Sponsored by the International Labor Organization, World Occupational Safety and Health Day is observed on April 28 every year. This day is a day to remember those who have been injured or killed at work, and to raise global awareness about how to prevent workplace accidents and illnesses.
To observe this day, the following success story explores what happens after an unexpected medical error occurs in a hospital. It reveals how such incidents severely affect health care workers as “second victims” and highlights the hidden psychological toll that has long been overlooked in workplace safety.
When the healer is hurt
What happens if an unexpected medical accident occurs at a hospital? As the old saying goes, “Errare humanum est” (to err is human). Rather than recklessness, many of these events involve honest mistakes resulting from system failures, excessive workloads, or communication failures. Patients are not the only ones who suffer in these situations. After such events, healthcare workers themselves often become “second victims” and suffer psychological distress, which can lead to burnout, depression, and even retirement. For decades, their silent struggle went largely unnoticed, hidden behind a culture that equated mistakes with failures.
However, this situation is starting to change thanks to the work of COST Action The European Researcher’ Network Working on Second Victims (ERNST Group) and its follow-up project, the European Certificate of Intervention in support of Second Victims (RESCUE), which is funded through the COST Innovators Grant (CIG). Europe is beginning to recognize that caring for the people who care for us is not a luxury, but the foundation of safer and stronger health care.
“The most fulfilling thing was seeing what was once invisible become a visible and respected topic on the European agenda.” says Professor José Joaquín Mira, Chair of the Action and CIG of the Valencian Community Health and Biomedical Research Promotion Foundation (Fisabio).
Building a European safety net
The ERNST Group brought together experts from 31 European countries to study the emotional impact that adverse events, the moments when something goes wrong despite the best of intentions, have on healthcare workers.
Traditionally, emotional support in healthcare has simply been rear Something went wrong. The ERNST group changed that thinking by proposing the ERNST five-layer model, which started much earlier.
- Prevention – Build awareness and resilience before harm occurs.
- Self-care – Give professionals the tools to manage stress and seek help early.
- Peer Support – Trained colleagues provide confidential, empathetic conversations.
- Structured professional support – psychologists and occupational health experts intervene as needed.
- Clinical Care – Targeted treatment for severe emotional impact.
This model does more than just protect individuals. “This is a cultural shift in healthcare.” Teacher Mira says: “From isolation and guilt to support and shared responsibility. It provides a safety net for professionals and helps institutions retain talent and foster a just culture.”
The first important milestone was that the action published a policy statement on the second victim phenomenon, which was supported by experts from 29 countries and featured in the 2024 Public Health Review. For the first time, Europe has clear, evidence-based recommendations and policy proposals to guide institutions in supporting healthcare workers following adverse events.
“That document culminates years of research and dialogue.” Professor Mira recalls. “This research attracted the attention of health authorities, even reached the President of the European Parliament, and we had the opportunity to discuss our approach to addressing this problem across Europe with our colleague Professor Sandra Buttigieg. That was the moment we realized we had moved from research to real impact. This laid the foundation for developing guidance and recognition systems to guide organizations on how to organize interventions to strengthen resilience and address the second-victim phenomenon.”
putting research into action
Another important step was the COST Innovators Grant RESCUE, which turned years of dialogue into a concrete plan of action. “It confirms that our work has grown into something that is viable, scalable and capable of making a real difference across Europe.” Jose Joaquín Mila remembers.
RESCUE has translated the ERNST Group’s findings into the RESCUE Certification System for hospitals and professionals. It sets European standards on what effective secondary victim support should look like and ensures that medical staff receive timely and systematic support when they need it most.
Certification is more than just a sign of quality. It is a framework for building trust between professionals and their facilities, and between patients and health systems.
“RESCUE provides a tested, evidence-based framework that ensures secondary victim support systems are truly effective.” Professor Mira explains. “For hospitals, it’s a way to strengthen trust and create a culture of justice. For professionals, it means structured and timely support. And for patients, it means safer care delivered by emotionally resilient professionals.”
“The basis for economic action is as strong as the moral basis.” continues the chairman. “In a German study, the annual cost for a nurse not to deal with the second victim phenomenon was around 14,000 euros. With our intervention, we can cut that in half.”
Awareness and reach
In 2024, ERNST Group received the Butterfly Patient Safety Award from the European Patient Safety Foundation (EUPSF). Recognized for groundbreaking work in establishing the European Certification Framework and developing peer supporters.
“Winning the Butterfly Award was an incredible honor.” Teacher Mira says: “But the recognition goes far beyond that. Our work is now embedded in policy briefs and national strategies. ERNST’s message resonates with professionals, patients, families and civil society.”
A new chapter for patient safety in Europe
In addition to this award, the ERNST Group and RESCUE have also been featured in WHO workshops, European conferences, and international policy forums. Our training manuals, podcasts, and training courses in seven languages are helping hospitals around the world establish their own support systems.
“Just a few days ago we signed an agreement with the EUPSF. “This is to ensure the long-term continuity of our system. We believe this will make the efforts made over the last few years even more valuable,” Professor Mira said.
For him, the message is simple and consistent. “RESCUE doesn’t just help secondary victims,” he says. “It’s about improving patient safety. That’s always been our goal.”
He sees this work as part of a deeper cultural shift. “Real change only happens when there is vision, collaboration and common purpose,” he concludes. “And that’s exactly what RESCUE stands for.”
sauce:
European Cooperation in Science and Technology (COST)
