Eyeworld

171 OPHTHALMOLOGY BUSINESS April 2017 digital.ophthalmologybusiness.org is the perfect time to be doing this and think that all trainees should get patient safety training so they are not taken by surprise when they see things go wrong." Dr. Wilkinson said those earlier in their career tend to be more in- trospective and blame themselves for certain events, wondering if there was anything they could have done differently. However, as you get older, he said, "you realize there are some things that happen that you don't have control over and you tend to be more kind to yourself, … but when you're younger, you don't have that experience." While there aren't many medi- cal institutions with a peer support program to help colleagues cope with medical errors, Dr. Wu said he thinks it's a concept that is catching on. He also said he could imagine something like this being scaled down for implementation in smaller practices, either through an employ- ee assistance program or through a hotline managed by another organi- zation. Medically Induced Trauma Sup- port Services (MITSS), a nonprofit organization dedicated to providing support for healthcare workers and patients who have experienced an adverse medical event, has a toolkit on its website for building a clini- cian and staff support program. When a mistake does happen, Dr. Wu said his first advice in coping is to get reassurance and support from a colleague. After that he sug- gested turning to stress relievers and relaxation techniques, such as exer- cise or spending time in nature. EW References 1. Wu AW. Medical error: the second victim. The doctor who makes the mistake needs help too. BMJ. 2000;320:726–7. 2. Ullström S, et al. Suffering in silence: a qualitative study of second victims of adverse events. BMJ Qual Saf. 2014;23:325–331. 3. Edrees H, et al. Implementing the RISE second victim support programme at Johns Hopkins Hospital: a case study. BMJ Open. 2016;6:e011708. Editors' note: The physicians have no financial interests related to their comments. Contact information Wilkinson: wilkinsonmd@wilkinsoneye.com Wu: awu@jhu.edu kinds of experiences. … To know someone has had a similar outcome, it's reassuring and fairly therapeu- tic," he said. In 2011, Johns Hopkins created the Resilience in Stressful Events (RISE) program, which is designed to provide relatively anonymous peer support. The program consists of 20 to 30 volunteer healthcare providers who are available 24 hours a day via a call line. Dr. Wu said volunteers aim to call back within 10 minutes of receiving a message and try to meet in person with the caller that same shift at the hospital. In September 2016, the British Medical Journal Open published anal- ysis of the RISE program. 3 A baseline survey of the staff found most had experienced an adverse medical situation and would have liked peer support. In the first 52 months of its establishment, the RISE pro- gram received 199 calls—most from nurses—4% of which were related to medical errors. Overall, the peer vol- unteers felt encounters were success- ful, but the study authors concluded there was a lack of awareness about the program within the institution overall. "People appreciate the oppor- tunity to talk to someone who is clinical [because] they can under- stand the situation, but I think they appreciate, more than anything, that there is someone who is there to support them, who doesn't report back to anyone, and who is divorced from patient safety-risk management and any disciplinary procedure," he said. As for why more nurses than doctors have taken advantage of the service, Dr. Wu said there can still be a level of mistrust and paranoia of disclosing feelings among second victims. In addition, "doctors are re- luctant to see anyone for anything," he added. Students at Johns Hopkins Medical School take a full week of patient safety training in their sec- ond year, Dr. Wu said. This training includes a session on how to disclose medical errors with patients and families and discussion about the second victim. "Medical students haven't been so 'medicalized' yet, socialized to the stiff upper lip, so they're much more candid about their fears and misgivings," he said. "We think this To make sure your optical dispensary is working efficiently, you need an experienced team. at's why the most successful practices turn to Partners In Vision. As a leader in Optical Dispensary Development + Management, we manage and grow your optical business through superior customer service, aention to detail, responsive inventory management and patient education. Let us be your team. Call for a free, no-risk assessment. PartnersInVision.com optical staffing • on-site presence • education • ar management managed care intgration • inventory control • marketing Since 1999 Do you really have the right team for the job? O P T I C A L D I S P E N S A R Y M A N A G E M E N T 888.748.1112

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