FOSTER’S PHILOSOPHY
Schwartz Rounds: our experience
M
y new Chief Executive started last week. He is well known for his passion for staff engagement. and has written to over 1900 employees in the trust asking what we like and dislike about working there. He has also asked us what we feel his priorities should be. I have my first one to one with him this week; I am sure that he will be interested to discuss what the nursing and midwifery teams are doing to improve our employee engagement. One of the areas I am keen to discuss with him is the pilots of Schwartz Rounds that we have been facilitating. In 2010, Lown and Manning found that:
© 2015 MA Healthcare Ltd
‘Rounds have been shown to be an effective strategy for providing support to healthcare staff and for enhancing relationships among them and with their patients’. In 2009, The Point of Care (POC) Foundation entered into an agreement with the Schwartz Center for Compassionate Healthcare (in Boston, USA) to pilot Schwartz Center Rounds® in the UK (Goodrich, 2011). The Rounds,which run very much like a traditional ‘grand round’-style forum, have been held in hospitals in the US for 14 years (Goodrich, 2011), and expanded to more than 320 healthcare organisations. In the UK, the number of organisations signed up to run Rounds has reached 104—a four-fold increase since April 2013 (POC Foundation, 2015). My organisation is working with the POC Foundation, the sole licensed provider of training and support to organisations wishing to run Schwartz Rounds in the UK.The King’s Fund has also secured National Institute for Health Research funding for research into the effectiveness of Schwartz Rounds (King’s College London, 2015); we look forward to being part of this project. 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. Normally the ‘case’ is presented by a panel of mixed staff who take it in turns to describe their involvement with the care, how it made them feel and what sort of challenges it raised for them. The discussion is then opened up for attendees to ask questions, share experiences and reflect on the challenges of care. The rounds are designed to be held in a safe and confidential environment. The evidence base has grown significantly in the last couple of years linking NHS employee engagement to high performance. For example, West and Dawson (2012) summarise that, in general, the more positive the experience for the staff, the better outcomes for patients.
British Journal of Nursing, 2015, Vol 24, No 5
We also know from the POC Foundation qualitative research by Goodrich and Cornwell (2008) that, although staff want to provide the kind and compassionate care that they would want for themselves or their families, it can be difficult for all sorts of reasons, (including personal reasons, the nature of the team and the hospital culture) to do this consistently. Goodrich (2011) undertook an evaluation of Schwartz Rounds and their transferability to the UK setting. The evaluation looked at three types of evaluation at two hospitals in the UK: feedback from participants after each round, a pilot survey before and after the first year of rounds completed by participants and qualitative interviews with key members of staff in both trusts (Goodrich, 2011). Results showed that the Schwartz Rounds: ■■ Have successfully transferred to the UK ■■ 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 (the Schwartz Rounds were given a mean rating of excellent/exceptional by 70% of all participants). (Goodrich, 2011) A number of senior staff from my organisation have undertaken training at the POC Foundation in order to facilitate Schwartz Rounds on site. To date, three Rounds have been facilitated, with monthly rounds planned through 2015. Subjects have included: sharing experiences in caring for a patient at end of life, being involved in a serious untoward incident and sharing experiences of my first day as a new consultant. We have gathered the views of over 110 staff who have attended the Schwartz Rounds and overall they are hugely positive, with staff feeling the benefit of reflecting in a multiprofessional forum. Staff are keen for them to continue and are returning bringing their colleagues, and have commented that they plan to be more supportive of colleagues following hearing different perspectives through the discussions. I look forward to discussing our ongoing commitment to Schwartz Rounds as one of many interventions planned to create a practice environment that supports BJN our teams to deliver high-quality care. Goodrich J (2011) Schwartz Centre Rounds. An evaluation of UK Pilots. The King’s Fund. http://tinyurl.com/n52mr2p (accessed 27 February 2015) Goodrich J, Cornwell J (2008) Seeing the person in the patient . The Point of Care review paper. The King’s Fund. http://tinyurl.com/komlobs (accessed 27 February 2015) King’s College London (2015) Supporting NHS staff at work: Could Schwartz Centre Rounds® hold key to a happier, healthier workforce and enhance compassionate care? 23 May. http://tinyurl.com/plehpfy (accessed 4 March 2015) The Point of Care Foundation (2015) “The ‘Francis effect’ at risk but not dead” says charity supporting strong growth of Scwhartz Rounds. 5 February. http://tinyurl.com/obkrbdc (accessed 4 March 20150 West MA, Dawson JF (2012) Employee engagement and NHS performance. http://tinyurl.com/bussx77 (accessed 27 February 2015)
Sam Foster Chief Nurse Heart of England NHS Foundation Trust @safetySamFoster
309 © MA Healthcare Ltd. Downloaded from magonlinelibrary.com by 137.122.008.073 on September 14, 2016. Use for licensed purposes only. No other uses without permission. All rights reserved.
