P4.001: Implementation and Evaluation of a Peer Support Program “Talk &Listen Confidentially” to Enhance Well-being Among Pediatric Primary Care Clinicians

Background: Children’s Primary Care Medical Group (CPCMG) is a 171-clinician, physician-owned pediatric practice serving 272,000 patients at 28 sites throughout San Diego and Riverside Counties. After an adverse event, uninvolved colleagues can provide a unique type of support. To promote clinician wellness, in 2017 CPCMG created a formal confidential Peer Support program called Talk & Listen Confidentially (“TLC”), which expanded using an innovative approach to engage more clinicians. Our objective is to share our experience about our Peer Support program as a best practice.

Methods: TLC was established in 2017, when the Wellness Committee surveyed all clinicians, requesting nominations. Ten clinicians participated in peer support training, facilitated by Jo Shapiro, MD (expert in peer support development: https://www.joshapiromd.com/peer-support). CPCMG’s CEO appointed two TLC Directors, who assigned referrals and tracked outreach calls.

A TLC email was created to receive confidential referrals from self, peers, supervising physicians, and executive leadership. To facilitate confidential tracking, each clinician was assigned a numeric code. To increase use and normalize a culture of peer support, in 2019 TLC Directors created a novel “checkup” system, in which Directors assign outreach calls to TLC Providers, who reach out to every clinician annually. In 2024, the TLC Directors started reaching out to all clinicians associated with a patient death, and TLC Directors started a process to track checkup calls. Also, in 2024, an anonymous survey was created to assess the value of the program with the goal of continued improvements.

Results: In 2024, TLC usage included 14 death referrals and 10 referrals for adverse events. All clinicians received a checkup and 33% completed a call. The remaining clinicians either did not respond or responded that it was not needed. 57 clinicians completed the survey (34%). 63% responded that the supporter “helped me to deal with the event”. 72% responded that “speaking with a TLC clinician improved my sense of wellbeing”. 82% responded that the annual outreach is valuable. Similar to other Peer Support projects at other institutions, we found that clinicians reported a downregulation in pathologic negative thoughts about an adverse event or work stress after speaking with TLC, when recalling how they felt.

Conclusion: CPCMG has created a Peer Support Team and Program which is enhanced by a novel yearly “checkup” approach, and based on survey results has broad acceptance with clinicians reporting fewer negative thoughts after interaction. The program’s structure and process for continuous improvement can be a model for other large medical group private practices.