Implementing RISE Module 1: Defining the Problem

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Disclaimer Specifically prepared for Siemens Healthineers © The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System Implementing RISE: Resilience In Stressful Events Module 1: Defining the Problem Caring for the Caregiver Peer Support for Caregivers in Distress: ? Implementing RISE Module 1 Welcome to Peer Support for Caregivers in Distress. This training is based off the Resilience In Stressful Events, RISE, peer support model that was implemented at The Johns Hopkins Hospital in 2011. Johns Hopkins Medicine has worked with the Maryland Patient Safety Center to create this curriculum so that other organizations can learn from our experience and extensive partnerships. We are so glad that you are interested in implementing a peer support program like RISE at your organization. For assistance navigating through the course, select the question mark at the bottom right of the screen. Helpful information is available to you in the Resources tab at the top right corner of your screen, including the RISE leadership toolkit. It’s highly recommended to have this toolkit nearby while taking this online training. At the end of this module you will have the opportunity to print all typed response from the course. We strongly recommend you share these responses with your RISE implementation group as a way to facilitate discussion as you plan your RISE program launch. ? Implementing RISE: Module 1 Define the Problem Module 1 is an introduction to getting your RISE program off the ground. 1 2 3 4 Describe the impact of stress on caregivers in healthcare Acknowledge the potential systemic impact of unsupported caregivers in healthcare Define second victims in healthcare Evaluate organizational readiness Module 1 Objectives Module 1 is an introduction to getting your RISE program off the ground. This module provides background information that will help you recognize the complexities and stresses of the health care environment and the impact on caregivers. We will also explore what it means to be a second victim in the healthcare environment. Finally, we will evaluate organization readiness for launching a RISE program. For the purposes of this training, we will refer to the program as RISE. You are welcome to use the RISE name but are not obligated to do so. ? Meet the Developers Albert Wu, MD, MPH Johns Hopkins Bloomberg School of Public Health - Professor of Health Policy & Management and Medicine Expert on the psychological impact of medical errors on patients and providers; perhaps best known for coining the term "second victim" Meet the Developers- Albert I am Dr. Albert Wu and I am delighted to be one of your guides throughout the RISE program. I serve as a physician with the Johns Hopkins hospital and as a professor at Johns Hopkins Bloomberg school of public health policy and management and medicine. As a leading expert on the psychological impact of medical errors on patients and providers I work with the RISE program to reduce the burden of these traumas. ? Meet the Developers Rev. Matt Norvell, D.Min, BCC, NBCC Johns Hopkins Hospital- Department of Spiritual Care Clinical Manager Pediatric Chaplain Nationally certified mental health counselor Meet the Developers Matt My name is Reverend Matt Norvell, a founder of the RISE program. I serve as the spiritual care clinical manager and pediatric chaplain at Johns Hopkins Hospital. As one of your guides through the RISE program, I look forward to showing you how this program adds to the well being of providers and contributors to a medical system. ? Meet the Developers Cheryl Connors, DNP, RN, NEA-BC The Armstrong Institute for Patient Safety & Quality Johns Hopkins Medicine- Patient Safety Specialist Senior Clinical Quality and Innovation Coach RISE program Director Meet the Developers- Cheryl C Hi, My name is Cheryl Connors. As the RISE program director and as an RN specializing in clinical quality at the Johns Hopkins Hospital, am fortunate to see the positive impacts of this program on a daily basis. Throughout the RISE training we look forward to introducing you to the power of this program. ? Welcome to the Program Welcome Video ? RISE Implementation Roadmap Sustain Peer Responders and Measure Success Module 5 Rollout RISE Module 4 Develop Your RISE Peer Responder Team Module 3 Design the Plan Module 2 Define the Problem Module 1 Implementation Roadmap To begin, I would like to introduce you to the RISE implementation road map. This road map depicts the key stages in developing and implementing the RISE peer support program. The five major stages of the journey are shown on this road map. The first step is to define the Problem which we will cover in this module. The second step is to design the Plan which we cover in module 2 and then in module 3 we focus on developing Your RISE Peer Responder Team. In module 4 we rollout RISE, and finally, in module 5 we discuss sustaining the Peer Responders and Measuring Success of your program. Select each marker along the map to view the steps of the program. ? Leadership’s Role Leadership's Role ? Define the Problem Define the Problem ? Understanding the Need Increased risk of patient injury When care providers