Who is there to assist medical practitioners in the event of clinical incidents?

Two statistical studies indicate that hospitals, residential care centres and other healthcare providers clearly benefit from a structured approach towards clinical incidents: at least 50% of emergency response workers and as much as 13.5% of patients were involved in a clinical incident at some point in their lives. While these incidents are not always of a severe nature, the figures show that a more structured approach is needed.

Lindsy Werrebrouck, prevention advisor on psychosocial aspects at Mensura, closely examined this topic and explains the main elements to consider.

“Whenever a clinical incident occurs, it is essential that all victims are identified straight away”, Lindsy says. Usually, there are three victims involved.

• First victim: the first priority when a clinical incident occurs is to ensure that the patient and their close relatives are cared for.
• Second victim: around 50% of emergency workers involved in a clinical incident suffer from this terribly. At a personal level, they may experience post-traumatic symptoms such as stress and depression. At work, they may display symptoms such as increased insecurity, burnout and absenteeism.
• Third victim: the healthcare facility where the incident took place may suffer financial harm and damage to their image.

“Each one of these victims comes with their own needs and requires a specific approach”, Lindsy continues. “A proper clinical incidents policy includes clearly set agreements about who will provide care and counselling for these people. Of course, the point of contact can never be one of the parties involved in the incident.”

Lindsy: “The first 48 hours are critical. All the victims need immediate care and support during this time. It’s in everyone’s interest to communicate openly about the events that occurred, even during follow-up care.”

• First victim: the designated supervisor or manager acknowledges the suffering of the patient and their close relatives, and expresses regret and empathy. The supervisor or manager immediately involves the victim in the root cause analysis and continues to do so until the case is finalised. This way, they clearly show that they are committed to preventing such incidents from occurring again in the future.  
• Second victim: colleagues and direct supervisors are there for the affected emergency response worker(s) and offer emotional support. They also immediately involve the victim in the root cause analysis. In some cases, specific aftercare may be required, such as from a clinical psychologist. If this is not sufficient, then the next step would be psychotherapeutic care, preferably by an external therapist.
• Third victim: the crisis management team implements the predefined crisis management plan. The team aims to protect the organisation against the negative impact of the incident, while safeguarding the interests of all parties involved and guaranteeing ongoing communication, support, investigation and solutions in the aftermath of the crisis.

Checklists are a useful tool for making sure all the requirements for an effective clinical incidents policy are met, in at least the following three areas:

• Does the crisis management plan contain all the elements required?
• Are all the necessary steps being taken in the event of a serious clinical incident?
• Does open communication take place in the event of a serious clinical incident? 

“Good cooperation from supervisors and managers can make or break the successful implementation of a clinical incidents policy”, Lindsy adds.

• Provide them with the necessary information and training.  
• Place the tools and documents in an easily accessible location.
• Schedule regular campaigns to keep the theme alive among your staff.