Schwartz Rounds: our experience
M
y new Chief Executive started last week. He is well known for his passion for staff engagement. and has written to over 1900 employees in the trust asking what we like and dislike about working there. He has also asked us what we feel his priorities should be. I have my first one to one with him this week; I am sure that he will be interested to discuss what the nursing and midwifery teams are doing to improve our employee engagement. One of the areas I am keen to discuss with him is the pilots of Schwartz Rounds that we have been facilitating. In 2010, Lown and Manning found that:
© 2015 MA Healthcare Ltd
‘Rounds have been shown to be an effective strategy for providing support to healthcare staff and for enhancing relationships among them and with their patients’. In 2009, The Point of Care (POC) Foundation entered into an agreement with the Schwartz Center for Compassionate Healthcare (in Boston, USA) to pilot Schwartz Center Rounds® in the UK (Goodrich, 2011). The Rounds,which run very much like a traditional ‘grand round’-style forum, have been held in hospitals in the US for 14 years (Goodrich, 2011), and expanded to more than 320 healthcare organisations. In the UK, the number of organisations signed up to run Rounds has reached 104—a four-fold increase since April 2013 (POC Foundation, 2015). My organisation is working with the POC Foundation, the sole licensed provider of training and support to organisations wishing to run Schwartz Rounds in the UK.The King’s Fund has also secured National Institute for Health Research funding for research into the effectiveness of Schwartz Rounds (King’s College London, 2015); we look forward to being part of this project. 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. Normally the ‘case’ is presented by a panel of mixed staff who take it in turns to describe their involvement with the care, how it made them feel and what sort of challenges it raised for them. The discussion is then opened up for attendees to ask questions, share experiences and reflect on the challenges of care. The rounds are designed to be held in a safe and confidential environment. The evidence base has grown significantly in the last couple of years linking NHS employee engagement to high performance. For example, West and Dawson (2012) summarise that, in general, the more positive the experience for the staff, the better outcomes for patients.
British Journal of Nursing, 2015, Vol 24, No 5
We also know from the POC Foundation qualitative research by Goodrich and Cornwell (2008) that, although staff want to provide the kind and compassionate care that they would want for themselves or their families, it can be difficult for all sorts of reasons, (including personal reasons, the nature of the team and the hospital culture) to do this consistently. Goodrich (2011) undertook an evaluation of Schwartz Rounds and their transferability to the UK setting. The evaluation looked at three types of evaluation at two hospitals in the UK: feedback from participants after each round, a pilot survey before and after the first year of rounds completed by participants and qualitative interviews with key members of staff in both trusts (Goodrich, 2011). Results showed that the Schwartz Rounds: ■■ Have successfully transferred to the UK ■■ 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 (the Schwartz Rounds were given a mean rating of excellent/exceptional by 70% of all participants). (Goodrich, 2011) A number of senior staff from my organisation have undertaken training at the POC Foundation in order to facilitate Schwartz Rounds on site. To date, three Rounds have been facilitated, with monthly rounds planned through 2015. Subjects have included: sharing experiences in caring for a patient at end of life, being involved in a serious untoward incident and sharing experiences of my first day as a new consultant. We have gathered the views of over 110 staff who have attended the Schwartz Rounds and overall they are hugely positive, with staff feeling the benefit of reflecting in a multiprofessional forum. Staff are keen for them to continue and are returning bringing their colleagues, and have commented that they plan to be more supportive of colleagues following hearing different perspectives through the discussions. I look forward to discussing our ongoing commitment to Schwartz Rounds as one of many interventions planned to create a practice environment that supports BJN our teams to deliver high-quality care. Goodrich J (2011) Schwartz Centre Rounds. An evaluation of UK Pilots. The King’s Fund. http://tinyurl.com/n52mr2p (accessed 27 February 2015) Goodrich J, Cornwell J (2008) Seeing the person in the patient . The Point of Care review paper. The King’s Fund. http://tinyurl.com/komlobs (accessed 27 February 2015) King’s College London (2015) Supporting NHS staff at work: Could Schwartz Centre Rounds® hold key to a happier, healthier workforce and enhance compassionate care? 23 May. http://tinyurl.com/plehpfy (accessed 4 March 2015) The Point of Care Foundation (2015) “The ‘Francis effect’ at risk but not dead” says charity supporting strong growth of Scwhartz Rounds. 5 February. http://tinyurl.com/obkrbdc (accessed 4 March 20150 West MA, Dawson JF (2012) Employee engagement and NHS performance. http://tinyurl.com/bussx77 (accessed 27 February 2015)
Sam Foster Chief Nurse Heart of England NHS Foundation Trust @safetySamFoster
309 © MA Healthcare Ltd. Downloaded from magonlinelibrary.com by 137.122.008.073 on September 14, 2016. Use for licensed purposes only. No other uses without permission. All rights reserved.
