Critical Incident Stress Management: Program Utilization & Perceptions of Organizational Support

Clinician well-being and resiliency has gained recent national attention as a priority for improving patient care. Without adequate coping strategies and organizational support following distressing workplace events, healthcare clinicians experience higher rates of secondary traumatic stress (STS), which can lead to compassion fatigue (CF) and burnout (BO). STS, CF, and BO result in significant consequences for the clinician, such as anxiety and depression. Furthermore, organizations can face higher turnover rates and absenteeism, lower workplace morale and patient satisfaction, and even medical errors related to STS, CF and BO. Despite the evidence that support programs such as the Critical Incident Stress Management (CISM) program, benefit clinicians following distressing events, challenges exist in increasing utilization of such programs. The purpose of this quality improvement project was to increase utilization of a currently existing CISM program at a Pediatric Level 1 Trauma Hospital, and thus increase registered nurse’s perceptions of organizational support after a distressing event. A CISM champion role was developed for this project, and formal and informal leaders throughout the hospital were identified and trained to fulfill this role. CISM utilization metrics were tracked, and a pre-post intervention survey was utilized to evaluate registered nurse’s perceptions of support. Findings demonstrated that some units increased utilization of the CISM program and increased perceptions of support after implementing the CISM champion role, while others did not. This project offers some insight into developing a sustainable plan for increasing utilization of a CISM program across a health system, and ultimately supporting employee and organizational resiliency.