LAUSR

T here is a growing realization that health care organizations are not doing enough to support their health care workers. We are in the midst of a crisis of clinician burnout, fueled by increases in workload and mandatory documentation and by reductions in autonomy and meaningful time with patients. These stressors are layered on top of the daily strains of patient care and interactions with families and co-workers. In this environment, clinicians sometime deal with patients harmed by care, and even with workplace violence. Burnout can have devastating personal consequences and can detract from the quality of care, leading to more medication errors and health care–associated infections, poorer perceptions of safety, and increased mortality. There is now momentum to pay more attention to the health of health care workers. In 2018, The Joint Commission emphasized the importance of creating peer support programs for health care workers, exposed to patient adverse events, which can manifest as symptoms similar to posttraumatic stress disorder after exposure to patient adverse events. As a program model, they recommended the Resilience in Stressful Events (RISE) service at The Johns Hopkins Hospital. RISE was established in 2011, 10 years after a tragic death in the Johns Hopkins Children’s Center. Josie King was a pediatric patient hospitalized for severe burns after a bathtub scalding accident. Although Josie was gradually recovering, a series of failures in care led to her death. Johns Hopkins quickly investigated. When Josie’s death was found preventable, her story was disclosed publicly, with an apology, full acceptance of responsibility, and a pledge to improve patient safety. Patient safety rose quickly to be a top priority for Johns Hopkins. Although the term “second victim” was coined more than a year before Josie’s death, the hospital did not recognize the trauma faced by staff nor