Dr Mila Felder Discusses Peer-to-Peer Support in Health Care Organizations

Mila Felder, MD, FACEP, emergency physician and vice president for Well-Being for All Teammates, Advocate Health, discusses the impact of peer support groups within a health care organization and its patients.

It is crucial that employees feel that they have the proper peer-to-peer support system and training in order to care for patients with distress trauma, says Mila Felder, MD, FACEP, emergency physician and vice president for Well-Being for All Teammates, Advocate Health.


Could you share some insights into the Peer-to-Peer Support program and its role in fostering workplace safety and support within the organization?

When we started the peer support program, it was right before COVID-19 started. One of my friends, an orthopedic surgeon, reached out to me. I was entering the medical staff as vice president, and he said, my wife works for United Airlines, and they have this program where they train any of their employees to understand distress trauma and to be able to step in. We as a health care organization had nothing like that.

We started building it. I reached out to a friend, Kim Miller, [PhD, director, Advocate Trauma Recovery Center,] and she is a trauma recovery specialist. She reached out to Ohio State University's Ken Yeager, [PhD, associate professor, Department of Psychiatry and Behavioral Health, Ohio State University,] where they already had an existing peer support program based on trauma-informed care, with foundational education on that, and I asked him to help build something like that.

We rolled our first peer support training in July 2020. And at that time, it was 35 doctors and nurses, virtually, because we're in the middle of COVID-19. We listened to 3 components of that foundational peer support training that Kim created. The first component was, what does trauma look like on impact? What may one experience if they are impacted by trauma? And during that, there's a very specific list of what it may look like, so people can identify themselves in it. The second component is, what do we offer as an organization when something happens or if you feel that you've been impacted? And we talked about what does an employee assistance program do. How do we destigmatize getting help? What does missional spiritual care do? How do we offer help to those that are faith based and how do they connect to others who are not faith based? What do we do with the peer support program moving forward and how do we make those peer supporters able to take care of themselves and empower others?

A part of the training is that our peer supporters get an ID badge. While this is an older ID badge because we have to print Advocate Health ID badges, I wanted to show this because our peer supporters get to take the badge home and decide when they wear it. It's separate from the work ID badge. They need to feel that they're in a space to offer help to others. Sometimes they want to be peer supporters seeking help and they could flip it over or not ever wear it. However, after that second piece of what are the resources, is also built in the third piece of the training, which allows people to learn how to start the conversation with someone who's been impacted by trauma that doesn't cause more trauma. How do you not give them a prescription for well-being, but instead just offer space, safely talking about how are you in the space you're in? Can I be here for you, what happened to you?

As we did that, we realized that the first 35 people in the room all had 20-plus of those symptoms or signs that were listed of being impacted by trauma. And we said you know what, this is going to be for you first. Yes, we are going to build a peer support network, but we're going to start by making sure you feel supported. And that's been really our idea. We build the program with understanding that the humans that come to training are going to be the first to get the oxygen on that plane. Only then can they offer it to someone else. As a result, following the training, people could choose to be ambassadors or not. But they have an option if they choose to be an ambassador.

Every week, there is a different topic. Following the foundational training, every week, there are 5 20-minute sessions at different times of the day. There are different times of the day, but it's the same session for that week, offering specific tools for one small piece of peer support. So maybe this week, we talk about psychological safety and last week, we talked about moral distress. Sometimes we talk about workplace violence. And through having specific trauma specialists starting and kicking off the conversation for 10 or 15 minutes virtually, and then allowing ambassadors that came on for help to weigh in with their questions or their experiences, it becomes something in between the peer support and coaching, allowing people to gain more and more as they go on. Feeling less like the organization is asking them to do one more thing for somebody else and more like this is really for them to be happier humans coming home and working. And I think that's how we got from 35 people in July of 2020 to over 2000 people today, with the goal of 30% of our 150,000 teammates being trained.

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