describe hospital nurses’ experiences with organizational support after an adverse event. Data collection and analysis followed a qualitative descriptive approach. Findings suggest that nurses yearn to feel valued and to receive timely support from nurse executives after an adverse event. Read more

Second victim • Meta-analysis

Secondary traumatic stress in Ob-Gyn: A mixed methods analysis assessing physician impact and needs doi: 10.1016/j.jsurg.2020.08.038

Kruper A, Domeyer-Klenske A, Treat R, Pilarski A, Kaljo K.

(Sep 2020) This study aims to evaluate the incidence of secondary traumatic stress in obstetrics and gynecology physicians including symptoms, impact, and programmatic needs for support. Safety and transparency with opportunities for group processing are identified as essentials for positive institutional culture, as well as peer support programs. Read more

Adverse event impact • Meta-analysis

COVID-19, stress, trauma, and peer support—observations from the field doi: 10.1093/tbm/ibaa056

Fisher ER, Miller SL, Evans MC, et al.

(Jun 2020) Researchers find that the role of peer support has increased and become more complicated amidst the pressing demands for food, housing, safety, and economic assistance. For behavioral medicine and public health, these findings make clear that preparedness needs to address not only clinical challenges and services but also the psychological and social needs of people. Read more

COVID-19 • Meta-analysis • Moral injury, distress and burnout

COVID-19 epidemic peer support and crisis intervention via social media doi: 10.1007/s10597-020-00624-5

Cheng P, Xia G, Pang P, et al.

(May 2020) This article describes a peer support project developed and carried out by a group of experienced mental health professionals, organized to offer peer psychological support from overseas to health care professionals on the frontline of the COVID-19 outbreak in Wuhan, China. Such a model for intervention may be used elsewhere in the face of current global pandemic, or future disaster response. Read more

COVID-19 • Programming and implementation

Web-based peer support education program for health care professionals

van Buschbach S, van der Meer C, Dijkman L, Olff M, Bakker A

(Apr 2020) This study describes the development and evaluation of a new online program to educate peer supporters. Forty-four health care professionals including nurses, physicians, residents and staff, completed the e-learning Peer Support and the online evaluation survey. The e-learning was well received and positively evaluated with regard to all studied indicators of acceptance, including perceived usefulness, ease of use, actual use, and effectivity. All participants would recommend the e-learning to future trainees. Read more

Programming and implementation

The impact of adverse events on clinicians: What's in a name? doi: 10.1097/PTS.0000000000000256

Wu AW, Shapiro J, Harrison R, et al.

(Mar 2020) This article explores terminology used to describe the professionals involved in adverse events and services to support them. Authors suggest it is most appropriate to label this phenomenon in a way that promotes its recognition and adoption of solutions. For example, for policy makers and health care managers, the term second victim may have value because it is memorable and connotes urgency. For support programs that appeal directly to health care workers, different language may attract more users. Read more

Programming and implementation • Second victim

Adverse events in obstetrics: Impacts on providers and staff of maternity care doi: 10.7759/cureus.6732

Margulies SL, Benham J, Liebermann J, Amdur R, Gaba N, Keller J.

(Jan 2020) This is a single-institution observational study evaluating the impact of adverse perinatal/neonatal and maternal events on providers and staff. Non-physicians, those using substances, those considering career change, and those seeking mental health treatment were found more likely to experience anxiety/depression and post-traumatic stress symptoms after a maternal or perinatal/neonatal loss, suggesting that these individuals should be identified and offered additional support. Read more

Adverse event impact

COVID-19: Peer support and crisis communication strategies to promote institutional resilience doi: 10.7326/M20-1236

Wu AW, Connors C, Everly GS Jr.

(Jan 2020) On the basis of their experiences responding to other pandemics, the authors summarize lessons learned and offer some best practices for facilitating organizational resilience and supporting health care workers during the COVID-19 pandemic. Read more

COVID-19 • Programming and implementation

Supporting the well-being of health care providers during the COVID-19 pandemic: The CopeColumbia response. doi: 10.1016/j.genhosppsych.2020.08.013

Mellins CA, Mayer LES, Glasofer DR, et al.

(Jan 2020) This paper describes CopeColumbia, a peer support program developed by faculty in a large urban medical center's Department of Psychiatry to support emotional well-being and enhance the professional resilience of health care workers.  Read more

COVID-19 • Programming and implementation

Are second victims real victims? Evidence and reflections on the traumatic impact of adverse events in the medical setting doi: 10.1016/j.jpsychores.2020.110033

Busch, I, Moretti, F, Purgato, M, Barbui, C, Wu, A, & Rimondini, M.

