A Model for Sustaining Second Victim Peer Support Programs in Healthcare: A Delphi Study

AIM(S): To identify essential attributes supporting the success and long-term sustainability of healthcare's second victim peer support programs. DESIGN: The Delphi technique and purposive sampling identified peer support team coordinators who served as the expert panellists in this study. METHODS: Panellists completed three Delphi rounds. Round 1 open-ended responses were analysed using content analysis to identify themes and sub-themes. In Rounds 2 and 3, panellists rated the importance of each theme using a 4-point Likert scale. RESULTS: Coordinators representing 23 healthcare organisations across 15 states identified core attributes for sustaining peer support programs. Key findings included the need for strong executive leadership commitment, adequate staffing through dedicated coordination, a culture of psychological safety, and peer supporter competency (empathy, communication skills, and confidentiality). Reported challenges included balancing competing responsibilities for both coordinators and peer supporters, maintaining peer supporter engagement, and addressing stigma related to help-seeking. These findings informed the development of the 5Cs Framework, a structured model illustrating how key priorities collectively support program sustainability and strengthen a culture of workplace well-being. CONCLUSION: Experienced peer support team coordinators highlighted the organisational structures and institutional drivers perceived to support the sustainability of peer support programs. The 5Cs Model is presented as a practical guide for long-term success. Findings can be used to help strengthen program sustainability and support effective responsive support team operations. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This study identified essential elements for optimizing peer support teams that support clinician well-being, normalise help-seeking, and promote a culture of psychological safety with implications for patient safety. IMPACT: Many healthcare organisations have embraced peer support teams to help staff cope with emotionally challenging clinical events. Sustaining these programs remains a common challenge. This study identified expert opinions on the attributes of successful peer support teams and introduced the novel 5CsModel to guide implementation and long-term sustainability within broader workforce well-being efforts. REPORTING METHOD: DELPHISTAR guidelines were followed. PATIENT OR PUBLIC CONTRIBUTION: None.