TABLE 1.

Summary of Included Programs

Program Name	Reference Articles(s)	Location	Program Description	Outcome Measures
Code Lavender: Holistic Rapid Response	Johnson26	Cleveland Clinic, Cleveland Ohio	Provides emotional support to patients, family members, and hospital personnel (clinical and nonclinical) via an interdisciplinary rapid response team. Triggers include unexpected death, death or illness of staff or long-term patients. First response is within 30 min, with repeated check ins over the next 72 h. Services offered include massage, spiritual care, Reiki, Healing Touch, aromatherapy, and access to EAP.	Reported subjective perceived benefit
forYOU	Scott et al7 Scott38 Scott37	University of Missouri Health Care, Columbia, Missouri	Rapid Response system available 24/7 to clinicians. Three-tiered model of support where tier 1 represents local or departmental support and response to promote identification and awareness of second victims. Tier 2 represents guidance and nurturing of identified second victims by specially trained peer supporters. Tier 3 represents access to professional services: chaplaincy, EAP, social work, and clinical health psychologists.	Reported Utilizations Statistics: 49 deployments in the first 10 mo. Average encounter lasting 30 min. Six team debriefings were held (average of 15 people lasting 77 min). Reasons for activations reported. Used the AHRQ-HSPOS survey 4 times. No statistical data comparing preimplementation and postimplementation.
Healing Beyond Today	Roesler et al31	Methodist Hospital of Indiana, Indianapolis, Indiana,	The “Healing Beyond Today” program was launched to help transition those involved with return to work. It was a CISD-based program. Attendance was mandatory for all unit staff, and invitations were extended to ancillary personnel. Sessions were conducted offsite.	5/6 HCPs retained their job at 1 y (1 had moved out of state). Some HCPs were resistant to attending the program and expressed feelings of ambivalence and frustrations stating that they had moved on and did not require support.
MITSS and the Peer Support Service (PSS)	van Pelt8 Tobin42	Brigham and Women’s Hospital, Boston, Massachusetts	PSS is a rapid response model that is available to access 24 h a day, 7 d a week. The program is voluntary and separate from hospital quality assurance. There is no record keeping or documentation. Support is 1:1 and may be provided over the telephone. Referrals to the PSS may be made by the individual requiring the services, or by EAP, Risk Management, or colleagues. The program is not meant to replace formal counseling, and has a list of resources for those who require these services. MITSS also offers counseling, referrals, or telephone conversation to patients and their families.	None reported
CISS Managers’ Toolkit	Health PEI39	Health PEI, Prince Edward Island, Canada	Toolkit outlining policies, articles, and checklists for managers responding to critical incidents. Information is listed as preincident or postincident (tier-based support).	None reported
RISE	Edrees et al24 Dukhanin et al22	Johns Hopkins Hospital, Baltimore, Maryland	Multidisciplinary team of peer supporters that can be activated through the paging system. It is available 24/7. The RISE team will page back within 30 min and arrange a meeting within the next 12 h. Group or individual support is possible. In this encounter, the RISE team member provides psychological first aid and provides a list of resources that may be helpful to the caller. All interactions are confidential. After the encounter, the peer supporter activates a debriefing, where the supporter receives support from other RISE members.	119 calls involving 500 individuals were received in the first 52 mo. Most were from nurses, and only 4% concerned medical error. Peer responders completed self-evaluations as well as participation in a focus group. 88% of peer responders stated they had successful encounters in 88% of cases, and 83.3% of the time, they reported meeting their caller’s needs. Preprogram (2011) and postprogram (2014) surveys issued at 2011 and 2014. No significant difference in awareness of second victim phenomenon. In the post program survey more respondents perceived that organizational support was available to them (60% versus 41%), and that there was benefit to reaching out for support (94% versus 85%). 93% would recommend RISE to a colleague.
