Are Schwartz Rounds the answer to workforce burnout?

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Schwartz round

Schwartz Rounds® (“Rounds”) are becoming increasingly popular, with almost half of all NHS Trusts currently providing them. Rounds are voluntary forums where clinical and non-clinical staff can discuss and reflect on the emotional and ethical challenges (or rewards) that result from working in healthcare in a safe and confidential space. A panel of several multidisciplinary members relate their experiences on a specific theme or patient experience, and the floor is then opened to all attendees for discussion and reflection. Rounds last approximately 1 hour and catering is provided. The NIHR recently funded a report on Schwartz Rounds® by Maben et al. (2018) to assess their potential effectiveness in improving staff wellbeing and engagement in healthcare settings across England.

Comparing NHS Survey data on Rounds providers against non-providers, those organisations that had adopted Rounds showed improved measures of staff engagement (in 2013 – not 2014 or 2015); however, no difference was seen in ratings of patient experience scores. Many Rounds champions felt maintaining attendance was vital yet challenging and groups such as clinical ward-based staff were under-represented across Trusts due to competing work demands. However, Rounds provider organisations reported overwhelmingly positive verbal feedback from attendees, describing Rounds as interesting, engaging and supportive. Rounds attendance did not appear to have an impact on work engagement, absence levels, self-reflection, empathy, and other such attitudes. However, regular Rounds attenders saw a significant decrease (25% to 12%) compared with non-attenders (37% to 34%) on a measure of psychological distress, namely the General Health Questionnaire (GHQ-12). According to the report, attendance at a single Round decreased the probability of being considered distressed by 43%. Through realist evaluation, the report showed that successful Rounds work by providing a trusting, safe environment for interaction amongst a diverse group of staff, who can share their stories and experiences, are able to show vulnerability, and highlight those hidden roles and responsibilities that are less visible in the organisation. This leads to an understanding of the context of staff and patient behaviour, decreases isolation, enhances teamwork and improves compassion and empathy. Follow this link for the full paper:

A realist informed mixed-methods evaluation of Swartz Centre Rounds in England. Health Services and Delivery Research.

What do you think? Should all organisations be providing Schwartz® Rounds? 

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