are stressed, performance can be impaired Healthcare works can fail to recognize stress Understanding the Need Let’s discuss the stresses that healthcare providers encounter. We will highlight some publicly known cases as well as routine situations that healthcare providers encounter in their role of caring for the patient. Healthcare providers often fail to recognize that stress can impact their performance. We will describe some of the profound impacts that acute or chronic stress can have on healthcare providers. When care providers are stressed, performance can be impaired and patients can be harmed. ? Josie’s Story Josie's Story Our need began with a story. Josie King was a pediatric patient admitted to JHH in 2001 after suffering severe burns from a bathtub accident. She required care by several different multidisciplinary teams. Although she was making progress, she coded and died as a result of her complex condition and a series of preventable failures. The hospital quickly investigated, determined that her death was preventable and disclosed the error to the family. The media became involved and blame was placed on Josie’s direct care providers at the #1 hospital in the nation. Any yet, no opportunity to receive support was provided. Imagine the reaction? In the following year, several members of the team chose to leave the unit, the organization and 1 even left the profession. Years later, Josie’s mother published a book and the case was reopened. The second Root Cause Analysis identified additional failures including the lack of support to the caregivers involved. ? Second Victim Second Victim: Health care providers who are involved with a patient-related adverse event or medical error experience emotional and sometimes physical distress Term victim can be controversial Can validate importance of issue Can be offensive First victims: Patient Patient’s loved ones Second Victim First victims in many of these situations are patients and their loved ones. The second victim term was first coined by Dr. Albert Wu in 2000. Second victims are health care providers who are involved with a patient-related adverse event or medical error, and as a result, experience emotional and sometimes physical distress. Someone may feel like a second victim without an error or adverse event occurring. It is important to note, the term “victim” has been controversial. To some it validates the magnitude of the incident. To others, it is offensive. Layer 2: Second Victims often have several feelings in common. They will often feel personally responsible for the outcome, as though they have failed the patient, and question their knowledge and competence. Second victim syndrome can occur after a Patient Death or other adverse patient outcomes, especially those that are sudden or unexpected, or when they happen to patients caregivers have a relationship with. Other situations that can cause the second victim response include near miss events and conflicts with patients or members of the health care team. Additionally, when a caregiver feels conflict about policy or resource constraints that hinder quality of care, the feelings associated with second victim syndrome can present. Often second victims: ? Second Victim Feel responsible for the outcome Feel they have failed the patient Question their knowledge and competence Describe a second victim experience. Type your answer in the field below. Think about a time you or someone you knew felt like a second victim. How were you or the individuals involved impacted? Reflection Note: This activity is required for course completion. Q1 Second Victim Let’s spend a moment reflecting. Think about a time when you or someone you knew felt like a second victim. Perhaps the experience was associated with an event at work, or perhaps outside of work. Think about that event. How were you or the person involved impacted? What did you feel? Was there emotional or physical distress caused by the event? Please take a moment to write your reflection in the text box. At the end of this module you will have the opportunity to print the answers you provide throughout the course. Thank You You will have the opportunity to print your results at the end of this course. ? Second Victim Reflection Feedback Second Victim Reflection Feedback Healthcare is a high-risk enterprise for patients and also for their providers. Patients quite commonly experience unanticipated and harmful events in the course of receiving healthcare. These events can inflict both physical and mental trauma on patients and their families, including shock, worry, grief, anger, guilt and loss of trust. Healthcare providers can also be psychologically harmed in the process, becoming “second victims” of the same events that harm patients. Select the image to hear examples of the second victim syndrome associated with the high-risk environment of healthcare. Layer 1: This is Nurse RaDonda Vaught. She accidentally administered the wrong medication to a 75 year old patient that resulted in their death. In court, she was found guilty of criminally negligent homicide and gross negligence. Ms. Vaught was sentenced to three years of probation and her nursing license was revoked. Layer 2: Meet pharmacist Eric Cropp. He approved a mistakenly