The Schwartz Center Mission To promote compassionate healthcare so that patients and their professional caregivers relate to one another in a way that provides hope to the patient, support to caregivers and sustenance to the healing process. Founded in 1996 in memory of Kenneth Schwartz I have been touched by the smallest gestures a squeeze of my hand, a gentle touch, a reassuring word. In some ways these quiet acts of humanity have felt more healing than the high dose of radiation and chemotherapy that hold the hope for a cure. --Ken Schwartz (1954-1995) 1
Schwartz Center Rounds Enhancing Patient Care through Provider Support Good caregiver communication is associated with: Vilma Barrios 2011 Compassionate Caregiver of the Year Increased patient and family satisfaction Improved clinical outcomes Improved adherence to treatment recommendations Reduced readmissions and lower spending on diagnostic testing Fewer malpractice claims Lown BA, Rosen J, Marttila J. Health Affairs, 2011 Schwartz Center Rounds regular forum for caregivers from diverse disciplines to discuss emotional and social challenges inherent in patient care and role that teamwork and communication plays in enhancing quality of care Harvard Vanguard Medical Associates, Cambridge 2
Schwartz Center Rounds Format Hour-long, held regularly 6-12 times per year Planning committee chooses patient case or topic Multidisciplinary panel shares experiences, thoughts and feelings (15-20 minutes) Facilitated discussion in confidential environment Usually open to staff from throughout facility; sometimes sited within a particular department (e.g. Cancer Center) Sample topics Winchester Hospital Non-compliant patient Caring for a colleague Team conflict around treatment plans Does stopping treatment mean giving up? Pain management in the addicted patient Things my patients have taught me Site responsibilities Secure support of senior management Appoint a physician leader, facilitator and administrative coordinator Establish a multidisciplinary planning committee Adhere to Schwartz Center Rounds model Submit evaluation summaries Acknowledge Schwartz Center support and Rounds funders 3
Schwartz Center provides Start-up training: Phone consultation & site visit Materials to build support and encourage attendance Ongoing consultation and quality assurance Periodic peer learning meetings for Rounds leaders Internet resources specifically for Rounds leaders 2011 Rounds Peer Learning Meeting Impact 87% of participants report new ideas and strategies for challenging patient situations 84% report more compassion for patients and families Lown, BA, Manning, CF. Academic Medicine, 2010 Teamwork 93% reported increased appreciation for the roles/contributions of colleagues from other disciplines 88% reported increased sense of belonging to a caregiving team 76% reported feeling less alone in work with patients Lown, BA, Manning, CF. Academic Medicine, 2010 4
Institutional benefits Caregivers reported feeling less stressed and better able to cope with the emotional demands of clinical work Approximately 50% reported changes in practices or policies within the department or hospital at large Lown, BA, Manning, CF. Academic Medicine, 2010 Other benefits CME for physicians (risk management in Massachusetts) CEUs for nurses, social workers and chaplains Helps satisfy ACGME communications requirements for residents and fellows Joint Commission Rounds included in JCR toolkit for meeting patient safety goals In participants own words Rounds are a place where people who don't usually talk about the heart of the work are willing to share their vulnerability, to question themselves. Rounds are an opportunity for dialogue that doesn't happen anywhere else in the hospital. 5
In participants own words There is more heart in what we do with patients the connections are deeper, we are less afraid of difficult topics. Since we know there is support for us in the institution, we're willing to take more risks. "The format allows for a free exchange of ideas, feelings and reactions, reinforcing the common humanity of caregivers, patients and families. They are clearly now part of the fabric of our institution. --Raymond J. Mayewski, MD,Vice President and Chief Medical Officer University of Rochester Medical Center Piloted at Massachusetts General Hospital in 1997 Now offered in 278 sites in 37 states, plus 14 in UK as of 9/30/12 6
For more information w w w. T h e S c h w a r t z C e n t e r. o r g For more information Please contact: Pat Forman, MPH, MA Consultant, The Schwartz Center for Compassionate Healthcare pmforman@sbcglobal.net www.theschwartzcenter.org 7