Managing the Risks of Psychosocial Hazards in Critical Incident Review—Mitigating Vicarious Trauma
Author: Nathan Paul Ross and Jessica Eddy | |
Associate Authors:
<p><strong>Introduction:</strong></p>
<p>Vicarious trauma is evident in our team, and critical incident review has had devastating impacts on those we work closely with.</p>
<p><strong>Objective:</strong></p>
<p>To explore the known risks and hazards of critical incident review via exploratory factor analysis in order to initiate purposive mitigation strategies for the psychosocial risks and hazards associated with our core function.</p>
<p><strong>Methods:</strong></p>
<p>An exploratory factor analysis was performed with cross-institutional critical incident review teams. The sample included clinical quality managers across state ambulance services. An interrater reliability analysis was performed to determine agreement on the key domains of psychosocial safety risks and hazards associated with critical incident review. We sought to identify agreement among prehospital clinicians involved in critical incident review to identify the dominant psychosocial triggers. Krippendorff’s coefficient was used to quantify the extent of agreement between raters of known domains of psychosocial triggers in critical incident review that cause vicarious trauma.</p>
<p><strong>Results:</strong></p>
<p>Independent raters (clinicians) agreed that psychosocial safety triggers were strongly associated with audit of emergency call-center calls and open disclosure with the family of the deceased in preparation for root-cause analysis (RCA).</p>
<p><strong>Conclusion:</strong></p>
<p>The team’s vision is ensuring our work environment is a psychosocially safe. Collectively, the team understands the unique nature of our workplace; we are exposed to stressors on a significant scale. The team reviews a significant volume of highly stressful incident details, which have a cumulative effect on mental health. The team is required to work under significant time pressures, and the team has an expectation to meet the demands of a dynamic workforce. Through an exploratory factor analysis, we sought valid agreement on the unique psychosocial risk factors associated with our core work function and set in place robust and reproducible means for psychosocial risk mitigation associated with emergency call review and vicarious trauma associated with open disclosure.</p>
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