In 2009 The Point of Care entered into an agreement with the Schwartz Center for Compassionate Healthcare (in Boston, United States) to pilot Schwartz Center Rounds® in the UK.
The Rounds have been held in hospitals in the United States for 14 years and have expanded to more than 225 sites. Rounds provide a forum for staff from a range of disciplines to meet once a month (or every other month) to explore together some of the challenging psychosocial and emotional issues that arise in caring for patients.
This paper draws together three types of evaluation: the feedback from participants after each Round; a pre- and post-pilot survey (first year of Rounds) completed by Rounds participants; and qualitative interviews with key members of staff in both trusts.
Results show that it is clear that the Rounds:
- have successfully transferred to England
- are firmly established and ongoing, with support from the top of the organisations
- have demonstrated a need
- are greatly valued by the staff who participate (Rounds were given a mean rating of excellent/exceptional by 70 per cent of all participants).
Comments
My main point is that whatever we call such groups, focusing on the patient-health professional relationship where the emotional impact of distressed patients who often have complex needs is acknowledged, thought about, not denied or pushed away because their distress is unbearable, seems to me essential in a modern day health service, not just a mental health service! Upskilling staff, training and education with hard evidence of certificates and diplomas is very laudable, but has to be built on the foundation of the relationship between professional and patient.
Moreover an organisation that can value reflective practice where
there is an open and transparent culture, is much less likely to end up in severe trouble, obsessed with meeting targets. Whereas Balint groups and Schwartz rounds involve clinicians, such principles can be applied in a wider context to higher management and even Trust Boards.
The Frances enquiry made a number of very important recommendations, but I dont think that it emphasises enough the centrality of human relationships in all their complexity, in providing ordinary good enough compassionate care.
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