Residents Impacted by Adverse Events: The Development of a Pilot Committee for Responding to and Supporting Psychiatry R
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EDUCATIONAL CASE REPORT
Residents Impacted by Adverse Events: The Development of a Pilot Committee for Responding to and Supporting Psychiatry Residents Vanessa Padilla 1
&
Jessica Healey 2 & Julia Salinas 2 & Cody Bryant 2 & Omar Muñoz 2 & Dante Durand 1
Received: 29 May 2020 / Accepted: 15 October 2020 # Academic Psychiatry 2020
Throughout their training, resident physicians treat severely ill patients across a variety of clinical care settings. Adverse events are, by their nature, difficult to predict or avoid. Trainees may encounter barriers when responding to adverse events for a variety of reasons, including lack of education, lack of knowledge of how to access the reporting system, lack of time to submit report, lack of knowledge of what to report, and too much information received during their initial intern orientation [1]. A cross-sectional study of post-graduate residents found that time needed to file a patient safety report was the strongest perceived barrier to report and that reporting increased by year of residency training [2]. Within this context, the authors propose that residency training programs should play an active role in helping trainees report adverse events, connect to resources, and maintain a sense of safety. Adverse events, such as assaults on providers, patient suicide completions/attempts, medical errors, and unexpected patient deaths, are unfortunate, but inevitable occurrences within healthcare settings. Per a survey of 3171 physicians in the USA and Canada, 92% reported previous involvement in adverse events and 81% reported some degree of job-related stress due to the event [3]. Healthcare providers often become second victims when adverse events occur due to the potential psychological impacts of the unanticipated traumatic events [4, 5]. Those symptoms often include troubling memories (81%), anxiety/concern (76%), anger towards the self (75%), regret/ remorse (72%), fear of future errors (56%), guilt (51%), and sleeping difficulties (35%) [6]. A Canadian cross-sectional survey of psychiatric staff found that exposure to violence and chronic stressors contribute significantly and independently to PTSD symptom checklist scores [7]. This psychological impact * Vanessa Padilla [email protected] 1
University of Miami Miller School of Medicine, Miami, FL, USA
2
Jackson Health System, Miami, FL, USA
can be mitigated by a supportive environment [8]. A 2014 survey among psychiatry residents identified that supervision received from attendings, senior/chief residents, peers, and supportive outreach significantly affected their emotional reaction to an adverse event [9]. A supportive culture has been shown to reduce the psychological impact of adverse events, whereas a “blame” culture increases the psychological impact [10]. To improve patient safety and decrease adverse events, healthcare providers should play an active role in event reporting [11]. Various reporting systems have been implemented in hospital systems across the USA [12], but it appears that these current sy
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