mixed chemotherapy solution prepared by a pharmacy technician. As a result of this mistake the child receiving the medication died. Mr. Cropp was terminated from his position, stripped of his license, convicted of involuntary manslaughter, and served six months in prison. In both of these examples the caregivers followed all proper procedures after the incidents, and in both cases system flaws were identified as contributing factors in the medical errors. Layer 3: Healthcare workers can be traumatized by many factors. Traumas are not always related to medical error or patient harm. For example, during the COVID-19 pandemic, feelings of distress became the norm among healthcare workers. This was due to a multitude of stressers including the personal risk of infection, fear of transmission, rapid and frequent changes in policy and work routines. As well as other stressors such as work isolation, and witnessing patients suffering alone. ? Factors Associated with an Adverse Event 8 The Event Peer Reaction Investigation Litigation Adverse Event Cascade There are at least four factors that are associated with an adverse event that can induce psychological trauma in a health professional. These include the event, peer reaction, the investigation, and potential litigation. These factors typically are triggered by each other. We can visualize this sequence of events like the response of hitting a ball on a pool table. Select each factor starting with the event to follow the adverse event cascade. The Event The first factor is the event itself. The accompanying shock and guilt the person experiences often manifests as an acute stress reaction. Peer Reaction The second factor is the reaction from one’s peers. Initial peer reaction is most often unsympathetic or even directly critical and hurtful. Investigation The third potential factor in the adverse event cascade is an investigation. Some health professionals experience the investigation as an interrogation or even an inquisition. Litigation The fourth factor associated with the adverse event is the threat or actual process of malpractice litigation. This causes additional trauma to the health professional. Fourth, is the threat or actual process of malpractice litigation which produces additional trauma. Select X to return to the course. Another potential factor is the ensuing investigation, which some health professionals experience as an interrogation or even an inquisition. Select X to return to the course. The second factor is the reaction from peers, who can react in ways that are unsympathetic or even directly critical and hurtful. Select X to return to the course. The first factor is the event itself, with the accompanying shock and guilt, often manifesting as an acute stress reaction. Select X to return to the course. ? Healthcare providers or those in healthcare environment become second victims Emotional trauma includes: Shock Worry Grief Anger Guilt Loss of trust Healthcare can be hard on patients and families as well as those working to help them Impacts of Stress Impacts of Stress Healthcare is a high-risk enterprise for patients and also for their providers. Patients quite commonly experience unanticipated and harmful events in the course of receiving healthcare. These events can inflict both physical and mental trauma on patients and their families, including shock, worry, grief, anger, guilt and loss of trust. Healthcare providers can also be psychologically harmed in the process, becoming “second victims” of the same events that harm patients. Select the image to hear examples of the second victim syndrome associated with the high-risk environment of healthcare. Layer 1: This is Nurse RaDonda Vaught. She accidentally administered the wrong medication to a 75 year old patient that resulted in their death. In court, she was found guilty of criminally negligent homicide and gross negligence. Ms. Vaught was sentenced to three years of probation and her nursing license was revoked. Layer 2: Meet pharmacist Eric Cropp. He approved a mistakenly mixed chemotherapy solution prepared by a pharmacy technician. As a result of this mistake the child receiving the medication died. Mr. Cropp was terminated from his position, stripped of his license, convicted of involuntary manslaughter, and served six months in prison. In both of these examples the caregivers followed all proper procedures after the incidents, and in both cases system flaws were identified as contributing factors in the medical errors. Layer 3: Healthcare workers can be traumatized by many factors. Traumas are not always related to medical error or patient harm. For example, during the COVID-19 pandemic, feelings of distress became the norm among healthcare workers. This was due to a multitude of stressers including the personal risk of infection, fear of transmission, rapid and frequent changes in policy and work routines. As well as other stressors such as work isolation, and witnessing patients suffering alone. ? Impacts of Stress Impacts of Stress- female This is Nurse RaDonda Vaught. She accidentally administered the wrong medication to a 75 year old patient that resulted in their death. In court, she was found guilty of criminally negligent homicide and gross negligence. Ms. Vaught