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Schwartz Rounds: A tale of two hospices

24 August 2017

The hospices of St Catherine’s in Crawley and Saint Francis in Havering-atte-Bower, Essex, share their experiences of Schwartz Rounds, a forum for staff to meet and talk through the emotional impact of their work.

Schwartz Rounds are a structured forum where all staff, clinical and non-clinical, come together regularly to discuss the emotional and social aspects of working in healthcare. 

The purpose of Rounds is to understand the challenges and rewards that are intrinsic to providing care, not to solve problems; they help staff feel more supported in their job. 85 per cent of staff said they help them care better for patients, whilst 90 per cent said they help them work better with colleagues.

Twice a year The Point of Care Foundation invites applications from hospices to be part of the Schwartz small cohort. Below, two hospices share their experiences of Schwartz Rounds.

St Catherine's Hospice

At St Catherine's Hospice, we signed up to run Schwartz Rounds in October 2015 and have never looked back! We are acutely aware of the emotional impact of working in palliative care and we continually seek ways to support our employees. We hoped Schwartz Rounds would help staff build resilience through sharing their experiences and build confidence in handling sensitive issues. We also hoped the Rounds would reinforce cross organisational working and help staff benefit from peer to peer support by better understanding the impact of each other's work.

Extensive training was undertaken prior to the launch of our Rounds by three members of staff who were taking on facilitator roles. "I made a difference when...." was one of our most powerful Rounds to date. Three stories were shared: one explained how a brooch had caught the eye of a patient who had been particularly hard to connect with, whilst another reflected on an evening walk that took place during a difficult time for one hospice team. The emotional Round allowed others to share their feelings in a safe, supportive environment.

Since attending Schwartz Rounds, the opinions of some staff have changed. As one panellist member admitted, "If I am honest, I was not a fan of the concept. I thought Rounds were just another excuse for tea and cake. However, since being a panellist my view has totally changed." Another colleague commented, "Before attending I thought most stories would be patient-focused, so it has been surprising to hear non-patient stories prompting discussion. It is nice to take time to reflect on what we do and the people we work with."

We now invite all our staff members to attend Schwartz Rounds during their induction and, as we hoped, our Rounds have enhanced cross organisational working within our hospice. There is now much greater understanding between staff, who also now feel listened to and supported. This helps them provide compassionate end-of-life care and benefits the people for whom we care.

"Schwartz Rounds really help to break down barriers and recognise the importance of others."

Saint Francis hospice

We hoped that the introduction of Schwartz Rounds to Saint Francis Hospice would help show our staff how valued they are, how their stories and experiences matter, and how sharing these would foster trust, develop mutual understanding, and strengthen relationships.

Our initial group of facilitators received face to face training from The Point of Care Foundation and the feedback was very good. More recently we invested in two new facilitators, a testament to how pleased we are with the impact of the Rounds.

We have had 12 Schwartz Rounds so far, with 40 different panellists from across our hospice teams. Our topics have been broad and varied, and feedback from the participants has been overwhelmingly positive.  Our average attendance is 35 people and it is not just the same familiar faces; we see new faces at each Round.

One Round that stands out as particularly powerful focused on the story of one person and their family who had accessed a number of hospice services. We had six panellists, including a child and family therapist, a nurse, a doctor, and a clinical nurse specialist. The range of emotional responses from each panellist was huge, and it was evident this case made a big impact on each of them for very different reasons.

The Round showed everyone how so many teams worked across the different departments for the common goal of providing care. It highlighted the journey through the different aspects of hospice care, and demonstrated how connected and integrated we are in each other’s work.

We believe our success comes not only from the Rounds themselves but also from a steering group member who is particularly adept at identifying panellists from teams that we may not have had on the panel before. The role of the communications team is crucial in letting staff know about the upcoming round, the topic, and of course the cakes and treats on offer. We have found this to be a very effective marketing tool!

Each Round has been wonderfully different; we have had lots of tears and lots of laughter.  The honesty and, on occasion, vulnerability shown by panellists have been met with support and admiration.

Our hopes when starting the Rounds have been realised. The comments from the evaluation forms have shown strong evidence of increased respect and awareness for all staff roles: “the Round was very moving, it made me reflect on how I treat my colleagues and my relationships with them.”

To join Schwartz Rounds and be part of the next cohort, visit The Point of Care Foundation

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