We all interact with the healthcare system in different ways. As taxpayers we have a vested interest in the efficiency of our system and good value for money. As patients or clients or family members caring for loved ones, priority number one is quality: we want to know that when we receive a therapy or treatment that it is going to make a difference and that it is the best available option. Access is another dimension of quality: we want to know that medical care is available when and where we need it. All of these dimensions are important and healthcare leaders are thinking about all of them including the team at Holland Bloorview.
However, there is another dimension of healthcare that we all expect and perhaps only notice in its absence: compassion. This may be the core dimension.
What do I mean when I talk about compassion or compassionate care? Compassion is found in the social relationship between the healthcare provider and the patient or client—the human connection made. Elements include communication, respect, mutual trust, emotional support and the involvement of families and loved ones in care decisions. As Holland Bloorview’s VP Human Resources, Organizational Development & Business Affairs Judy Hunter has described it: “Compassionate care … means treating patients as people, not just clients.”
Wanting to deliver compassionate care is why we all get into healthcare in the first place. But sometimes compassion can get lost in the mix. Keith Adamson, Holland Bloorview’s Senior Director of Collaborative Practice, captures this conflict well: “In today’s fast-paced, cost-conscious healthcare environment, it’s becoming increasingly challenging for clinicians to balance between the need for efficient versus compassionate care.”
This is where “Schwartz Rounds” enters the picture. The Schwartz Center for Compassionate Healthcare is a nonprofit organization. It describes its mission as nurturing the patient-caregiver relationship in order “to strengthen the human connection at the heart of healthcare.” The Schwartz Center piloted what it calls Schwartz Rounds at Massachusetts General Hospital in Boston in 1997.
What are Schwartz Rounds? A typical session might include a panel of clinicians who present an anonymized client case or theme that brought up interesting or thought-provoking social and emotional issues. All staff present are invited to share thoughts and feelings related to the day’s topic. Unlike traditional rounds, these sessions focus not on clinical problem solving, but rather on exploring and working through the emotions that come up in the daily work of care in a hospital. This uniquely interprofessional focus includes everyone who works in the hospital: a nurse and a member of the custodial staff might find themselves sitting next to each other with the CEO on one side and a pharmacist on the other. For a video that shows an example of Schwartz Rounds click here.
While this may sound like a “nice to have,” research is showing that compassionate care has an impact on health outcomes: patients do better. And this isn’t all: healthcare providers do better too. Compassionate care helps providers connect with clients emotionally, improves communications among healthcare teams and decreases stress among employees.
We know we have an amazing team at Holland Bloorview. We value and support them through education and innovative professional development. We put client and family centred care at the core of all of our practices. Focusing on the emotional and social dimensions of care just seemed like the logical next step.
On April 9, Holland Bloorview held its first Schwartz Rounds. A standing room only group came together to discuss the most challenging emotional and social issues they face caring for kids and their families. For employees at Holland Bloorview, caring for children with a range of diagnoses, disabilities and complex medical needs often means developing relationships over a period of years, often seeing children and their families from infancy (or first diagnosis) until they transfer into adult care. Difficult conversations and decisions can be part of that journey. This is why we believe that providing our employees with a structured and safe outlet for expressing their feelings will lead to better health outcomes for our clients.
It is very exciting to be the first and lead hospital in Canada to establish a Schwartz Center Rounds Program. We are joining over 450 hospitals in the United States and the United Kingdom by recognizing compassion as essential to the delivery of high quality care and at the heart of any healthcare system. But our work won’t stop there. As part of our implementation we will be undertaking research to understand the impact of Schwartz Rounds in a Canadian hospital and on the unique populations we serve. As part of our commitment to accelerating knowledge we look forward to sharing what we learn.
Perhaps what I am most proud of is how much our employees wanted us to implement Schwartz Rounds. The Holland Bloorview team didn’t need to be convinced – they wanted compassion to be at the forefront of the care we provide. We all know compassion is what our clients and families should be able to count on from us today, tomorrow and every day.