Avoiding ‘second victims’ in healthcare: what support do staff want for coping with patient safety incidents, what do they get and is it effective? A systematic review

Objectives Incontrovertible evidence surrounds the need to support healthcare professionals after patient safety incidents (PSIs). However, what characterises effective organisational support is less clearly understood and defined. This review aims to determine what support healthcare professionals...

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Main Authors: Reema Harrison, Rebecca Lawton, Ruth Simms-Ellis, Raabia Sattar, Elizabeth Sweeting, Hannah Hartley, Matthew Morys-Edge
Format: Article
Language:English
Published: BMJ Publishing Group 2025-02-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/2/e087512.full
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author Reema Harrison
Rebecca Lawton
Ruth Simms-Ellis
Raabia Sattar
Elizabeth Sweeting
Hannah Hartley
Matthew Morys-Edge
author_facet Reema Harrison
Rebecca Lawton
Ruth Simms-Ellis
Raabia Sattar
Elizabeth Sweeting
Hannah Hartley
Matthew Morys-Edge
author_sort Reema Harrison
collection DOAJ
description Objectives Incontrovertible evidence surrounds the need to support healthcare professionals after patient safety incidents (PSIs). However, what characterises effective organisational support is less clearly understood and defined. This review aims to determine what support healthcare professionals want for coping with PSIs, what support interventions/approaches are currently available and which have evidence for effectiveness.Design Systematic research review with narrative synthesis.Data sources Medline, Scopus, PubMed and Web of Science databases (from 2010 to mid-2021; updated December 2022), reference lists of eligible articles and Connected Papers software.Eligibility criteria for selecting studies Empirical studies (1) containing information about support frontline healthcare staff want before/after a PSI, OR addressing (2) support currently available, OR (3) the effectiveness of support to help prevent/alleviate consequences of a PSI. Study quality was appraised using the Quality Assessment for Diverse Studies tool.Results Ninety-nine studies were identified. Staff most wanted: peer support (n=28), practical support and guidance (n=27) and professional mental health support (n=21). They mostly received: peer support (n=46), managerial support (n=23) and some form of debrief (n=15). Reports of poor PSI support were common. Eleven studies examined intervention effectiveness. Evidence was positive for the effectiveness of preventive/preparatory interventions (n=3), but mixed for peer support programmes designed to alleviate harmful consequences after PSIs (n=8). Study quality varied.Conclusions Beyond peer support, organisational support for PSIs appears to be misaligned with staff desires. Gaps exist in providing preparatory/preventive interventions and practical support and guidance. Reliable effectiveness data are lacking. Very few studies incorporated comparison groups or randomisation; most used self-report measures. Despite inconclusive evidence, formal peer support programmes dominate. This review illustrates a critical need to fund robust PSI-related intervention effectiveness studies to provide organisations with the evidence they need to make informed decisions when building PSI support programmes.PROSPERO registration number CRD42022325796.
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spelling doaj-art-04c509e622c84362bd5d054df2e7dd8b2025-02-11T08:55:12ZengBMJ Publishing GroupBMJ Open2044-60552025-02-0115210.1136/bmjopen-2024-087512Avoiding ‘second victims’ in healthcare: what support do staff want for coping with patient safety incidents, what do they get and is it effective? A systematic reviewReema Harrison0Rebecca Lawton1Ruth Simms-Ellis2Raabia Sattar3Elizabeth Sweeting4Hannah Hartley5Matthew Morys-Edge6Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, AustraliaThe Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford, UKThe Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford, UKThe Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford, UKImprovement Academy, Bradford Institute for Health Research, Bradford, UKThe Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford, UKSchool of Psychology, University of Leeds, Leeds, UKObjectives Incontrovertible evidence surrounds the need to support healthcare professionals after patient safety incidents (PSIs). However, what characterises effective organisational support is less clearly understood and defined. This review aims to determine what support healthcare professionals want for coping with PSIs, what support interventions/approaches are currently available and which have evidence for effectiveness.Design Systematic research review with narrative synthesis.Data sources Medline, Scopus, PubMed and Web of Science databases (from 2010 to mid-2021; updated December 2022), reference lists of eligible articles and Connected Papers software.Eligibility criteria for selecting studies Empirical studies (1) containing information about support frontline healthcare staff want before/after a PSI, OR addressing (2) support currently available, OR (3) the effectiveness of support to help prevent/alleviate consequences of a PSI. Study quality was appraised using the Quality Assessment for Diverse Studies tool.Results Ninety-nine studies were identified. Staff most wanted: peer support (n=28), practical support and guidance (n=27) and professional mental health support (n=21). They mostly received: peer support (n=46), managerial support (n=23) and some form of debrief (n=15). Reports of poor PSI support were common. Eleven studies examined intervention effectiveness. Evidence was positive for the effectiveness of preventive/preparatory interventions (n=3), but mixed for peer support programmes designed to alleviate harmful consequences after PSIs (n=8). Study quality varied.Conclusions Beyond peer support, organisational support for PSIs appears to be misaligned with staff desires. Gaps exist in providing preparatory/preventive interventions and practical support and guidance. Reliable effectiveness data are lacking. Very few studies incorporated comparison groups or randomisation; most used self-report measures. Despite inconclusive evidence, formal peer support programmes dominate. This review illustrates a critical need to fund robust PSI-related intervention effectiveness studies to provide organisations with the evidence they need to make informed decisions when building PSI support programmes.PROSPERO registration number CRD42022325796.https://bmjopen.bmj.com/content/15/2/e087512.full
spellingShingle Reema Harrison
Rebecca Lawton
Ruth Simms-Ellis
Raabia Sattar
Elizabeth Sweeting
Hannah Hartley
Matthew Morys-Edge
Avoiding ‘second victims’ in healthcare: what support do staff want for coping with patient safety incidents, what do they get and is it effective? A systematic review
BMJ Open
title Avoiding ‘second victims’ in healthcare: what support do staff want for coping with patient safety incidents, what do they get and is it effective? A systematic review
title_full Avoiding ‘second victims’ in healthcare: what support do staff want for coping with patient safety incidents, what do they get and is it effective? A systematic review
title_fullStr Avoiding ‘second victims’ in healthcare: what support do staff want for coping with patient safety incidents, what do they get and is it effective? A systematic review
title_full_unstemmed Avoiding ‘second victims’ in healthcare: what support do staff want for coping with patient safety incidents, what do they get and is it effective? A systematic review
title_short Avoiding ‘second victims’ in healthcare: what support do staff want for coping with patient safety incidents, what do they get and is it effective? A systematic review
title_sort avoiding second victims in healthcare what support do staff want for coping with patient safety incidents what do they get and is it effective a systematic review
url https://bmjopen.bmj.com/content/15/2/e087512.full
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