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New guide on implementing and sustaining Schwartz rounds

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A new organisational guide and film has been developed to help nurses running or planning to run Schwartz rounds, based on findings from the first national evaluation of the initiative in the UK.

Schwartz rounds are monthly forums offering a space for healthcare staff to share experiences with colleagues and to discuss the highs and lows of their work and some of the challenges they face.

“Their sustainability requires organisational commitment demonstrated by ensuring adequate resources”

Jill Maben

Regular attendance has been shown to cut stress levels in the workplace by at least half, down from 25% to 12%, according to the Point of Care Foundation, which licenses the programme in the UK.

The foundation said that the new tools were intended to improve awareness and understanding of Schwartz rounds and support their “sustainability, development and evaluation in practice”.

They have been designed by researchers from the University of Surrey, University of Sheffield, King’s College London and the King’s Fund, with funding from the National Institute for Health Research.

As reported in October, the same group of organisations recently carried out the first in-depth study in the UK on the impact of Schwartz rounds for both clinical and non-clinical staff.

Researchers found sustaining the rounds over time was a challenge, with responsibility for planning and running them often falling on the shoulders of one facilitator.

To overcome this problem, they recommended training more facilitators in each site, rotating steering group membership and having administrative support as ways to share the workload.

Their findings also indicated that facilitators and clinical leads would benefit from more psychological support to prevent burn out due to regularly hearing about trauma and loss, and the caregiving role they often undertook towards those sharing their stories.

cropped maben jill

cropped maben jill

Jill Maben

In addition, recommendations were made to help healthcare staff overcome practical difficulties they faced in attending the forums.

These include improving awareness of Schwartz rounds in their organisations, as well as innovations such as “pop-up” rounds, which have been used successfully in some sites to increase the reach.

Meanwhile, to avoid cancelling when facilitators or clinical leads’ time was limited, experts suggested showing a film in the round to promote discussions or alternatively using video conferencing.

Professor Jill Maben, from Surrey University of Surrey, said: “These forums are a proven way to reduce psychological distress amongst healthcare 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,” she noted.

In a foreword for the new organisational guide, Point of Care Foundation chief executive Dr Jocelyn Cornwell said: “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?”

Robert Francis

Robert Francis

Robert Francis

Sir Robert Francis, author of two seminal reports on the NHS, including whistleblowing and the care scandal at Mid Staffordshire NHS Foundation Trust, has also written foreword supporting the guide.

He said the researchers had 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,” he added.



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