title: Impact of health care adversity on providers: Lessons learned from a staff support program.
abstract: BACKGROUND
  Health care providers often experience traumatic events and adversity that can have negative emotional impacts on the profession and on patients. These impacts are typically multifaceted and can result from many different events, such as unanticipated outcomes, licensing board complaints, claims, and litigation. Because health care providers are exposed to diverse situations, they require adequate and timely support, imperative for provider resilience and patient safety. This study evaluated the success of an institution's second victim health care support program and best practices in responding to these traumatic experiences effectively.
  
  
  METHODS
  Twenty faculty and medical residents who utilized the support program at a large hospital system located in Central Texas from 2001 to 2012 participated in 1 of 6 focus groups. Qualitative data were collected from these groups to describe program requirements for the adequate delivery of health care adversity support and necessary program improvements. Responses were first transcribed verbatim. Each research team member analyzed data using a thematic framework approach. This approach helped to characterize traumatic experiences and to design a support system.
  
  
  RESULTS
  The results revealed that (1) provider experiences are traumatic, (2) it is necessary to communicate an adverse event in a confidential and timely manner, preferably with a peer, (3) preemptive education regarding risk management and the legal process is helpful, and (4) there is a need for further support of the specific experience of a board complaint.
  
  
  CONCLUSIONS
  Focus group data indicated the complexity of the emotional impact of traumatic experiences. Specific program components are needed to create best practices for providers affected by health care adversity, including support when providers face board complaints. The program's unique combination of support and education allowed us to expand upon leading national health care adversity programs.
authors.affiliation: Baylor Scott & White Health.
authors.forename: Maxine
authors.initials: M
authors.lastname: Trent
authors.affiliation: Baylor Scott & White Health.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Waldo
authors.affiliation: Baylor Scott & White Health.
authors.forename: Hania
authors.initials: H
authors.lastname: Wehbe-Janek
authors.affiliation: East Tyler Medical Center, Tyler, Texas.
authors.forename: Daniel
authors.initials: D
authors.lastname: Williams
authors.affiliation: Baylor Scott & White Health.
authors.forename: Wendy
authors.initials: W
authors.lastname: Hegefeld
authors.affiliation: Baylor Scott & White Health.
authors.forename: Lisa
authors.initials: L
authors.lastname: Havens
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000523:psychology*; D008505:Medical Staff, Hospital / Q000523:psychology*; D008875:Middle Aged; D019982:Organizational Case Studies; D012944:Social Support; D013781:Texas