(Jan 2020) The data confirm that adverse events can be of traumatic nature which may lead to avoidance behaviors, thus negatively affecting second victims’ personal and professional well-being, the therapeutic alliance, and the quality of care delivered by the health care system. Read more

Meta-analysis • Second victim

Supporting staff who are second victims after adverse health care events doi: 10.7748/nm.2019.e1872

Elizabeth Marran J.

(Nov 2019) This article explores the concept of health care professionals as "second victims," as well as the effects of adverse events on these individuals, their managers and organizations. It details the investigation process, the health care professional’s legal and professional responsibilities after an adverse event, and the resources and services available to support second victims. Read more

Second victim

Peer support: A needs assessment for social support from trained peers in response to stress among medical physicists doi: 10.1016/S0140-6736(16)31332-0

Johnson J, Ford E, Yu J, Buckey C, Fogh S, Evans SB.

(Sep 2019) A survey of 1,297 medical physicists finds that a majority is willing to seek social support after involvement in a medical error or adverse patient outcome, and that they want colleagues to provide support. Given these results, peer support could be considered among medical physicists. Read more

Adverse event impact

Supporting clinicians after adverse events: Development of a clinician peer support program doi: 10.1097/PTS.0000000000000508

Lane MA, Newman BM, Taylor MZ, et al.

(Sep 2018) Many “second victims,” particularly physicians, do not receive adequate support by their organizations after an adverse event. Authors describe the multiple steps necessary to create a successful peer support program focused on physicians and midlevel providers. Read more

Programming and implementation • Second victim

Surgical catastrophe. Supporting the gynecologic surgeon after an adverse event doi: 10.1016/j.jmig.2018.05.012

Carugno J, Winkel AF.

(May 2018) This commentary reviews common reactions to adverse events and strategies to support clinicians through the aftermath. The goal is to create awareness of the mental health impact and to describe options to help physicians involved in intraoperative adverse events to recover from their experience related to bad surgical outcomes. Read more

Adverse event impact

Suffering in silence: Medical error and its impact on health care providers doi: 10.1016/j.jemermed.2017.12.001

Robertson JJ, Long B.

(Feb 2018) Studies have found that many physicians feel a lack of personal and administrative support after a medical error. This review looks at potential solutions including provider counseling, learning from mistakes without fear of punishment, discussing mistakes with others, focusing on the system versus the individual, and emphasizing provider wellness. Read more

Adverse event impact

Barriers to support nurses as second victim of medical errors: A qualitative study doi: 10.21767/AMJ.2018.3515

Mokhtari Z, Hosseini M, Khankeh HR, Fallahi-Khoshknab M, Nasrabadi AN.

(Jan 2018) This study was conducted to identify the barriers to supporting nurses as second victims of nursing errors in clinical settings in Iran. According to the results, mismanagement, cultural barriers, inadequate information, and legal barriers were the main barriers. Read more

Meta-analysis • Second victim

Beyond burnout — Redesigning care to restore meaning and sanity for physicians doi: 10.1056/NEJMp1716845

Wright AA, Katz IT.

(Jan 2018) High burnout rates among physicians are taking a high financial and human toll. This article describes how some medical organizations are starting to tackle the challenge. Read more

Moral injury, distress and burnout

Burnout in Belgian physicians and nurses doi: 10.1093/occmed/kqx126

Vandenbroeck S, Van Gerven E, De Witte H, Vanhaecht K, Godderis L.

(Sep 2017) This article investigates the prevalence of burnout in Belgian hospitals and its association with job demands, job resources, individual well-being, work-related attitudes and behavior in physicians and nurses across different specialties. Read more

Moral injury, distress and burnout

The undiagnosed pandemic: Burnout and depression within the surgical community doi: 10.1067/j.cpsurg.2017.07.001

DeCaporale-Ryan L, Sakran JV, Grant SB, et al.

(Sep 2017) For physicians in the aftermath of a medical error, learning from the event and working toward future safety improvements was correlated with growth and resilience. Authors argue that this learning cannot occur in a shame and blame environment. To promote well-being, there must be relational trust within the organization, with a particular focus on large-scale projects promoting teamwork, respectful interpersonal communication, and peer support. Read more

Moral injury, distress and burnout

The emotional impact of errors or adverse events on health care providers in the NICU: The protective role of coworker support doi: 10.1111/jan.13403

Winning AM, Merandi J, Lewe D, et al.