was sentenced to three years of probation and her nursing license was revoked. ? Impacts of Stress Impacts of Stress-male Meet pharmacist Eric Cropp. He approved a mistakenly mixed chemotherapy solution prepared by a pharmacy technician. As a result of this mistake the child receiving the medication died. Mr. Cropp was terminated from his position, stripped of his license, convicted of involuntary manslaughter, and served six months in prison. In both of these examples the caregivers followed all proper procedures after the incidents, and in both cases system flaws were identified as contributing factors in the medical errors. ? Impacts of Stress Impacts of Stress- group Healthcare workers can be traumatized by many factors. Traumas are not always related to medical error or patient harm. For example, during the COVID-19 pandemic, feelings of distress became the norm among healthcare workers. This was due to a multitude of stressors including the personal risk of infection, fear of transmission, rapid and frequent changes in policy and work routines. As well as other stressors such as work isolation, and witnessing patients suffering alone. ? Stress Cascade Stressed/Unsupported Staff Stressed/Unsupported Staff Stressed/Unsupported Staff Low Morale/ High Turnover Poor Patient Care/Unsafe Care Environment Poor Patient Care/Unsafe Care Environment Poor Patient Care/Unsafe Care Environment Dissatisfied/Injured Patients + Employees Stressed Institution + Leadership Stressed Institution + Leadership Stressed Institution + Leadership Stress Cascade I would like to introduce you to a diagram that depicts the vicious stress cascade we often see in the medical workplace. The stress cascade shows how lack of support for caregivers can impact unit operations, the quality of patient care, the satisfaction of caregivers and patients and the reputation of the organization as a whole. Hover over each section of the diagram to hear details on each stage. Stressed/Unsupported Staff: Lack of staff support can lead to Absenteeism, presenteeism, burnout, Team dysfunction, Increased turnover, and Medical errors. If someone goes home feeling this way after an event at work, they aren’t likely to be performing at their full potential the next day. They may show up but are not the best team member. Stressed staff will have an impact on the entire team. Low Morale/High Turnover: Caregivers coming to work late or inconsistently and feeling miserable will adversely affect team dynamics. Other caregivers may not want to continue to work on such a unit. Poor Patient Care/Unsafe Environment: Patient care suffers when there is dysfunction within a healthcare team. Inadequate staffing or lack of experienced staff can create an unsafe environment for both caregivers and the patients increasing the likelihood of a medical error. Dissatisfied (Possibly Injured) Patients and Employees: Evidence suggests that low caregiver satisfaction contributes to low patient satisfaction, and ultimately results in a higher risk for patient harm. Stressed Institution/Leadership: With low patient satisfaction scores, there is a threat to the institution’s reputation. Reduced satisfaction scores may discourage patients from seeking care at your institution, resulting in financial distress for the organization. First (Most challenging) High Turnover Second Workplace Violence Third Medical Error Fourth Ethical Dilemmas Drag each response from the right column to its corresponding item on the left. Rank the challenges that you have identified in your healthcare environment. Reflection 1 of 3 Fifth (Least challenging) Other ? Reflection Break Lets spend a moment reflecting. Think of your healthcare environment. What challenges can you identify in your organization? Rank the challenges listed here in the order of concern for your workplace. Other challenges in my environment include…. Please type your other challenges in the field below. Did you identify other challenges in your healthcare environment? Reflection 2 of 3 Note: This activity is required for course completion. Q2 Challenges If you have identified other challenges in your healthcare environment please take a moment to write those down. It will be helpful to have these notes to reference with your implementation team in the future. Thank You You will have the opportunity to print your results at the end of this course. A situation in which a staff member or individual was not supported by the organization. Type your answer in the field below. Reflecting on the Stress Cascade Diagram, describe a situation in which a staff member or individual was not supported by the organization. Reflection 3 of 3 Note: This activity is required for course completion. Q3 Not Supported Next, let's think about the stress cascade diagram we discussed. Please use the text box to describe a situation in which a staff member was not supported by their organization. What associated stressors did that person experience? How did those stressors impact the overall workplace? Thank You You will have the opportunity to print your results at the end of this course. Select all applicable options. ? What have you seen in your employees when they are emotionally unsupported? Reflection Turnover Low Morale Poor Mental Health