NIHR Signal 5 February 2019
- Regular participation in structured organisation-wide forums, known as Schwartz Center Rounds®, helps support healthcare staff. The forums are linked with increased empathy and compassion for colleagues and patients, and they facilitate practice change. Levels of poor psychological well-being decrease in forum attendees compared with non-attendees.
- Schwartz Rounds originated in the USA, but are widely used in the UK.
- This evaluation is a mixed-methods, large-scale evaluation of the forums in England based in Acute/Ambulance/Community/Learning Disability Trusts and hospices. The evaluation identifies learning and practical tips on running these forums well which could be useful for other organisations.
Findings of the review and Bibliography
- Psychological well-being scores improved significantly in regular forum attendees between baseline and eight months. According to the General Health Questionnaire-12, the proportion who scored more than 3 (scale 0 to 12 with scores above 3 indicating mental distress) dropped from 25% to 12% in attendees compared to from 37% to 34% with non-attenders (odds ratio 0.66, 95% confidence interval 0.43 to 0.99).
- Four core components and four adaptable components were identified as being key to success. Essential core components are senior clinical leadership; facilitator-led; group participation; availability of food. Adaptable components which can be modified according to the structures and systems of the organisation are number of panellists, e.g. 2-4 panellists; scale, e.g. single vs multiple organisations; regularity, e.g. more or less than once a month; and type of forum, e.g. teleconferencing or video conferencing.
- Attendees reported a better understanding of colleague, patient and carer behaviours, increased empathy, closer teamwork and improved communication.
- The impact of forums can be cumulative as attendees understanding of the purpose of forums grows and their ability to contribute increases.
- Attendance can be problematic for those with limited autonomy over their workload or where attending the forum conflicts with other clinical priorities.
- Maben J, Leamy M, Taylor C et al. An organisational guide: understanding, implementing and sustaining Schwartz Rounds®. London: Kings College London; 2018.
- NICE. Mental wellbeing at work. PH22. London: National Institute for Health and Care Excellence; 2009.
- Taylor C, Xyrichis A, Leamy MC et al. Can Schwartz Center Rounds support healthcare staff with emotional challenges at work, and how do they compare with other interventions aimed at providing similar support? A systematic review and scoping reviews. Health Services Research. 2018;8(10).
- The King’s Fund. Schwartz Center Rounds. London: The King’s Fund; 2019.
- The Point of Care Foundation. About Schwartz Rounds. London: The Point of Care Foundation; 2019.
