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Sept. 5, 2013 Volume 35, No. 3

MU Health program a national model for other hospitals

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Sue Scott, left, patient safety coordinator, and Laura Hirschinger, facility leader of the forYOU Team, are part of a program that has become a national model. Photo by Justin Kelley.

Early in Sue Scott’s work as patient safety coordinator in the Office of Clinical Effectiveness at MU Health Care, she was working with a clinician who had lost a patient. Scott asked the clinician how he was coping, and the clinician started crying. 

Scott didn’t know how to handle it. “I felt like I was reaching into an empty toolkit,” she said.

The encounter was the impetus for the University of Missouri Health System’s forYOU Team for peer support. The first of its kind when launched in March 2009, the program helps health care workers recover from a traumatic clinical event or an unexpected patient death.

Scott and colleagues dug into the literature on “second victims,” or health care workers who suffer mental trauma following a stressful clinical event. Second victims can feel personally responsible for the outcome and often second-guess their abilities, sometimes dropping out of the profession entirely, Scott said.  

Health care workers are often given the impression that to look professional, they need to not become emotional over the death of a patient. So when Scott and Laura Hirschinger, patient safety clinical improvement specialist at the health system and facility leader of the forYOU Team, were looking for interviewees for their research project on second victims, they thought it might be difficult to find participants willing to share their stories.

They found the opposite. Physicians, nurses, managers and other allied health care workers were looking for a way to heal. 

Scott, Hirschinger and two additional researchers identified a six-stage grieving process and an intervention model to support those who struggle, such as creating a “safe zone” to express their thoughts and emotions and providing assurance that what they are experiencing is a normal human reaction to a stressful event. 

Since its inception, more than 100 MU Health System staff members have been trained and nearly 900 hospital employees supported through peer mentoring. After an eight-hour training program, team members work to care for the caregivers through one-on-one or group mentoring sessions. Scott said she’s seen the culture of support evolve at the hospital. 

“Now whenever we have an event that could be disturbing, there is a heightened awareness for recognizing the need to support one another,” Scott said. 

That proactive way of thinking is leading to more informal mentoring sessions. “Just that momentary pause to show that somebody cares about you as an individual [makes a difference],” Scott said. 

In 2009, the forYOU Team received the HOPE Award from the Medically Induced Trauma Support Services organization for the program’s innovative model. In 2012, the team was recognized with the Cheers Award from the Institute for Safe Medication Practices for the pioneering efforts to support clinicians. 

Other hospitals are taking notice and reaching out for ideas on how to implement similar programs in their own facilities. Clinician support teams are now popping up around the country. Scott and Hirschinger have been actively involved with assisting several facilities with the establishment of their own forYOU Team.

“It’s a lesson in civility for health care. How can we provide better care and support for the caregiver, enabling the clinician to care for themselves so they are ready to care for the next patient?” Scott said. “When you change that attitude and provide a nurturing environment, you change habits, and that changes the culture.”  

— Kelsey Allen