Irritability, Sensitivity Errors Physical Illness Reflection Break As we know, the healthcare environment can be very stressful. The simple fact that we are accountable for the lives of others when they may be very fragile is a hefty responsibility. The work is physically, emotionally and mentally draining. Most healthcare staff work long shifts, sometimes with very little break, bearing witness to sad or difficult situations. Patients, families and colleagues can become stressed and often the healthcare worker is on the receiving end of the demands or incivility. This can leave us feeling emotionally unsupported. In reflecting here, what impacts have you seen in your workplace as a result of emotionally unsupported employees? Select all that apply. ? Stress Cascade to Support Response Supported/ Satisfied Staff High Morale/ Low Turnover Excellent Patient Care/ Safe & Healthy Environment Satisfied & Engaged Patients & Employees Satisfied & Joyful Institution/ Leadership Support Response: Stress Cascade Let’s revisit the stress cascade diagram. Support can promote a virtuous cycle where staff enjoy coming to work, and feel an increased sense of commitment to their role. These positive feelings lead to high quality of care which positively impacts patient and family satisfaction. Your organization gains a great reputation and everyone is happy! Clearly the benefit is not just for the individual but to the team and the organization as a whole. Select each section of the diagram to see the benefits of a Support Response system. Use of existing resources Willingness to use resources Experience with stressful events RISE Employee Survey evaluates: Gather first hand accounts from staff to highlight the stress cascade Staff satisfaction survey Employee engagement survey SOPS assessments Patient safety assessments ? Gathering Your Data What surveys are conducted at your organization? Gathering Your Data Now that we have demonstrated the need and benefits of a peer responder program, we will review several tools to help you with data collection specific to your organization. This will help you better understand the experiences and desires of your staff. What surveys do you currently conduct at your organization? Are there any domains or items that would be relevant to your peer support program? Some example surveys include patient safety culture assessments, S-O-P-S being one of the most common tools, employee engagement surveys, and staff satisfaction surveys. These surveys can provide you details on areas where your staff feels supported and areas that need more support. Consider inviting members of the staff to share some of the experiences they have encountered that caused them stress. These first hand accounts can be telling of units that are experiencing the stress cascade. We have created an employee survey to assess awareness of the second victim phenomenon. The survey also looks at staffs use of existing resources, willingness to use support resources, and their experience with stressful events. This survey provides an opportunity for staff to voice their desired features of a supportive program. Please find these resources in the reference tool kit. ? Identify Stakeholders & Secure Buy-In Select the tab arrows to learn more Engage Stakeholders Develop a Mission Statement Sample Mission Statement Pilot Testing Identify Stakeholders Engage Stakeholders Senior leadership is key. Identify your senior leaders that are most involved in patient safety and staff wellness. They will be essential members to your RISE stakeholders team, but other leaders should also be considered. Other leaders to consider include risk management, legal, patient safety and quality, and your employee assistance program representatives. Once you have the results from your staff survey, which help to identify the extent of the problem and the need and desire for a peer support program, host a debriefing with senior leadership and those you feel are key stakeholders for your organization. Schedule a group meeting in advance so you can move forward planning your RISE implementation roadmap without delay. When engaging the stakeholders to design the RISE plan, all survey elements should be highlighted and considered. Allow for the stakeholders to provide input on the plan once the results have been presented. Allowing the stakeholders to participate will engage them and generate additional support. Stakeholders may also be aware of conflicting initiatives or other stakeholders that should be taken into consideration. Mission Statement Mission statements are designed to provide direction and an enduring statement of purpose. Establishing your program mission statement is a foundational step in implementation and is important to share early with your key stakeholders. Consider developing objectives and strategies while creating the mission statement to help guide the process. The Johns Hopkins Hospital RISE Mission Statement is “To provide confidential, timely support to employees who encounter stressful, patient related events.” This example is broad, targets all employees, and relates to any event the employee defines as stressful. You may find there are other significant events that are not adverse events or medical errors but are still stressful