Schwartz Center rounds offer emotional outlet

Focus is on compassionate care

The focus of The Schwartz Center for Compassionate Healthcare's programming is something called The Schwartz Center Rounds, which would have a familiar ring to most clinicians.

"The mission of our organization is to strengthen the patient/caregiver relationship and to help educate and support clinicians to provide compassionate health care, to provide support and hope to patients, and sustenance to the healing process," Executive Director Julie Rosen tells Medical Ethics Advisor. "But 90% of what we focus on is training, educating, supporting clinicians."

Rosen describes the rounds, which are primarily for hospitals, as a "multidisciplinary forum where approximately once a month . . . a multidisciplinary group of clinicians get together to talk about the tough psychosocial issues they face in caring for patients."

Currently, the rounds are in 32 states, in 210 hospitals, reaching about 60,000 clinicians a year. While primarily for hospital staff, The Schwartz Center is also conducting rounds programming in "some outpatient settings, nursing homes, and managed care organizations," Rosen says.

Clinicians who want to launch this program at their individual institutions must first get buy-in from the executive leadership, and a contract is drawn up for the facility. Then, the clinicians who have elected to initiate the program must first travel and observe The Schwartz Center Rounds programming, "usually at a Boston hospital or a New York hospital," Rosen says.

Rounds 'all have a theme'

Once the rounds get under way at an institution, an outside facilitator leads or moderates them. A planning committee at that institution will determine an actual case within that institution to serve as the topic for that particular rounds session, Rosen says.

"[The rounds] all have a theme about . . . the struggles that caregivers face in their daily interactions with patients, and the families' struggles . . . ," Rosen explains. "So, the theme could be: 'How do I take care of my fellow colleague who is dying, and what kinds of issues does that bring up for me? How do I take care of the difficult patient that is from a different culture? How do I show empathy and sympathy towards an incarcerated patient?'"

Following a presentation by a multidisciplinary group about an actual case at that institution, and the session is "professionally facilitated, there's a discussion where clinicians share their thoughts, feelings, experiences about similar cases," she says.

Not your typical rounds

Beth A. Lown, MD, who is medical director at The Schwartz Center, suggests that The Schwartz Center Rounds are "not like any other rounds in a hospital."

"[With] grand rounds, you come in; you sit down; it's a lecture; and people present technical material and data . . . so these are only rounds in name, but not in spirit," Lown explains, adding that The Schwartz Center Rounds are a "place for anybody who touches the care of a patient in a hospital or other setting where we have the rounds can come together and talk about some of the psychosocial, the emotional, the psychological aspects of care of patients and their impact on patients, on family members, and particularly on us — the people" who provide that care.

The Schwartz Center Rounds may be the "only place that happens; people don't get together in this way" ordinarily, Lown says.

"You rush through the day; you try to do your best and take care of all the emergencies that comes your way; and all of these other things that happen to patients have to get stuffed away somewhere, so that you can continue to function and carry on the things you need to do," she says. "But we need places to come together like this to sort of share what these experiences have been like, so that we can hear what it's like from the perspectives of our colleagues."

Sources

  • Beth A. Lown, MD, Medical Director, The Schwartz Center for Compassionate Healthcare at Massachusetts General, Boston. E-mail: balown@partners.org.
  • Julie A. Rosen, Executive Director, The Schwartz Center for Compassionate Healthcare at Massachusetts General, Boston. E-mail: jarosen@partners.org.