SWADDLE	Trent et al40 Baylor Scott & White Medical Center—Temple36	Baylor Scott & White Medical Center, Temple Texas	1:1 ongoing peer support provided with psychological first aid, and referral to outside resources if needed. Based on the Scott 3-tiered model of staff support. Program provides prevention education for compassion fatigue, secondary traumatic stress, and burnout. Resilience Rounds are scheduled bi-monthly. It has both a didactic educational component, as well as a facilitated, confidential 20- to 30-min group discussion.	None reported
USVIC	Bueno Domínguez et al27	Grup SAGESSA, Tarragona, Spain	The support unit comprises a bioethicist, 2 nurses, a psychologist, and a lawyer. Provides psychological and medical support to second victims, as well as legal guidance. The unit can be activated through self-referral, or by colleagues or management. Once activated, a rapid response team will appear on scene as soon as possible. If required, more visits/telephone calls can be arranged. A root cause analysis is carried out simultaneously, and a report is made available to staff.	None reported
We Care	Gatzert et al43 We Care Team Family Brochure. Barnes Jewish Hospital, 2015	Barnes Jewish Hospital, St Louis, Missouri	Team members may proactively contact potential second victims, or may receive referrals from other HCPs via telephone or email. Debriefings may be individual or group-based. We Care Team is available 24 h a day, 7 d a week. We Care team meetings are scheduled monthly to discuss encounters and support other team members. All support is confidential and no personal or situational details are recorded.	None reported
Clinician Peer Support Program	Lane et al28	Barnes-Jewish Hospital and St. Louis Children’s Hospital	Clinicians can be referred by safety or risk management staff, peer support providers, or could self-nominate. Clinician PSP proactively contacts all physicians involved in a serious medical error or adverse event. Clinicians are matched with an available peer supporter with attempts made not to match them within the exact fields, or with those who may be in a supervisory role. Clinician PSP contacts them by email or telephone. Support is offered to the clinician, and if they decline, permission is asked to follow up in 1 week. Peer support providers debrief with a PSP director after contact with a clinician. The program conducts monthly program meetings or conference calls to share any lessons learned and program updates.	No clinician-centered outcomes. Usage stats reported
YOU Matter	Krzan et l27	Nationwide Children’s Hospital, Columbus, Ohio,	Coverage for the program is provided 24 h a day, 7 d a week. Interventions are based on the Scott 3-Tiered Model of Staff Support. Encounter forms can be accessed through SharePoint, and record only nonidentifiable data. This website also contains meeting minutes, lists of resources, and promotional materials.	Preimplementation and postimplementation surveys were conducted. 85% of those surveyed felt that the Department of Pharmacy had benefitted from the YOU Matter program.
CISMP of the First Nations and Inuit Health Branch	Lynch35	First Nations and Inuit Health Branch	They have preventative and proactive education sessions. The CISM program is based on modified Mitchell Criteria and is managed by a national coordinator in Winnipeg with 2 assistant coordinators and 1.5 clerical assistants. They have access to a peer supporters and mental health professionals. Service is available 24/7 through coordinators “during working hours” and via telephone/EAP at nights and on weekends. The initial telephone call determines whether or not further intervention is required. They can bring the staff member out of the remote community for 2 sessions with the first-line provider, and up to 6 sessions over a 4-wk period with a second level provider. After this, if more support is required, they can be assessed by a psychologist. Treatment costs are covered by the program or through disability/worker’s comp. Group debriefings are rare.	Program was initiated in 1993. A follow-up survey in 1996 found 81% of respondents reported subjective benefit. 52% said without the services, they would have left their current job. 92% would use the service again, and 100% would recommend to others.
Provider Support Group	The Washington Patient Safety Coalition41	The Everett Clinic, Everett, Washington	HCPs are matched with physician mentors that have been involved in similar types of events to those that have recently experienced an adverse event/claim/lawsuit. Mentors meet monthly to address barriers. Postmentor/mentee surveys are distributed once the partnership has ended. Confidential	None reported
After the Event: Care Provider Recovery Toolkit	The Washington Patient Safety Coalition41	St Luke’s Health System, Boise, Idaho	The toolkit is a resource for managers to supplement the EAP and CISM teams after an adverse event. Toolkit includes slides, talking points, and videos.	None reported
Physicians Insurance Peer Support Program	The Washington Patient Safety Coalition41	Physicians Insurance, Seattle, Washington	Program is administered by volunteer clinician members retained as consultants to the Claims Department. They contact members by telephone to offer short-term, confidential, emotional support and resources after an adverse event is reported to the Claims Department in anticipation of litigation.	None reported
Care for the Caregiver: Providence Peer Support Team	The Washington Patient Safety Coalition41	Providence Everett Regional Medical Centre, Everett, Washington	A peer support program to support providers who are involved in an adverse event or “other difficult situation”	None reported
When Things Go Wrong	Bell et al16	Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, Massachusetts,	Curriculum includes (1) baseline assessment of experiences, attitudes, and perceptions; (2) interactive curriculum using filmed patient narratives; and (3) implementation strategy for real-time disclosure. The curriculum was launched with separate tracks for staff physicians and residents. There is a 24-h pager number for support and communication after adverse events.	100% of faculty physicians surveyed indicated that they felt better prepared to teach and address this topic. 79% of trainees and 92% of faculty physicians indicated that the session would affect their practice as clinicians.
