COST Action ERNST focuses on taking care of second victims

Patient Safety is a Priority in Europe and has improved over the years. Nevertheless, every year between 8 and 12% of the people admitted to hospitals and around 6% of those in primary care suffer from an adverse event (AE) while receiving healthcare. Second victims are healthcare providers and caretaker involved in an unexpected adverse event, medical error or injury affecting a patient, who become victims in the sense they are traumatized by it.

Numerous studies about second victim have mainly been studied in the USA, while in Europe, the problem of medical errors has not been studied at the EU level in a systematic manner. The advancement of work on this topic has been slow and justifies the need to further understand factors leading to second victim phenomenon.

The European Barometer indicates that 53% of EU citizens think that patients could be harmed by hospital care.

Last September, during the first Management Committee kick-off meeting, the European Researchers Network Working on Second Victims (ERNST) was born in this context. ERNST pursues enhancing resilience of healthcare workforce in stressful events as a prerequisite for achieve optimal care for patients. Understanding the causes of this phenomenon and opening a discussion to break the taboo around medical mistakes leading to second victims are the challenges this new Action will focus on for the next four years.

The ERNST COST Action aims at sharing scientific knowledge, perspectives, legislation, rules, and best practices concerning advert event in healthcare institutions. This cross-national collaboration is gathering research teams from 27 European countries, plus experts from the USA, Japan and, Latin American. A total of 92 professionals from universities, healthcare, and research institutions, across the world will establish a more in-depth understanding of the complexities of these issues requiring a multidisciplinary approach.

How did the idea of creating an international network on second victims come about?

"The germ of this European project was conceived at a meeting held on 19 and 20 July 2018 in Alicante (Spain). Some of the leaders of the Working Groups of the current ERNST and members of the Spanish team participated in this initial meeting. Prof. Vanhaecht (KULeuven, Belgium) in several previous meetings had already proposed that we should cooperate in Europe. At that time there were only a few research teams on second victims and the studies were just beginning. Now, the situation is absolutely different. There are new teams, new experiences in health centres and it is understood that giving support to professionals means working on quality care, which is working for the benefit of patients. ERNST has integrated almost all the teams that seek to increase the resilience of professionals in stressful situations and we have a network capable of identifying appropriate solutions. In addition, we have the support of researchers from other countries outside Europe who are leading research in this field worldwide and whose orientation further strengthens our capacity to work in this field." says Prof José Joaquín MIRA, Chair of the Action.

The direct consequences the second victim phenomenon is causing insecurity in the provision of healthcare, loss of quality of the care provided, absenteeism, defensive medicine, burnout at the individual level, and inadequate risk management, an avoidable burden of human cost, detachment, and loss of reputation at the institutional level.

Understanding factors causing healthcare provider errors, implementing a blame-free patient safety culture, and developing a legal certainty framework in the health care context can reinforce the care provider commitment to patient safety and reduce SV-related trauma.

Prof José Joaquín MIRA, Chairing the Action, adds: "Our intention is to generate a space for the exchange of ideas, interchange experiences and open controversy on how safety incidents limit the capacity of teams and healthcare professionals. We want to increase the understanding of this phenomenon and to provide the public and patients with information and data to raise awareness of what safety incidents are. We want to involve in these debates with all stakeholders such as the academic and legislative world, clinicians, managers, policy makers and patient associations. Analysing the phenomenon of second victims, conceptualizing it (which also means looking for alternatives to the term second victims), measuring its impact and developing interventions to reduce its effect is also working for the benefit of the quality of care received by patients".

During the first semester of 2021, the Action Network has begun its activities marked by the impact of the COVID-19 pandemic on health systems and society as a whole. ERNST approach to caring for those who care for patients become more meaningful when we consider the healthcare workforce as the second victim of SARS-CoV-2.

The Action has also joined the new network COST Actions against COVID-19 an interdisciplinary network gathering useful information and details of all the Actions wishing to connect and collaborate.

Branching out

Next March, the network is organizing an international forum: 'Caring for Caregivers: Lessons Learned from the COVID-19 Pandemic'.

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