Table 2 Summary of categories and main themes

Perceptions of managers and policy makers, regarding the SVP—definition, risk factors scope, and potential consequences

Perception of definition:

The risk of suffering from the SVP is connected to the severity or actual damage caused to the patient

Perception of risk factors:

1. Professional seniority- younger staff are at higher risk

2. Intensity of the work environment- extreme events, and acute clinical settings increase the risk of SVP

3. Awareness of the phenomenon- most practitioners in various sector do not know the phenomenon and do not seek help

Perception of scope and potential consequences:

1. The phenomenon is considered marginal related to an error and/or actual harm to the patient

2. Most practitioners understand how to separate personal experience and adequate treatment and return to complete functioning

3. There is no connection between burnout, dropout and SVP

4. There is no connection between risk management and dropout rates in an organization

Presence of organizational support programs following AE

A main goal of a risk management unit is to identify AE, map processes with risk potential, draw conclusions and conduct organizational learning. A risk management system in every institution is structured and organized

There is no operational policy to identify or provide emotional support to a practitioner who has been involved in an AE

Addressing the emotional needs of the practitioner depends greatly on the individual managing the event, and the manager’s awareness of SVP

As of 2021, under the auspices of directed support for programs that improve safety culture, budgetary resources have been allocated without specified content or scope of the training

In several organizations, there are local /sporadic programs, mainly during crises

There is no dedicated position to offer supportive treatment to the practitioner [after an AE], nor is there specific training on the topic

Components of developing a support program

The organization has a responsibility to the practitioner; thus, it is important to develop a support program for the ‘second victim’

There is a disagreement between operating an anonymous hotline versus training colleagues or direct managers, as an initial response

There is a difference of opinion as to whether it is recommended to take a proactive organizational approach and offer assistance from the onset, or take a passive position and provide help when the practitioner requests support

There is a difference of opinion as to whether initiating a support program should be dependent on the submission of an adverse event report

Appropriate training for peer support / risk managers

Separation between managerial and treatment roles

Challenges in developing support programs

Allocated budget

Suitable staff

Compliance—stigma and labeling of ‘second victim’ as a barrier to identify and treat practitioners

Organizational culture that creates feelings of fear and anxiety about losing anonymity and livelihood