Secondary victims: An individual issue or a systemic problem?

Abstract

Patient safety incidents include any error, failure, or circumstance that could cause or has caused unnecessary harm to a patient due to the care received. Due to their frequency, significance, and the potential to prevent many of them, healthcare-associated injuries are a public health issue. The goal of patient safety initiatives is to reduce these harms to an acceptable minimum based on scientific knowledge and available resources. Patient safety initiatives aim to reduce these harms to an acceptable minimum based on scientific evidence and available resources. System failures related to safety culture, work organization, equipment, and various personal and environmental factors facilitate the occurrence of errors and safety-related incidents. Avoiding them requires implementing barriers with a triple aim: reducing the risk of incidents occurring (primary prevention); addressing them early to mitigate consequences for the patient and the system (secondary prevention); and preventing their recurrence and minimizing long-term impact (tertiary prevention). Incident reporting systems that allow for retrospective analysis of contributing factors and learning from them is essential to prevent recurrence. Despite being legally recognized for over 20 years as a basic safety infrastructure, their effective use is hindered by the lack of a clear regulatory framework. This framework should guarantee legal protection for those reporting incidents, conducting in-depth analyses, or raising concerns about service safety. The current lack of protection, coupled with professional distrust, further impedes their utilization. The term “second victim” describes the emotional, physical, and professional impact experienced by healthcare professionals involved in patient safety incidents and unexpected poor outcomes in care provided. Although controversial, it is a frequent problem of varying intensity depending on different factors, requiring preventive measures, early intervention, and follow-up, with training and the existence of a fair and proactive culture being prioritized actions. Peer and specialized support can improve the recovery process. Information and communication with patients and their families following an incident, as well as clinical, organizational, and, if necessary, legal follow-up, are crucial matters. Although controversial, it is a frequent problem of varying intensity depending on different factors, requiring preventive measures, early intervention, and follow-up, with training and the existence of a just and proactive culture being prioritized actions. Peer and specialized support can improve the recovery process. Information and communication with patients and their families following an incident, as well as clinical, organizational, and, if necessary, legal followup, are crucial matters.