Survey of peer messengers about their role in a whole-of-hospital program that aims to reduce unprofessional behaviour amongst hospital staff

Background: Professional accountability programs have been developed to address unprofessional behaviour amongst hospital staff. Peer messengers play a key role in these programs by providing informal feedback to staff about their unprofessional behaviour with the aim to raise awareness of behaviour and how it is perceived by other staff. However, little is known about the experiences of peer messengers. This study examined the experiences of peer messengers and their perceptions of a whole-of-hospital professional accountability program called ‘Ethos’.

Method: Peer messengers across eight Australian hospitals were invited to complete an online survey. The survey consisted of close-ended questions asking respondents about their experiences delivering messages to peers, as well as their perceptions of the Ethos program. Open-ended questions asked respondents about the most rewarding and challenging aspects of being a peer messenger and what they would change about the Ethos program.

Results: Of an estimated 145 peer messengers, 60 provided responses to the survey. The majority of respondents were from nursing and medical groups (53.4%). A majority had delivered 1-5 feedback for reflection messages to staff (57.7%). Rewarding aspects of being a peer messenger included having a meaningful conversation, having staff embrace the reflection process, and contributing to positive culture change. Challenging aspects included practical issues related to organising a time to talk with staff, delivering feedback for reflection effectively, and difficulties related to dealing with negative staff responses to feedback. Suggested changes to the Ethos program included improved promotion of the Ethos program and more support for peer messengers and recipients of feedback.

Implications: Professional accountability programs have shown promise in reducing unprofessional behaviour. Support and skills development for peer messengers are key in supporting their effectiveness and the sustainability of their central roles in such programs.