Schwartz Rounds

What is a Schwartz Round?

• They 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 explore the challenges and rewards that are intrinsic to providing care, not to solve problems or to focus on the clinical aspects of patient care.

• Rounds can help staff feel more supported in their jobs, allowing them the time and space to reflect on their roles.

• Evidence shows that staff who attend Rounds feel less stressed and isolated, with increased insight and appreciation for each other’s roles. They also help to reduce hierarchies between staff and to focus attention on relational aspects of care.

Compassion shown by staff can make all the difference to a patient’s experience of care,

but that in order to provide compassionate care staff must, in turn, feel supported in their work.

Format of Rounds at LUHFT 

• Rounds will follow a standard model to ensure that they are replicable across all of our sites.

• We will have them monthly for an hour at a time and refreshments will be available

• Once the Round starts, a panel, comprised of three staff, share their experiences for the first 15-20 minutes. On each panel, there should ideally be a mix of clinical and non-clinical staff with different levels of seniority.

• A Round can either be based on different accounts of a case, or can explore a particular theme such as ‘when things go wrong’ or ‘a patient I’ll never forget’.

• Experiences are shared from the perspective of the panel member – not the patient – and the emphasis is on the emotional impact

• The remainder of the hour features trained facilitators leading an open discussion.
  • They do this by asking participants to share their thoughts and reflections on the stories.
  • The key skill is for the facilitators to steer the discussion in such a way that it remains reflective and does not become a space to solve problems.
  • The facilitators will remind participants that Rounds are a confidential space, in which patient and staff identities are protected.

Differences between Schwartz Rounds and other staff forums

Schwartz Rounds provide the only forum for staff at all levels across an organisation to come together.

Traditional staff forums	Schwartz Rounds
Grand Rounds: aim to help medical staff learn about recent developments in medicine and focus on the clinical details of a case.	Schwartz Rounds: do not focus on the clinical aspects of patient care;  instead learning is focused on understanding staff  experience from a social and emotional point of view.
Balint groups: follow a similar format to Rounds in terms of their reflective nature and focus on emotional impact, but they are only open to certain members of clinical staff.	Schwartz Rounds: are open to all staff members including non-clinical staff. Three or four stories are told at each Round, which are used as a springboard for a wider discussion beyond the case itself.
Supervision: involves expertise and advice; is generally aimed at a specific staff group or 1:1 and focuses on technical aspects of care, clinical outcomes or personal development, unlike Rounds.	Schwartz Rounds: are not designed as a form of peer supervision and do not fit the traditional model of clinical supervision.
Debriefings: are usually structured meetings that aim to help staff following stressful or traumatic clinical events, through education, normalising and support.	Schwartz Rounds: should not be used as a form of debriefing. If there is a case that has been particularly troubling for staff and the organisation, a certain amount of time will need to pass before it is addressed in a Round.

Benefits of Schwartz Rounds 

Links between patient and staff experience are increasingly clearly articulated.Evidence suggests that if staff are positive about the care they are offering and feel that they are supported in providing that care, this is beneficial for them, the patients, and the organisation as a whole; staff wellbeing is the antecedent to patients’ wellbeing

Enhanced Psychological Well-being: Schwartz Rounds provide a supportive environment for healthcare staff to share their experiences, challenges, and emotions. This can contribute to reduced feelings of isolation and stress, fostering a sense of community and support among colleagues. This reflective practice fosters a growth mindset, which is associated with increased job satisfaction and well-being. By discussing coping strategies and resilience during Schwartz Rounds, healthcare staff can gain insights into effective ways to manage stress and challenging situations. Discussing challenging cases and emotional experiences during Schwartz Rounds allows individuals to process and express their emotions in a safe and confidential environment. This emotional processing can contribute to a reduction in stress and an improvement in overall mental well-being.

Improved Team Communication: Regular participation in Schwartz Rounds encourages open communication and collaboration among staff members. This can enhance teamwork, facilitate better understanding of diverse perspectives, and improve patient care. Discussing the personal impact of working in healthcare reduces the sense of hierarchy that exists between staff. Seeing beyond the professional identity of colleagues allows staff to feel more connected to one another.

Increased Empathy: By sharing personal stories and experiences, healthcare staff develop a deeper understanding of the emotional impact of their work. This can lead to increased empathy, which is crucial for providing compassionate and patient-centered care. Participation in Rounds also helps to provide staff with greater insight into how all colleagues, regardless of role, play a vital part in the patient journey.

Professional Development: Schwartz Rounds provide opportunities for personal and professional growth. Reflecting on challenging cases and learning from others' experiences can contribute to ongoing education and development for healthcare professionals. Stories shared in Schwartz Rounds have the ability to empower staff and their organisations.

Reduced Burnout: Listening to colleagues describe the challenges of their work helps to normalise emotions, which are part and parcel of working in healthcare but are often kept under the surface. The emotional demands of healthcare work can contribute to burnout and Schwartz Rounds provide a platform for healthcare professionals to address and cope with stress, potentially reducing burnout and its associated negative effects on job satisfaction and retention.

Enhanced Patient Care: 85% of staff who participate in Schwartz Rounds feel better able to care for patients.Schwartz Rounds give staff confidence in their ability to attend to the emotional aspects of patient care and through increased empathy, improved communication, and a supportive team environment, healthcare staff may be better equipped to provide high-quality, patient-centered care.

Promotion of a Learning Culture: Schwartz Rounds foster a culture of continuous learning and improvement. The focus on reflection and sharing experiences encourages a commitment to ongoing professional development and quality improvement within healthcare teams.

Confidentiality and Safety: Schwartz Rounds are designed to be confidential, creating a safe space for healthcare professionals to discuss their experiences without fear of judgment. This confidentiality fosters trust and openness among participants.

Staff Resilience: Participating in Schwartz Rounds can contribute to the development of resilience among healthcare professionals. Discussing and processing challenging experiences in a supportive environment can help individuals cope more effectively with stress and adversity.

Organizational Culture Improvement:It is essential that organisations support their staff in order to create a strong, open culture where high quality and compassionate care can flourish. Implementation of Schwartz Rounds can positively impact the overall organisational culture by promoting emotional well-being, teamwork, and a commitment to continuous improvement. Staff can reconnect with their values and reaffirm their motivation to work in healthcare. Over time, providing this reflective space can have an impact on the organisation more broadly.  For example, staff often disclose experiences of fallibility and mistakes, which if carried into everyday practice can foster an open and transparent culture. 

How will I find out about Schwartz Rounds?

We will promote the Rounds through Liverpool news and all communication channels, they will be on the wellbeing timetable each month and promoted through the Wellbeing Champions and through the various staff networks.

Details about attending a Round or speaking as a panel member will be on the posters/ communications and you will be supported to attend and support by the team. 

Find out more about Schwartz Rounds here: Point of Care