Second victim support program and patient safety culture: A quasi experimental study in Bali International Medical Centre (BIMC) Hospital

Background: Patients are the first victims of patient safety incidents. However, healthcare providers are also the victims. In 2000, a doctor named Wu introduced the term "second victim" to describe the healthcare providers who involved in patient safety incidents. In Indonesia, there is no second victim support program implemented in the hospitals. Studies need to be done regarding second victim support program and its effect on patient safety culture. Objective: To study the effect of second victim support program on patient safety culture. Method: This study is a quasi-experimental study conducted from 2015 to 2017. The treatment given is the Second Victim Support Program. Eighty-seven healthcare providers in BIMC Hospital Kuta are selected as the treatment group, while another 103 healthcare providers in BIMC Hospital Nusa Dua are selected as the control group. The study is analyzed with difference-in-differences and paired-sample t-test. Phase 1 (2015) is the baseline, phase 2 (2016) is when the program is implemented up to one year (to study its effect on patient safety culture), and phase 3 is one to two years after the treatment to study the sustainability of its effect. Result: Difference-in-differences revealed that the treatment significantly increased the patient safety culture (beta coefficient of 0.738, SE = 0.258, P-value = 0.007). There is no significant difference between patient safety culture in phase 2 and phase 3 (t (11) = 0.378 with P-value of 0.713 and (ohen's d of 0.0476). Conclusion: Second victim support program increases patient safety culture. If the program is maintained, the effect on the patient safety culture will be sustainable.