Peer2Peer Program Offers Safe Place for Stressed Caregivers

Burnout among healthcare providers is a hot topic these days—for good reason. The National Academy of Medicine reports that 35-54 percent of doctors and nurses have substantial symptoms of burnout. Some are calling it an epidemic that leaves providers feeling disengaged, apathetic and, in the worst cases, suicidal.

At Cincinnati Children’s, staff are telling us via employee engagement surveys and the Maslach burnout inventory that they are experiencing similar issues. Patient complexity and acuity have increased, which brings with it a higher mortality rate. These factors, combined with a prolonged high census (and a pandemic), have put more stress on employees, especially frontline caregivers. In addition, administrative tasks involving the electronic medical record, productivity goals, etc., are getting more complex. That’s why Cincinnati Children’s launched Peer2Peer, a support program designed to help frontline caregivers

who have experienced an adverse event, such as a patient injury or death, medical error or other stressors.

The program is modeled after one that was implemented at Brigham and Women’s Hospital in 2009 under the leadership of Jo Shapiro, MD, director of the Center for Professionalism and Peer Support.

“Peer2Peer takes a proactive, thoughtful and proven approach that addresses the needs of employees,” said Christine White, MD, associate professor, Associate Chief of Staff-Inpatient. “We looked at similar programs at other hospitals, but this one was the best fit for us.”

How It Works

Peer2Peer supporters are nominated by colleagues based on trust, approachability, communication skills, clinical excellence and emotional intelligence. They are then trained to engage in difficult conversations and how to normalize feelings that surround adverse events. They also familiarize themselves with wellness resources offered through the Employee Assistance Program, the Lindner Center of HOPE and the community. The first round of training was led by Shapiro in February.

“Peer2Peer partners with other Cincinnati Children’s entities, such as division/department leadership, clinical and medical directors, and Risk Management, to help

identify clinicians who may be at risk,” said Paul Samuels, MD, professor of Anesthesiology and chair of the Cincinnati Children’s Professional Health Committee.

"Staff can also self-refer. Either way, they will be confidentially paired with a trained peer supporter based on clinical discipline, level of experience and other demographic similarities. The Peer2Peer supporter will then reach out to the clinician to check in with them to see how they are doing following a difficult clinical situation.”

Additional Resources

Cincinnati Children's offers all employees an array of services to help you reduce stress, boost vitality and build resilience. Download this list and keep it as a handy reference for self-care.

What It Is Not

Peer2Peer is not a long-term counseling service. It’s an intervention meant to express concern for a colleague at risk and to share information about available resources. It could be a phone call or a chat over coffee, whatever feels comfortable and right. There is no requirement that staff accept the support.

In addition, Peer2Peer is not a process to evaluate what happened or why. It is completely confidential, a safe place to be vulnerable and open to asking for and receiving help.

Units Involved

Cincinnati Children’s conducted a phase I pilot with nurses and physicians (including trainees) in four high-stress areas—the Emergency Department, Perioperative Services, the Newborn Intensive Care Unit and the Pediatric Intensive Care Unit, initially training 34 staff members in this area. With the success of these pilot units, the program will be launched in the Heart Institute, Hospital Medicine, Cancer and Blood Diseases Institute, as well as in Respiratory Care this fall. An additional 30-plus staff will be trained as Peer2Peer supporters. These supporters will not only serve their units, but have and will serve others across the institution.

“As the recipient of meaningful support from my colleagues following an adverse event early in my career, I know the positive impact it can have. My work as a

Peer2Peer supporter has allowed me to pay that kindness forward by providing a confidential outlet for healthcare providers who may otherwise be reticent to seek assistance in times of stress, poor patient outcomes or other life events. I consider it to be some of the most important work I do and have been humbled by the gratitude expressed by those who have participated in the program” said Renee Kreeger, MD, Peer2Peer supporter and associate professor of Anesthesia. To date, support has been provided to more than 200 employees.

If you have questions or want to seek support for yourself or a colleague, please contact us at: Peer2Peer@cchmc.org

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