Healthcare staff who regularly share the emotional, social or ethical challenges they face in the workplace experience less psychological distress, improved teamwork and increased empathy and compassion for patients and colleagues, a new study commissioned by the National Institute for Health Research reports.
In the first in-depth study in the UK, researchers from the University Sheffield, the University of Surrey, Kings College London, and The King’s Fund examined the impact of Schwartz Center Rounds® (Rounds), on both clinical and non-clinical staff. Rounds are monthly forums that offer a space for staff to share experiences with colleagues and to discuss the challenges they face in their work and its impact on them.
The psychological wellbeing of 500 staff members who attended Rounds regularly, irregularly or not all, was measured over an eight-month period, using the clinically validated GHQ-12 questionnaire.
Researchers found that the wellbeing of staff who attended Rounds regularly significantly improved, with the proportion of those with psychological distress halving – down from 25 per cent to 12 per cent. There was little change in the psychological wellbeing of staff that did not attend Rounds over this period.
When asked of the benefits of Rounds, participants noted that attending led to greater understanding, empathy and tolerance towards colleagues and patients and positive changes in practice.
Following the publication of the Francis report which highlighted Schwartz Rounds as being a way of fostering good teamwork and improving morale amongst staff, the implementation of Rounds in the UK rapidly increased. The research found that Rounds were implemented variably and challenges to implementation and sustainability included ward staff attendance, and the workload and resources required for planning and running Rounds.
Professor Jeremy Dawson, Professor of Health Management from the Institute of Work Psychology at the Management School, said: “Schwartz Center Rounds provide an innovative forum for healthcare staff to discuss the difficult emotional, social and ethical challenges they face at work.
“Now used in over 160 healthcare organisations in the UK, they allow a safe setting to explore issues relating to compassion, empathy and strain, which can be difficult to talk about otherwise. However, in the 14 organisations we examined in this study, we saw that they need to be carefully planned and facilitated for them to be the most effective.”
He added: “The results can be very powerful, though. Our research team at Sheffield University Management School conducted a longitudinal survey in ten organisations, comparing staff who started attending Rounds with those who did not attend. We found that the proportion of staff with high levels of stress more than halved over an eight-month period for those who attended Rounds, compared with almost no change for those not attending Rounds.”
Jill Maben, Professor of Nursing at the University of Surrey and formerly of Kings College London, said: “Delivering care to patients at some of the most challenging times in their lives has an emotional impact on staff, which undoubtedly impacts on their own wellbeing and on their work.
“Our study is the first in the UK to demonstrate that those who regularly attend Rounds see significant benefits; their symptoms of anxiety and depression are reduced, they are better able to cope with the issues they face and have more empathy towards patients and colleagues, which undeniably has a positive impact on those in their care.
“Given these impacts it is good to see Rounds running in over 160 organisations in the UK, particularly in light of the Francis report, which called for more compassionate patient care. The challenge is for organisations to continue to invest in Rounds in resource-constrained environments.”
Dr Cath Taylor, Reader at the University of Surrey and formerly of King College London, said: “NHS and hospice staff are the unsung heroes of our society, but the physical and emotional demands placed on them often go unnoticed, leading to high rates of burn out and people often leaving the profession. Rounds are a unique organisational wide intervention that we found benefitted many attendees”.
Jocelyn Cornwell, Chief Executive of The Point of Care Foundation (which holds the licence to promote and support Schwartz Rounds in the UK and Ireland) said: “We are delighted that this research shows that Schwartz Rounds have significant positive impacts on the well-being and experience of the staff who take part in them. The Rounds offer a unique space for all staff in organisations to come together as equals, to share experience and listen to one another.
“In environments in which staff are under tremendous pressure, the Rounds offer a much–needed space for reflection and renewal. We hope that organisations that are not doing Rounds will pay attention to the research findings, and organisations that are doing them, will re-double their efforts to sustain them.”