Abstract
BackgroundWork stress and compassion fatigue are prevalent among healthcare staff and their negative effects on staff well-being and patient care are well-known. This paper reports on the implementation and evaluation of Schwartz Rounds® (Rounds) in UK healthcare organizations, predominantly part of the National Health Service (NHS). Rounds are one-hour, typically monthly, multidisciplinary forums during which clinical and nonclinical healthcare staff discuss the emotional and social demands of delivering patient care. The purpose of this research was to evaluate the effectiveness of Rounds attendance on the psychological distress, work engagement, compassion and self-reflection of healthcare staff.MethodsWe used a pre-post control design to assess the effect of Rounds attendance across 10 UK healthcare organizations. This design was most appropriate given the voluntary nature of Rounds and ensured the study had ecological validity. Self-reported data were collected from attenders and non-attenders at baseline and at eight-months follow-up. The outcomes were psychological distress, work engagement, compassion and self-reflection.ResultsDuring the 8 months’ study duration, regular attenders (N = 51) attended Rounds on average 4 times (2–8). Attenders showed a significantly greater decrease in psychological distress (as measured with the General Health Questionnaire (GHQ)) than non-attenders (N = 233; odds ratio of 0.197; 95% confidence interval (0.047–0.823)). However, Rounds attendance had no significant effect on work engagement, compassion and self-reflection.ConclusionsRounds attendance was linked to a 19% reduction in psychological distress adjusting for covariates. As an organization-wide intervention, Rounds thus constitute an effective, relatively low-cost intervention to assist staff in dealing with the demands of their work and to improve their well-being.
Highlights
Work stress and compassion fatigue are prevalent among healthcare staff and their negative effects on staff well-being and patient care are well-known
The remaining respondents had either attended fewer than 50% of available Rounds, or did not provide sufficient information to determine the number of Rounds attended, and were excluded from the analysis
This study evaluated the effectiveness of Rounds with healthcare staff from 10 UK healthcare organizations, all part of the National Health Service (NHS), except for one hospice
Summary
Work stress and compassion fatigue are prevalent among healthcare staff and their negative effects on staff well-being and patient care are well-known. The work of healthcare staff is characterized by various ethical, moral, social and emotional challenges and demands [1, 2], such as caring for a large number of patients, interacting with their families, or dealing with patients’ deaths [1, 3] Such demanding work comes at a cost [4], as reflected in rising levels of burnout and compassion fatigue and sadly, psychological morbidity [5,6,7,8]. Key benefits of Rounds over comparative interventions (e.g., resilience training and after action reviews) include that Rounds do not require verbal contribution on part of attenders and are open to clinical and non-clinical staff [13] The latter point is relevant in the context of well-being and burnout as ‘all staff’ are exposed to the various challenges inherent in patient care. This study focuses on exploring the effectiveness of Rounds in improving well-being of staff
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