P3.J182: A Novel Approach to Peer Support: From the HeaRT

Background: Peer support programs have emerged as a mechanism to address high burnout and turnover rates in healthcare. They provide healthcare workers (HCW) with an opportunity to emotionally debrief challenging situations with peers. At Children’s Hospital Los Angeles (CHLA), we created a peer support program that allows flexibility, in hopes of retaining peer supporters and sustaining the program.

Methods: The Department of Quality at Children’s Hospital Los Angeles (CHLA) joined well-being champions to develop a peer support program called Healing Response Team (HeaRT). Stress First Aid (SFA) concepts such as compassionate listening and triage of distress helped shape program philosophy. The implementation approach included multiple factors to minimize barriers experienced at other institutions: designated program leader, hospital-wide program launch, interprofessional supporter recruitment, minimal peer supporter service commitments, refresher trainings, intentional program integration with other emotional, and access to escalated mental health support services. Throughout the first three years of the program, there has been continued emphasis on honoring peer supporters' capacity to respond to peer support requests. Post-training evaluations, peer supporter unit representation, and peer support encounter details help to assess program sustainability.

Results: Nearly 300 employees at CHLA have completed HeaRT peer supporter training, representing 27 different clinical and non-clinical positions from 45 different departments or units across the hospital. A majority of the 101 individuals who attended the training but are not currently active peer supporters are no longer CHLA employees or decided not to commit to the role. More than 97% of peer supporters trained in 2023 indicated that they agreed or strongly agreed that they understand the concepts of SFA, methods of triaging distress, and how to escalate emotional support. From August 2021 to December 2023, there were 543 novel peer support encounters. Most of these peer encounters were self-initiated in response to a variety of emotional distress triggers including patient deaths, code blues, behavioral challenges, medical errors or unexpected medical outcomes, personal/family life stressors, and general burnout.

Conclusion: The number of employees trained in conjunction with the number of peer support encounters reflect a cultural shift towards one of support. Because the program was initiated institution-wide and the structure regularly delivers new and refresher trainings, the critical mass is still maintained, despite employee turnover. The agency given to HeaRT training participants and active peer supporters to decide how and when they serve has had a significant impact on program sustainability. Ongoing evaluation will include assessment of program effectiveness on supported peer outcomes.