Clinicians benefit from peer support program after traumatic patient events, as does bottom line

By Liz Meszaros, MDLinx
Published May 12, 2017

Key Takeaways

Since its launch 6 years ago, a peer-support program designed to help doctors and nurses recover after traumatic patient-care events may save Johns Hopkins Medicine in Baltimore, MD, almost $2 million annually, according to results from a recent cost-benefit analysis, published online in the Journal of Patient Safety.

“We often refer to medical providers who are part of these stressful events as ‘second victims,’” says study leader William V. Padula, PhD, assistant professor, department of health policy and management, Bloomberg School, using a term coined by Johns Hopkins professor Albert Wu, MD. “Although providers often aren’t considered to be personally affected, the impact of these events can last through their entire career.”

After these traumatic events—which can include the death of a patient, patients in extreme pain, overwhelmed family members, or patient harm caused by a medical error—clinicians may be unable to cope with the stress, or not feel supported. This may cause them to decrease their work productivity, take time off, or even quit their jobs.

According to Dr. Padula, in a large, academic medical center like Johns Hopkins, these events happen on a daily basis.

In 2011, administrators at Johns Hopkins Medicine began the Resilience In Stressful Events (RISE) program, which involves a multidisciplinary network of peer counselors who help fellow clinicians in need within 30 minutes of a request for help after a traumatic care-related event.

In order to continue the program, Dr. Padula and colleagues were tasked with demonstrating its financial benefit. To do so, they developed a model focused on only the nursing population, and sought to predict the financial outcomes of a year with and without the RISE program. They used data from a survey taken by nurses familiar with the program on their probability of quitting or taking a day off after a stressful event with or without the program in place, as well as data from Johns Hopkins human resources department and published data on the costs of replacing a lost nurse.

Upon inputting this information into their model, Dr. Padula and fellow researchers saw that the annual cost of the RISE program per nurse was roughly $656, but the expected annual cost of not having the RISE program was $23,232, for a net cost savings of $22,576.

If these results were then extrapolated to all system users, including doctors, the total savings in 1 year was estimated to be about $1.81 million.

But according to Dr. Padula, even the significant financial benefits are not the only reason for keeping the RISE program in place.

“It’s hard to put a true price on the emotional support and coping mechanisms this program provides for clinicians after tragic events,” he concluded.

Funding for this study was provided by the Josie King Foundation and the Maryland Patient Safety Center.

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