Title: A Longitudinal National Evaluation of Schwartz Centre Rounds®: an intervention to enhance compassion in relationships between staff and patients through providing support for staff and promoting their wellbeing
Funder: Department of Health (England)

Abstract: BACKGROUND:Rounds are recommended as an organisational intervention to enhance the quality of patient care by providing emotional support to staff through reflection and facilitated group discussion. Initiated by the ‘Schwartz Center for Compassionate Care(Schwartz Center) in Boston USA they were brought to the UK by the Point of Care Programme in 2009. To date evidence of benefit has relied upon relatively weak design and small scale evaluations. Due to the rapid uptake and growing interest in Rounds UK research is now needed to determine what mechanisms affect their uptake and successful implementation at the organisational level as well as determine their impact on individual staff wellbeing and the culture of teams and the wider organisation.AIMS:1)To investigate contexts in which/mechanisms whereby Rounds influence staff wellbeing at work and social support; 2)To identify and evaluate any changes in relationships between staff who attend Rounds and their patients/colleagues. 3)To identify/consider any wider changes in teams/the wider organisation in relation to the quality of patient care and staff experience and to suggest whether/how these may be linked.RESEARCH QUESTION: To what extent is participation in Rounds associated with enhanced staff wellbeing at work social support for staff and improved relationships between staff and patients including compassion and empathy? METHODS AND ANALYSIS Longitudinal evaluation of Rounds using mixed methods underpinned by realist evaluation to determine what works for whom in what circumstances in terms of the impact of Rounds on staff well-being and staff capacity to deliver patient-care compassionately.PHASE 1: Scoping review of the literature; Rounds Provider Mapping & costs: profile of all UK Rounds provider organisations and reasons for adoption (interviews with key Rounds champions).PHASE 2: Ten organisational case studies (sampled for maximum variation and to include new providers)2a) Longitudinal survey (baseline/8 months)to 800 attenders and 2500 controls to measure changes in staff work wellbeing social support and relationships with staff and patients.PHASE 2b)Ethnographic field work: including observation and interviews with Rounds facilitators; presenter teams in Rounds and in practice; attenders non-attenders and stakeholders. Synthesis of findings from Phases 1&2 to produce recommendations.OUTPUTS1. A review of evidence base to determine mechanisms by which Rounds may ‘work’2. Descriptive profiles of current provider organisations including reasons for adoption and associated costs.3. Relationship of Rounds attendance to self-reported changes in staff wellbeing social support and behaviour towards patients and colleagues4. In-depth understanding of the process of Rounds and the mechanisms and contexts in which they may (or may not) be (i) effective for staff and (ii) impact on patient care5. An understanding of any wider changes in teams or across the wider organisation in terms of quality of patient care and staff experience.Few interventions exist to support staff with the emotional aspects of providing patient care and to sustain compassion in practice and even fewer have been evaluated. This robust evaluation will provide evidence for the NHS/other providers regarding the potential effectiveness of Rounds as an intervention to support staff and has the potential to affect patient care quality and practice.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE