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Abstract

Introduction: Healthcare providers may experience critical incident, medical error, or other adverse patient events in their clinical practice. Those that do encounter such events, may experience second victim syndrome (SVS), a condition in which providers feel psychological, cognitive, or physical reactions rendering care in these instances. Those with SVS may experience symptoms such as anxiety, depression, or burnout. Organizational support may mediate the impacts of SVS after an adverse patient event. We conducted a scoping review to explore and synthesize the literature on the support strategies implemented by healthcare organizations in the United States, for healthcare providers, after adverse patient events. Methods: The initial search strategy yielded 244 articles, 84 of which were removed for duplication. The 3-person review team completed title and abstract screening, reference screening, and full-text review, reaching 2-person consensus for article inclusion at each phase. To be included in analysis, studies had to have taken place in the United States, and had to include real or perceived outcomes of organizational support strategies for healthcare providers related to adverse patient events. During title and abstract screening, 144 articles did not meet inclusion criteria. The references of the remaining articles (n = 16) were screened and 6 articles were added to the review pool. Twenty-two articles were included in the full text analysis, during which 16 articles were removed for not meeting the inclusion criteria. Six articles were included in the final extraction and analysis. Results: The studies included in the final analysis, assessed SVS and organizational support across a variety of healthcare work settings and professions, using several strategies, both quantitative and qualitative, to measure provider experiences. The Second Victim Experience and Support Tool (SVEST) (n = 2/6, 33.3%) and the Medically Induced Trauma Support Services Staff Support Survey (n = 2/6, 33.3%) were the most commonly used tools to measure SVS experiences. Our findings indicate that healthcare providers believe organizational support after adverse patient events was or would be beneficial for minimizing SVS. Despite the perception of its value, the frequency of perceived organizational support given to healthcare providers differed across studies, ranging from 43 – 94% of the participants believing they received some form of support. Our findings also demonstrated a discrepancy in the types of support strategies healthcare providers preferred or desired after an adverse event, as the level of agreement differed between sampled populations. Conclusion: Healthcare providers believe support from their organization is important after experiencing an adverse patient event, but support strategies may not be universal. Certain support strategies may be contextual, with potentially different preferences for support based on organization or profession. Organizations should establish provider support systems for adverse events, but first need to assess provider preferences to implement the strategies most desired. That being said, little is known about the effectiveness of the discussed organizational support strategies, outside of their perceived value. Athletic trainers in physician practice are situated among a variety of healthcare providers, all of whom are susceptible to SVS. As organizations develop their support systems, they should consider the interprofessional nature of their staffs to aid in collective support following a crucial incident.

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