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The Just Culture, Second Victimization and Clinician Support: An Educational/Awareness Program

Due to the continued numbers of medical errors and unexpected patient outcomes, the student project manager identified the collateral damage that health care providers involved in the patient care events experienced while acting as a risk manager at one medical center. This concept is referred to as "second victimization". The patient and/or family are the primary victims of errors and unexpected outcomes, but the close second is that of the clinician caring for the patient. As a result of this, the concern for the needs of these second victims was considered. A review of the literature was conducted. The review supported the concept of organizational support systems that provide the second victims with emotional and professional support during these challenging times. Medically Induced Trauma Support Services (MITSS) created an evidence based toolkit for initiating a clinician support program at any facility. The literature and the MITSS toolkit were utilized to create a plan, budget, evaluation and timeframe for a pilot program educating and making clinicians aware of the need for a clinician support program at Massachusetts General Hospital in Boston. Twenty potential participants were identified by a nomination process and invited to participate. Eleven completed the program in its entirety (pre-survey, educational program, and post-survey). Each member (100%) reported their knowledge increasing on second victimization and just culture as a result of the program. A significant number reported their interest in being part of a future peer support program. It is the hope of the student project manager that this pilot serves as a foundation for a future clinician support program.