and upsetting and indicate a need for support. You may also find that this applies to all employees, including non-clinical or indirect care providers such as housekeeping, laboratory staff, security and facilities management. All of this must be considered when drafting your mission statement. Sample Mission Statement The RISE mission statement of the Johns Hopkins Hospital is available for your use. You are also welcome to customize it to best fit your organizational needs. A copy of the Sample RISE Mission Statement is in the Resources tab of this course. What changes would you make to the mission statement to make it best fit your program and organization? While our mission statement at Johns Hopkins Medicine is to provide confidential and timely support to employees who encounter stressful, patient-related events, our team will also respond to other work-related stressors like work place violence, burnout, or collegial trauma. Pilot Testing It may be beneficial to pilot test the program in one location before rolling out to the entire organization. This pilot could help you evaluate the demand, volume and nature of calls within your organization. It is important to keep in mind that call volume may be low initially, but should increase over time. Piloting your program in one department may allow you to test your plan, evaluate and revise before expanding. However, organization-wide implementation has been proven very successful. Remember, needs and barriers may vary for each organization. Pilot Testing What barriers might arise? Evaluate Revise 1 Department Pilot Program: Select X to return to the course. Sample Mission Statement Johns Hopkins RISE statement is available for your use. What does your mission statement need to include to meet the needs of your staff? “To provide confidential timely peer support to employees who encounter stressful, patient related events.” Select X to return to the course. Develop a Mission Statement: Defining Your Scope Ideal Mission Statement Features: Broad Relates to any stressful event Targets all employees: Clinical Non clinical Johns Hopkins RISE Mission Statement: “To provide confidential timely peer support to employees who encounter stressful, patient related events.” Considerations for Development: Write objectives Include strategy Purpose of Mission Statement: Provide direction Enduring statement of purpose Provides scope of program Support the second victim Select X to return to the course. Select X to return to the course. Stakeholder Meeting: Schedule in advance Share survey results Ask for input Incorporate stakeholder feedback Organize survey results Highlight areas of need Share stories of success and those of stress Use charts to present data Engage Stakeholders Senior leadership Risk management Legal Employee assistance program Patient safety Quality Resources Type your answer in the field below. What organizational, financial, or survey related resources can you think of that may assist with the implementation of your RISE program? Reflection 1 of 3 Note: This activity is required for course completion. Q4 Resources Thank You You will have the opportunity to print your results at the end of this course. Key stakeholders to engage with in your organization. Which key stakeholders should you engage with as you develop the RISE program? Reflection 2 of 3 Type your answer in the field below. Note: This activity is required for course completion. Q5 Stakeholders Thank You You will have the opportunity to print your results at the end of this course. Sample mission statement for my organization. Type your answer in the field below. Write a sample mission statement for your organization’s RISE program. Reflection 3 of 3 Note: This activity is required for course completion. Q6 Mission Thank You You will have the opportunity to print your results at the end of this course. ? Course Review Congratulations! You have completed the Implementing RISE: Module 1. Select the numbered buttons below to review the material before proceeding to the final assessment. Define second victims in healthcare Acknowledge the potential systemic impact of unsupported caregivers in healthcare Describe the impact of stress on caregivers in healthcare 1 1 1 3 3 3 2 2 2 4 4 4 Evaluate organizational readiness Course Review Congratulations! You have completed the Implementing RISE: Module 1 course. Select the numbered buttons to review the material associated with each objective before proceeding to the final assessment. Evaluate Organizational Readiness Leaders of the initiative can review survey results of the RISE implementation survey. Results should be de-identified and presented in a graphic report to highlight trends. Be sure to display and share the results. Select X to return to the course. Use real cases or case scenarios to emphasize the need for support for healthcare workers. This is a great strategy to begin your campaign. Define Second Victims in Healthcare Understanding the term second victim is a powerful way to introduce the rationale for implementing a program like RISE. Select X to return to the course. Acknowledge the Systemic Impact of Unsupported Caregivers in Healthcare The impact of stress on our healthcare workforce goes far beyond any individual. Acknowledging