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Interventions in health organisations to reduce the impact of adverse events in second and third victims

机译:对卫生组织的干预,以减少第二和第三位受害者的不良事件的影响

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摘要

Adverse events (AE) are also the cause of suffering in health professionals involved. This study was designed to identify and analyse organization-level strategies adopted in both primary care and hospitals in Spain to address the impact of serious AE on second and third victims. A cross-sectional study was conducted in healthcare organizations assessing: safety culture; health organization crisis management plans for serious AE; actions planned to ensure transparency in communication with patients (and relatives) who experience an AE; support for second victims; and protective measures to safeguard the institution’s reputation (the third victim). A total of 406 managers and patient safety coordinators replied to the survey. Deficient provision of support for second victims was acknowledged by 71 and 61?% of the participants from hospitals and primary care respectively; these respondents reported there was no support protocol for second victims in place in their organizations. Regarding third victim initiatives, 35?% of hospital and 43?% of primary care professionals indicated no crisis management plan for serious AE existed in their organization, and in the case of primary care, there was no crisis committee in 34?% of cases. The degree of implementation of second and third victim support interventions was perceived to be greater in hospitals (mean 14.1, SD 3.5) than in primary care (mean 11.8, SD 3.1) (p?
机译:不良事件(AE)也是造成所涉卫生专业人员痛苦的原因。本研究旨在确定和分析西班牙初级保健和医院采用的组织级策略,以解决严重不良事件对第二和第三位受害者的影响。在医疗机构中进行了一项横断面研究,评估:安全文化;严重不良事件的卫生组织危机管理计划;计划采取的行动,以确保与发生AE的患者(和亲属)沟通的透明度;支持第二受害者;和保护性措施以维护该机构的声誉(第三位受害者)。共有406位经理和患者安全协调员回复了调查。分别有71%和61%的参与者来自医院和初级保健机构,承认为第二受害者提供的支持不足。这些受访者报告说,他们组织中没有针对第二个受害者的支持协议。关于第三个受害者倡议,有35%的医院和43%的初级保健专业人员表示他们的组织中没有针对严重AE的危机管理计划,就初级保健而言,在34%的案例中没有危机委员会。医院中第二次和第三次受害者支持干预措施的实施程度(平均14.1,标准差3.5)被认为比初级卫生保健(平均11.8,标准差3.1)要大(p <0.001)。许多西班牙卫生组织没有针对严重不良事件的第二和第三位受害者支持或危机管理计划。

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