Background Schwartz Center Rounds® (SCR) are facilitated, experiential, reflective opportunities in the workplace focusing on the ‘human dimension’ of care. Originating in America, and introduced to UK hospices and Trusts from 2009, uptake rose after the 2013 Francis Report. UK SCR focus on staff wellbeing, rather than fostering compassion. Repeated attendance enables recognition of organisational dysfunction rather than blaming the individual, with reduced self-criticism. Beneficial team and personal outcomes are reported which may address, not only patient care, but also stress, burnout and clinician suicide. Feedback, focus groups and staff surveys have been reported, but no account of SCR content, which is pertinent to their mode of efficacy.
Method Evaluation of Trust SCR content. Twenty rounds of quantitative feedback analysed using Chi-squared; 23 SCR facilitator notes analysed by Interpretative Phenomenological Analysis. Consent to share learning but not to attribute content is taken.
Results 55% attendees doctors; 8% nurses; 8% Professions Allied to Medicine; 4% other; 25% undeclared. 71% of attendees fed back. 69% rated SCR excellent or exceptional. ‘Staff developing insight into how others think and feel’ rated higher than ‘knowledge for patient care’. Superordinate themes: Alone and fearful; Chaos and tumult; Psychological defences; Failure and loss; Recognising humanity; Responsibility and courage; and Encouragement. 39 comments in 18/23 SCR related to death and dying. Themes: Positive fulfilment; Uncertainty and self-doubt; Frustration and futility; Guilt and regret; Facing own mortality.
Discussion SCR content reveals personal psychological coping mechanisms, empathy for patients and families, as well as the moral burden of caring for the dying and their families.
Conclusion SCR rate highly. Ward-based staff attend less. Experience is addressed more than process. SCR content demonstrated staff sharing trauma, challenge, coping, telling of courage, encouraging teamwork; and the experience of caring for the dying. Staff support mechanisms remain a priority.
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