Resident Wellness Curriculum	Arnold et al al18	2017 Resident Wellness Consensus Summit in Las Vegas, Nevada,	The curriculum includes a 2-module introduction to wellness; a 7-module “Self-Care Series” focusing on the appropriate structure of wellness activities and everyday necessities that promote physician wellness; a 2-module section on physician suicide and self-help; a 4-module “Clinical Care Series” focusing on delivering bad news, navigating difficult patient encounters, dealing with difficult consultants and staff members, and debriefing traumatic events in the emergency department; wellness in the workplace; and dealing with medical errors and shame.	None reported
Resident Educator Toolkit	Chung et al20	2017 Resident Wellness Consensus Summit in Las Vegas, Nevada,	Three educator toolkits were developed. The second victim syndrome toolkit has 4 modules, each with prereading material and a leader (educator) guide. In the mindfulness and meditation toolkit, there are 3 modules with a leader guide in addition to a longitudinal, guided meditation plan. The positive psychology toolkit has 2 modules, each with a leader guide and a PowerPoint slide set. These toolkits provide educators the necessary resources, reading materials, and lesson plans to implement didactic sessions in their residency curriculum.	None reported
Second Victim Curriculum for Nurse Anesthetists	Daniels and McCorkle21	American Association of Nurse Anesthetists, Park Ridge, Illinois	Six basic domains including (1) define and describe second victim; (2) second victim risks for nurse anesthetists; (3) barriers for the second victim; (4) unintended consequences of the second victim; and (5) evidence-based understanding and interventions frameworks 6. Support systems	None reported
MISE	Mira et al29	Alicante-Sant Joan Health District, Alicante, Spain	The website was structured in 2 packages: demonstrative and informative. The informative package offered information on basic patient safety concepts including near misses, adverse events, and second victims. The demonstrative package included descriptions of the emotional consequences of adverse events as well as recommendations for actions after adverse events. This package had 15 videos to show what and what not to do in these situations. Information was also available through a mobile app.	Efficacy of the program was assessed with pretest and posttest. Users who finished MISE demonstrated knowledge of patient safety terminology, prevalence and impact of adverse events and clinical errors, second victim support models, and recommended actions after a severe adverse event (P < 0.001). There was no significant difference in the scores on the general knowledge test, or the demonstrative or informative test packages. The participants also completed an evaluation of MISE: HCPs rated the website 8.8/10.
Creating Debriefing Sessions for Perceived Medical Errors in Residency: A Step Towards Wellness	Choi et al19	University of Illinois, Illinois, Chicago	Small groups of 9 residents and 2 facilitators (a staff and chief resident) who participate in facilitated discussions each month. Sessions were held on-campus, during noon hour, with protected time to attend. The goal of the sessions was to provide a safe space for discussion about perceived medical error, sharing coping strategies, and providing resources where necessary.	Pre survey and postsurvey were completed. No results reported in the abstract.

This table summarizes the names, locations, and descriptions of each program included in our scoping study, as well as outcome measures reported, where possible.

ARHQ-HSPOS, Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture; CISD, Critical Incident Stress Debriefing; CISS, Critical Incident Staff Support; MISE, Mitigating Impact in Second Victims; PSP, Peer Support Program; USVIC, Unidad de Soporte a las Segundas Victimas del Incidente Critico.