and normalizing the stress response is a key first step in shifting the culture as you prepare to launch a peer support program. Select X to return to the course. Review local or national cases that have been publicized in the media and cases that may have been encountered at your organization; Literature review articles available in the RISE toolkit. Describe the Impact of Stress on Caregivers in Healthcare Health care providers can be psychologically harmed in the process of providing care, becoming “second victims” of the same events that harm patients. Select X to return to the course. Assessment This assessment will test your retention of the presented content. A passing score of 80% or higher is required to complete the course and earn your certificate . Assessment questions must be answered completely to receive full credit. Partial credit will not be given for assessment questions that require multiple answers. You may repeat the assessment as many times as needed. Start ? Assessment Select three (3) answers. Question 1 of 5 Select three factors that are associated with the occurrence of an adverse event. Reaction from Peers Ensuing Investigation Increased Wages/Hazard Pay Threat or Process of Malpractice Investigation Multiple Answer Incorrect One or more answers are incorrect. Correct Select the best answer. Question 2 of 5 What is the most common experience of the second victim? Feels personally responsible for the error Feels personally responsible for the error Feels the error was someone else’s fault Does not feel emotional Feels confident in their knowledge Feels confident in their knowledge Feels confident in their knowledge Multiple Choice Incorrect The second victim feels emotional about the error. Incorrect The second victim questions their knowledge. Incorrect The second victim feels the error was their fault. Correct Stressed Staff Burnout Low Morale High Turnover Inadequate Staffing Unsafe Patient Environment Low Patient Satisfaction Scores Threat to Institution’s Reputation Drag each response from the right column to its corresponding item in the left column. What are the impacts of the stress cascade? Question 3 of 5 Matching Incorrect One or more answers are incorrect. Correct The Event Peer Reaction Investigation Litigation 4. 3. 2. 1. What is the correct order of adverse events? Drag each response to place the list in the correct order. Question 4 of 5 Sequence Incorrect One or more answers are incorrect. Correct Select three (3) answers. Question 5 of 5 Which key stakeholders are most likely needed to implement a RISE program? Risk Management Patient Safety Transportation Management Employee Assistance Program Multiple Answer Incorrect One or more answers are incorrect. Correct YOUR SCORE: PASSING SCORE: Review Review Review Retry Retry Retry Continue Continue %Quiz1.ScorePercent%% %Quiz1.PassPercent%% Assessment Results Select Print to print a copy of all of your typed answers from this course. Exiting the course will not save your responses. Select Continue to complete the course. Print Assessment Results Please select Print on your screen to print a copy of all typed answers throughout this module. Typed responses are not saved after exiting. Select continue to complete the module and access your certificate of completion. You did not pass the course. Take time to Review the assessment then select Retry to continue. Congratulations! You passed the course. Exit To access your Certificate of Completion, select the Certificates tab from the learning activity overview page. You can also access the certificate from your PEPconnect transcript. ? You have completed the Implementing RISE: Module 1 Online Training Completion Navigation Help Select the icon above to open the table of contents. Click Next to continue. Next Welcome Slide The timeline displays the slide progression. Slide the orange bar backwards to rewind the timeline. Click Next to continue. Next TImeline Select the CC icon to display closed captioning (subtitles). Click Next to continue. Next Caption Icon Select the buttons to learn more about a topic. Be sure to review all topics before navigating to the next slide. Click Next to continue. Next Tab Arrow Slide Select the X to close the pop-up. Click Next to continue. Next Layer Slide Some images may have a magnifier icon. Select the image to see an enlarged view. Select it again to return to the normal view. Click Next to continue. Next Zoom Slide Some images have a magnifier icon in the bottom-left corner. Select these image to see an enlarged view of the image. Select the image again to return to the normal view. Select Submit to record your response. Click the X in the upper right corner to exit the navigation help. Assessment Slide Question Bank 1 HOOD05162003355572 | Effective Date: 21 May 2023 Implementing RISE Leadership Toolkit 1.1 Disclaimer 1.2 Implementing RISE Module 1 1.3 Module 1 Objectives 1.4 Meet the Developers 1.7 Welcome Video 1.8 Implementation Roadmap 1.9 Leadership's Role 1.10 Define the Problem 1.11 Understanding the Need 1.13 Second Victim 1.15 Second Victim Reflection Feedback 1.16 Adverse Event Cascade 1.17 Impacts of Stress 1.21 Stress Cascade 1.27 Gathering Your Data 1.28 Identify Stakeholders 1.32 Course Review 1.33 Assessment