From Invisible to Essential: How a European Initiative is Transforming Support for Healthcare Professionals After Medical Errors
The World Day for Safety and Health at Work, observed annually on 28 April, highlights a quiet revolution in healthcare: moving from a culture of blame to one of shared responsibility for those affected by adverse events.
The Hidden Toll of Medical Errors
For decades, the traditional culture in healthcare equated error with failure. Professionals involved in adverse events—known as "second victims" —suffered in silence, grappling with guilt, isolation, and emotional trauma. This phenomenon, long overlooked, is now gaining international attention thanks to pioneering work led by the International Labour Organization and a dedicated European research network.
Meet the Changemakers: The ERNST Group
At the heart of this transformation is COST Action The European Researchers' Network Working on Second Victims (The ERNST Group) . Uniting experts from 31 countries, this network studied the profound emotional impact that adverse events, including medical errors, have on healthcare professionals.
Their work has spawned a follow-up project, RESCUE (European certification of interventions in support of second victims) , funded through the COST Innovators Grant. Together, these initiatives are reshaping how healthcare systems support their own.
A New Model for Support: The ERNST Five-Tier System
The group proposed a comprehensive support framework that moves beyond blame:
- Prevention: Building awareness and resilience before harm occurs.
- Self-care: Providing tools for professionals to manage stress independently.
- Peer support: Training colleagues to offer confidential, compassionate conversations.
- Structured professional support: Engaging psychologists and occupational health experts.
- Clinical care: Delivering targeted treatment for severe emotional consequences.
Key Milestones
2024 proved to be a landmark year:
- A Policy Statement on the Second Victim Phenomenon was published in Public Health Reviews, endorsed by experts from 29 countries.
- The statement was discussed with the President of the European Parliament, elevating the issue to the highest political level.
- The RESCUE project turned years of research into a certification system for hospitals and professionals.
- The ERNST Group received the Butterfly Patient Safety Award from the European Patient Safety Foundation (EUPSF).
- A formal agreement was signed with EUPSF to sustain the certification system long-term.
Voices from the Frontline
"The most fulfilling part has been watching something that was once invisible become a visible and respected topic on the European agenda."
— Professor José Joaquín Mira, Chair of the ERNST Group
Professor Mira describes the model as "a cultural shift in healthcare: from isolation and guilt to support and shared responsibility."
On the new certification system, he adds: "RESCUE provides a validated, evidence-based framework to ensure that second victim support systems are truly effective."
The economic case is equally compelling. Professor Mira notes: "In a German study, the annual cost of not addressing the second victim phenomenon for a single nurse was about €14,000. Our interventions can cut that by half!"
Global Reach and Practical Impact
The work has been highlighted at WHO workshops, European conferences, and international policy forums, signaling its growing influence. To make the findings accessible, the group has developed:
- A comprehensive training manual
- Podcasts featuring expert discussions
- Training courses available in 7 languages
The Bigger Picture
"RESCUE is not only about supporting second victims. It's about improving patient safety."
— Professor José Joaquín Mira
By addressing the emotional fallout of adverse events, this initiative creates a healthier, more resilient healthcare workforce—ultimately leading to safer care for everyone.