Annotation: Psychological safety in the provision of health care is a key factor in the quality of the care provided, the safety of patients and the good psychological condition of health workers necessary for the performance of this profession.  The aim of the project is to  (1) assess the level of psychological safety, experiences with patient safety incidents, open communication, the second victim phenomenon and identify their risk and protective factors, as well as the impacts on the mental health of HCWs (cross-sectional study), and (2) develop or adapt an existing intervention aimed at supporting psychological safety in healthcare delivery (e.g., open communication support, second victim support) and evaluate its feasibility in Slovakia  (feasibility study). 

Aim: The aim is to explore diverse perspectives of Slovak medical professionals on psychological safety in speaking up about patient safety concerns in the clinical environment. 

Anotation: Psychological safety in the provision of health care is a key factor in the quality of the care provided, the safety of patients and the good psychological condition of health workers necessary for the performance of this profession.  Using individual semi-structured interviews with Slovak medical professionals and the conventional content analysis method and the consensual qualitative research method, we aim to explore diverse perspectives of Slovak medical professionals on psychological safety in speaking up about patient safety concerns in the clinical environment. In our previous study (Kupkovicova et al. 2024) we identified eight responses to a PSI from medical professionals themselves as well as their colleagues, many of which were active and regarding ensuring patient safety (e.g., notification), but some of them were passive and ultimately threatening patients’ safety (e.g., silence).  Moreover, five superiors’ responses to the PSI were identified, both positive (e.g., supportive) and negative (e.g., exaggerated, sharp). 

Since: September 2023 

The aim of this CIG is twofold. Firstly, it seeks to implement the existing Action technology to certify both individuals and systems, thereby facilitating effective interventions that support Second Victims (SVs) and introducing a European Certification-based recognition system, named RESCUE (based on Action 19113 outcomes). Secondly, it aims to devise a business model for the implementation of RESCUE across Europe and globally. 

Funding: COST Innovators Grant (CIG) European certification of interventions in support of second victims RESCUE CA19113 

Our team also participates in the European Cooperation in Science and Technology project BETTERCARE on the provision of safety care at home, particularly on the consequences of caregivers’ errors and conditions that ensure an error-free care environment at home. The Care Economy is a groundbreaking field due to population ageing and the increase of non-communicable diseases. Caregiving at home has increased in the complexity of care and intensity, which augmented the risk of making errors impacting on both, recipients’ health and caregivers’ wellbeing. The project  will provide opportunities to re-think national and international deinstitutionalization policies, ensuring the same care safety at home as the one received in residential facilities, assessing available resources to meet the qualification threshold, and modifying the support net available for the management of the risk of caregiving and dispensing medications at home. 

More information here https://www.cost.eu/actions/CA22152/ 

Funding: COST CA22152 BetterCare  Supporting Emerging Care Economy, Empowering Caregivers to Provide Safe Care at Home; 2023-2027 

The second victim phenomenon refers to healthcare professionals who are involved in an adverse event where the patient’s health is affected negatively (first victim). Such an event brings negative consequences for the working life of the health professional but also for the health care organization. It has a negative impact on the quality of health care and patient safety. The aim of the project is to facilitate discussion, share scientific knowledge, improve legislation, and reveal the examples of good practice related to adverse events in the health care context. 

Findings from an international study within the ERNST network revealed a gap in psychological safety training during medical education across 11 countries. These results underscored the importance of incorporating psychological safety competencies into medical programs and providing actionable recommendations for clinical practice .  As part of this collaboration, we co-developed and validated multimodal training aimed at increasing awareness of the second victim phenomenon and supportive interventions. This training proved effective across different levels of experience within the field. In collaboration with international partners, we surveyed 56 key stakeholders across 35 countries to map the strategies used during the pandemic to support healthcare workers  In-depth interviews revealed varied responses among healthcare professionals to patient safety incidents, with some fostering psychological safety and others undermining patient care. We also contributed to the conceptualization of the second victim phenomenon and the theoretical models and interventions, which were developed and tested within the ERNST network. These interventions and findings were disseminated at international forums, furthering global awareness and support strategies for healthcare professionals impacted by adverse events. 

More information here https://cost-ernst.eu/ 

Funding: COST CA19113 The European Researchers’ Network Working on Second Victims (2020 – 2024). 

The research team is also involved in the new project concerning COVID-19 from the perspective of health care professionals. In collaboration with the PURE consortium (Palacky University Olomouc, University of Groningen, University of Galway, University in Oxford) our research will focus on health care providers in the first line during the pandemic with the aim to explore the burden of the pandemics on their work, psychological wellbeing and trauma, second victims phenomenon and the legal, cultural and work environment contexts.  

Almost 40% of dentists considered leaving their jobs during the first wave of COVID-19 (Pačutová et al., 2022a), and a significant number of healthcare workers on the front lines in hospitals (Pačutová et al., 2022b) reported experiencing irritability (46%), insomnia (37%), depression (36%), and anxiety (34%) more than once a week over the past six months. Those who feared they would have to perform triage or work outside their specialization, or had to comply with restrictions, or those who mentioned that staff shortages or workload made their work more difficult, had a significantly higher risk of suffering from these symptoms. On the other hand, those who reported personal resilience resources, good department management, support from colleagues, and a positive work atmosphere had a significantly lower risk of experiencing these symptoms (Pačutová et al., 2022a-b). More than a third of healthcare workers in this study reported that, over the past year, they had witnessed or heard of an incident that jeopardized patient safety, which was nearly an error (incidents that could have harmed the patient but were corrected in time) or an adverse event with serious consequences for one or more patients (Pačutová et al., 2023). In this study, approximately half of them expected that such an event would happen again in their department (42%) or hospital (56%) in the following year, and most (70-80%) expressed interest in training in relevant areas (such as how to communicate bad news, how to manage a non-cooperative or aggressive patient, how to inform a patient about an adverse event, and how to better manage the consequences of adverse events) (ibid.). Those who had experienced an adverse event in the past year were significantly more likely to suffer from symptoms of irritability, anxiety, or depression and believed that such an event leads to conflicts with other healthcare workers (Pačutová et al., 2023). 

Funding: PURE Spreading scientific excellence to improve the health of vulnerable groups, contract No. VVGS 2020-1444 (2020 – 2021).