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Scott Three-tiered Interventional Model for Second Victim Support: Critical Analysis and Scoping Review
Maria Kappes1, Macarena Chepo-Chepo2, Miguel Valencia-Contrera2
1Faculty of Healthcare Sciences, School of Nursing, Universidad San Sebastián, Puerto Montt, Chile.
Journal of Patient Safety
|May 25, 2026
Summary
The Scott 3-Tiered Interventional Model for Second Victim Support is valuable but needs refinement. This study proposes enhancements for clarity, measurability, and practical utility in healthcare settings.
Area of Science:
- Healthcare Management
- Organizational Psychology
- Patient Safety
Background:
- Healthcare workforce well-being is a priority amid projected shortages.
- The Scott 3-Tiered Interventional Model guides support for healthcare staff after challenging events.
- Opportunities exist to refine the Scott model based on implementation experiences.
Purpose of the Study:
- To critically analyze the Scott 3-Tiered Interventional Model for Second Victim Support.
- To identify areas for conceptual and structural refinement of the model.
- To enhance the model's clarity, measurability, and practical utility in healthcare organizations.
Main Methods:
- A scoping review of studies applying the Scott model (2010-2025) was conducted.
- Databases searched included PubMed, Web of Science, Scopus, ProQuest, and CINAHL.
- Chinn and Kramer's reflective critique framework guided the analysis.
Main Results:
- Eight studies met inclusion criteria, with 5 reporting full implementation and 3 partial/adapted uses.
- The model was valued for practical relevance in supporting professionals post-event.
- Methodological rigor was heterogeneous, with identified limitations in conceptual precision and measurable indicators.
Conclusions:
- The Scott model provides a valuable foundation for addressing the second victim phenomenon.
- Refinements are proposed to improve the model's clarity, measurability, and utility.
- Enhancements aim to foster a sustained culture of support and safety in healthcare organizations.
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