New resources to support implementation and sustainability of Schwartz Rounds

Following the first national evaluation of Schwartz Rounds (Rounds) in the UK, a new organisational guide and film has been developed to help those running (or planning to run) Rounds, implement the research findings.

Designed by researchers from the University of Surrey, University of Sheffield, King’s College London and The King’s Fund and funded by the National Institute for Health Research (NIHR), these new tools will improve awareness and understanding of Rounds and support their sustainability, development and evaluation in practice.

Rounds are monthly forums that offer a safe space for healthcare staff to share experiences with colleagues and to discuss the highs and lows of healthcare work and some of the challenges they face in their work. Regular attendance has been shown to cut rates of stress in the workplace by at least half- from 25 per cent to 12 per cent.

Researchers found sustaining Rounds over time was a challenge with responsibility for planning and running Rounds often falling on the shoulders of one facilitator.  To overcome this the research team recommends training more facilitators in each site, rotating steering group membership and having administrative support as ways to share the workload. Research findings indicated that facilitators and clinical leads would benefit from more psychological support to prevent burn out due to their exposure (through hearing others’ stories) to experiences of trauma, loss and risk, and the caregiving role they often undertake towards those sharing their stories.

Recommendations are also made to overcome practical difficulties healthcare staff face in attending the forums. These include improving awareness and understanding of what Schwartz Rounds are in organisations, as well as innovations such as ‘Pop-Up’ Rounds, which have been used successfully in some sites to increase the reach of Rounds.

When facilitators or clinical leads’ time is limited, to avoid cancelling, experts suggest showing a film in the Round to promote discussions or alternatively the use of video conferencing (panellist and audiences may be at different Round venues).

Jill Maben, Professor of Nursing at the University of Surrey, who led the research whilst in the Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care at King’s College London, said:

“These forums are a proven way to reduce psychological distress amongst health care workers, but their sustainability requires organisational commitment demonstrated by ensuring adequate resources, support and recognition of their value to workforce wellbeing, and thereby to patient care, at Board level.” 

Dr Jocelyn Cornwell, Chief Executive of The Point of Care Foundation, the organisation responsible for licensing Schwartz Rounds in the UK and Ireland, wrote a foreword for the new organisational guide. She wrote:

“I commend the guide and endorse the recommendations. It answers questions we know people want answered: Why should we do Rounds? What do we need to do to make them work here, in this organisation? And once they are up and running – How do we sustain them?”

Sir Robert Francis QC writes in his foreword to the guide that:

“Professor Maben and her colleagues have produced a valuable and independent insight into the ingredients required for successful Schwartz Rounds in practical and easily understood guidance. This illuminating work should be read not just by those responsible for organising Rounds but also by those who commission them or who are thinking of doing so”.

The team’s film on Schwartz Rounds can be found here  

For more information on introducing Schwartz Rounds visit www.pointofcarefoundation.org.uk

The National Institute for Health Research

The National Institute for Health Research (NIHR): improving the health and wealth of the nation through research.

Established by the Department of Health, the NIHR:

• funds high quality research to improve health
• trains and supports health researchers
• provides world-class research facilities
• works with the life sciences industry and charities to benefit all
• involves patients and the public at every step

For further information, visit the NIHR website www.nihr.ac.uk