Implementation of an Institutional Physician and Advanced Practicing Provider Peer Support Program

Health care professionals may experience second victim syndrome (SVS) after adverse events or critical incidents in the workplace. This may result in untoward consequences: second victims may feel personally responsible for patient outcomes, second guess their clinical skills and knowledge, are at increased risk of future errors and have increased turnover intention. Peer support programs (PSP) are one iteration of institutional support that has the potential to systematically intervene in SVS. PSPs can reduce emotional distress, foster coping strategies, promote resilience, and reduce turnover intention.

We describe the novel, broad approach to implementing an enterprise-wide physician and advanced practicing provider (APP) specific PSP at a large urban academic medical center. Since the program launch, 107 physicians and APPs across all departments have been trained as peer supporters.

In the first year of program implementation (2023), there were 10 physicians and 5 APP referrals. In the second year (2024), utilization increased by 63% with 27 physicians and 3 APP referrals, with consistent utilization into 2025 with 22 physicians and 3 APP referrals. The program was utilized by physicians and APPs across 16 departments. The top 3 reasons for referral included patient death (37%, 26/70), emotional stress (39%, 27/70), and other (43%, 30/70). Most referrals (61%, 43/70) had no/unknown peer supporter departmental preference.

Our experience demonstrates the feasibility of implementing an institutional PSP in a large urban academic medical center if there is executive sponsorship, dedicated program leadership, an existing institutional culture of safety, and education/training that increases awareness of SVS.