Extending Peer Support Across the Military Health System to Decrease Clinician Burnout

Clinician burnout is widespread throughout medicine, affecting professionalism, communication, and increases the risk of medical errors, thus impacting safe quality patient care. Previous studies have shown Peer Support Programs (PSPs) promote workforce wellness by supporting clinicians during times of heightened stress and vulnerability. Although these programs have been implemented in large institutions, they have not been used in military hospitals, which have high staff turnover and added stressors of deployments.

In December 2018, 50 physicians received 5 hours of PSP training at a military hospital from a nationally recognized PSP expert, following the programmatic structure described by Shapiro and Galowitz (2016). Utilization of the program was tracked from December 2018 to December 2019, recording only classification of provider type, triggering event, and provider specialty to maintain confidentiality. Qualitative comments from recipients and supporters were saved anonymously for quality improvement purposes.

In the first year of our PSP, 254 clinicians (102 [40.2%] residents/fellows, 91 [35.8%] staff physicians, 4 [1.6%] medical students, 35 [13.8%] nurses, 22 [8.7%] allied health) received 1:1 peer support. Primary specialties utilizing peer support included 135 (52.9%) medical, 59 (23.2%) surgical, 43 (16.9%) obstetric, and 18 (7.1%) pediatric. Patient death (25%), risk management notification (22%), medical error/complication (15%), and poor patient outcome (13%) were the most common events triggering peer support. Peer support was provided at 8 locations across the continental United States with universally positive comments from recipients.

Implementation of a PSP at our institution led to rapid utilization across multiple hospitals in the military health system, a model that could easily expand to deployed settings and remote locations. Access to peer support across the military health system could both mitigate the increased risks of military clinician burnout, and improve patient safety, healthcare worker resilience, and service member readiness.