Peer Support to Promote Surgeon Well-being: The APSA Program Experience

Fari Fall; Yue Yung Hu; Sarah Walker; Reto Baertschiger; Iljana Gaffar; Daniel Saltzman; Steven Stylianos; Jo Shapiro; Minna Wieck; Terry Buchmiller; Mary L Brandt; Thomas Tracy; Kurt Heiss; Loren Berman

doi:10.1016/j.jpedsurg.2023.12.022

Peer Support to Promote Surgeon Well-being: The APSA Program Experience

J Pediatr Surg. 2024 Jan 6:S0022-3468(23)00792-3. doi: 10.1016/j.jpedsurg.2023.12.022. Online ahead of print.

Authors

Fari Fall¹, Yue Yung Hu², Sarah Walker³, Reto Baertschiger⁴, Iljana Gaffar⁵, Daniel Saltzman⁶, Steven Stylianos⁷, Jo Shapiro⁸, Minna Wieck⁹, Terry Buchmiller¹⁰, Mary L Brandt¹¹, Thomas Tracy¹², Kurt Heiss¹³, Loren Berman¹⁴

Affiliations

¹ Department of Surgery, Nemours Children's Health, Wilmington, DE, USA; Department of General Surgery, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, PA, USA.
² Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
³ Department of Surgery, Texas Tech University Health Sciences Center, El Paso, TX, USA.
⁴ Division of Pediatric Surgery, Department of Surgery, Dartmouth Health Children's Hospital, Lebanon, NH, USA.
⁵ American Pediatric Surgical Association, USA.
⁶ Department of Surgery, Division of Pediatric Surgery, University of Minnesota Medical School, Minneapolis, MN, USA.
⁷ Division of Pediatric Surgery, Columbia University Vagelos College of Physicians & Surgeons and NYP-Morgan Stanley Children's Hospital, New York, NY, USA.
⁸ Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, USA.
⁹ Department of Pediatric Surgery, University of California Davis Children's Hospital, Sacramento, CA, USA.
¹⁰ Department of Surgery, Boston Children's Hospital, Boston, MA, USA.
¹¹ Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA.
¹² Executive Director, American Pediatric Surgical Association, East Dundee, IL, USA.
¹³ Department of Surgery, Division of Pediatric Surgery, Emory University School of Medicine, Atlanta, GA, USA.
¹⁴ Department of Surgery, Nemours Children's Health, Wilmington, DE, USA; Department of General Surgery, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, PA, USA. Electronic address: loren.berman@nemours.org.

PMID: 38272766
DOI: 10.1016/j.jpedsurg.2023.12.022

Abstract

Background: Peer support programs have evolved to train physicians to provide outreach and emotional first aid to their colleagues when they experience the inevitable challenge of a serious adverse event, whether or not it is related to a medical error. Most pediatric surgeons have experienced the trauma of a medical error, yet, in a survey of APSA membership, almost half said that no one reached out to them, and few were satisfied with their institution's response to the error. Thus, the APSA Wellness Committee developed an APSA-based peer support program to meet this need.

Methods: Peer supporters were nominated by fellow APSA members, and the group was vetted to ensure diversity in demographics, practice setting, and seniority. Formal virtual training was conducted before the program went live in 2020. Trained supporters were surveyed 6 months after the program launched to evaluate their experiences with providing peer support.

Results: 15 referrals were made in the first year, 60 % of which were self-initiated. Most referrals were for distress related to adverse events or toxic work environments (33 % each). While only about 25 % of trained supporters had provided formal support through the APSA program, more than 80 % reported using the skills to support colleagues and trainees within their own institutions.

Conclusion: Our experience in the first year of the APSA peer support program demonstrates the feasibility of building and maintaining a national program to provide emotional first aid by a professional society to expand the safety net for surgeons who are suffering.

Keywords: Burnout; Medical error; Peer support; Physician wellness; Psychological impact of complications; Second victim syndrome.