(Jul 2017) Researchers measure the impact of adverse events on health care providers in the neonatal intensive care unit, and the moderating role of coworker support. Experiencing an event was associated with higher levels of anxiety and depression when coworkers were perceived as low in supportiveness, but not when they were viewed as highly supportive. Read more

Adverse event impact

The "seven pillars" response to patient safety incidents: Effects on medical liability processes and outcomes doi: 10.1136/qshc.2008.031633

Lambert BL, Centomani NM, Smith KM, et al.

(Dec 2016) A study on the process for responding to patient safety incidents adopted at a large, urban tertiary care centre in the United States. In the first two years, the "seven pillars" process led to more than 2,000 incident reports annually, prompted more than 100 investigations with root cause analysis, translated into close to 200 system improvements and served as the foundation of almost 106 disclosure conversations and 20 full disclosures of inappropriate or unreasonable care causing harm to patients. Read more

Moral injury, distress and burnout

Executive leadership and physician well-being: Nine organizational strategies to promote engagement and reduce burnout doi: 10.1016/j.mayocp.2016.10.004

Shanafelt TD, Noseworthy JH.

(Nov 2016) This article summarizes nine organizational strategies to promote physician engagement and how the Mayo Clinic has successfully operationalized the approaches. Authors argue that deliberate and comprehensive efforts to reduce burnout and promote engagement can make a difference. Many effective interventions are relatively inexpensive, and small investments can have a large impact. Leadership and sustained attention from the highest level of the organization are the keys to making progress. Read more

Moral injury, distress and burnout

Increased risk of burnout for physicians and nurses involved in a patient safety incident doi: 10.1097/MLR.0000000000000582

Van Gerven E, Elst TV, Vandenbroeck S, et al.

(Oct 2016) This study looks at the prevalence of health care professionals being personally involved in a patient safety incident, and its relationship to problematic medication use, excessive alcohol consumption, risk of burnout, work-home interference, and turnover intentions. A total of 5,788 nurses (79.4%) and physicians (20.6%) in 26 acute and 11 psychiatric hospitals in Belgium were included. Read more

Moral injury, distress and burnout

Doing something about physician burnout doi: 10.1016/S0140-6736(16)31332-0

Epstein RM & Privitera MR

(Sep 2016) Evidence suggests that burnout negatively affects physicians’ effectiveness and availability to patients as well as patient safety. Physicians, health care organizations, and the public are concerned about quality of patient care and the health of health care institutions. Read more

Moral injury, distress and burnout

Peer support for clinicians: A programmatic approach doi: 10.1097/ACM.0000000000001297

Shapiro J, Galowitz P.

(Sep 2016) The Center for Professionalism and Peer Support at Brigham and Women's Hospital redesigned the peer support program in 2009. The program was one of the first of its kind; over 25 national and international programs have been modeled off of it. This perspective describes the origin, structure, and basic workings of the peer support program, including important components for the peer support conversation. Read more

Programming and implementation

Psychological impact and recovery after involvement in a patient safety incident: A repeated measures analysis doi: 10.1136/bmjopen-2016-011403

Van Gerven, Eva, Bruyneel, et al.

(Aug 2016) Survey data from physicians, nurses and midwives in 33 Belgian hospitals finds that the psychological impact of a patient safety event is higher when the degree of harm for the patient is more severe, when health care professionals feel responsible for the incident, and among female health care professionals. The impact of degree of harm differed across clinicians and decreased significantly over time. Read more

Adverse event impact • Meta-analysis

Health care staff wellbeing, burnout and patient safety: A systematic review doi: 10.1371/journal.pone.0159015

Hall L, Johnson JA, Watt I, Tsipa A, O’Connor DB.

(Jul 2016) A review of 46 studies aims to determine whether there is an association between health care professionals’ wellbeing and burnout with patient safety. Read more

Moral injury, distress and burnout

Serious reportable events within the inpatient mental health care: Impact on physicians and nurses doi: 10.1016/j.cali.2016.04.004

Martens JA, Van Gerven E, Lannoy K, et al.

(Jan 2016) A quantitative, cross-sectional study of six psychiatric hospitals in Belgium looks at the impact of adverse events on physicians and nurses. About one in eight respondents considered quitting their job, and almost 18% declared that due to the impact of the event, they believed that the quality of the administered care was affected for longer than one month. Read more

Adverse event impact