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May 31, 2018

How NYC Health + Hospitals is treating the 'second victims' of trauma

Daily Briefing

    NYC Health + Hospitals earlier this year introduced a program aimed at helping doctors, nurses, and other frontline staff members cope with the traumatic events they experience on the job, Jonathan LaMantia writes for Crain's New York Business.

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    The 'second victims'

    Staff members who interact with patients are sometimes referred to as the "second victims" of trauma, because they can be personally affected by a patient's traumatic experience.

    But according to Jonathan Ripp, senior associate dean for well-being and resilience at the Icahn School of Medicine at Mount Sinai, there's a culture of toughness among clinicians that leads them to believe they can avoid emotionally responding to stressful situations.

    With that in mind, Ripp said, "If you want to run a high-functioning health care system, you have to pay attention to the well-being of your providers." Further, he added, "There is a return on investment to doing that."

    A study of University of Missouri Health Care supports that claim. Researchers studied more than 4,200 clinicians and found that staffers who received organizational support outperformed those who didn't at a statistically significant level on 12 out of 13 measures used to assess patient safety, LaMantia writes.

    Helping Healers Heal

    Eric Wei, an emergency physician by training, started the Helping Healers Heal program while he was chief quality officer at Los Angeles County-USC Medical Center. With Wei at the helm, the Los Angeles health system provided 100 one-on-one or group debriefings over nine months. Participants received referrals for mental health and spiritual support, if needed.

    Wei joined NYC Health + Hospitals earlier this year and brought the Helping Healers Heal program with him.

    At a recent session at Harlem Hospital following the death of a firefighter, Wei recalled his own experience coping with a similar loss as a physician. Wei said he felt an emotional reaction when he saw the man's wife and child. "That 8-month-old boy looked exactly like my 7-month-old baby girl," Wei said.

    After sharing, Wei opened up the floor. Twenty-one seconds of silence followed, and then someone spoke: "Seeing this young man die kind of brought up the day that my brother died at a very young age," one doctor said. "It put the elephant back on [my] chest, and it took years for that elephant to come off. You think it's gone, but then something happens to bring it right back."

    The session lasted about 45 minutes, with doctors, nurses, receptionists, and facility staff recalling the event.

    Ebow Hanson, 32, a staff nurse in Harlem's ED who took part in the debriefing, said he heard stories about staff members' personal lives that they'd never discussed at work before.

    Since Wei introduced the program at NYC Health +  Hospitals in February, other hospitals have taken notice. Elmhurst Hospital adopted the program after a child died of the flu, and Lincoln Medical Center adopted the program after a violent confrontation between a patient and family member.

    Ultimately, Wei wants to spread the program across every facility in NYC  +  Hospitals' network. He also intends on introducing four-hour training sessions to help people serve as "peer support champions" who can lead the one-on-one sessions. Wei hopes to have about 300 of these peer support champions at large facilities like Bellevue Hospital.

    Because employees run the program and volunteer their time, the costs are minimal, a NYC Health +  Hospitals spokesperson said (LaMantia, Crain's New York Business/Modern Healthcare, 4/16).

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