HR Pulse - Spring 2008 - (Page 19) where something went wrong medically or ethically. The sessions facilitated by the Schwartz Center are very different. “Schwartz Center Rounds are not about any of that,” says Michael Fisch, MD, medical director of the Community Clinical Oncology Program at M.D. Anderson Cancer Center in Houston, which has been ranked by U.S. News and World Report as the top hospital in the nation for cancer care five times in the past eight years. “They’re about mindfulness and trying to understand ourselves better. It’s about being awake to our blind spots, and that’s not easy for anyone, especially those of us in medicine. These sessions normalize the whole idea of noticing your own emotions.” Fisch directs the Rounds program at MD Anderson and helps facilitate sessions. The unique Schwartz Center Rounds forum is designed to improve relationships and increase understanding between patients and clinical caregivers by: • Exploring the human dimension of health care • Enhancing communication among caregivers • Promoting teamwork among caregivers • Providing support to caregivers • Giving caregivers knowledge and insight into the non-clinical aspects of patient care. Schwartz Center Rounds are usually held once a month or every other month, with sessions lasting for one hour. The format begins with a 10- to 15-minute presentation by two or three clinicians from different disciplines that provides a confidential clinical history of a specific patient, including relevant information about the family situation, patient’s attitude, and special circumstances. Each panelist discusses the case from his or her perspective in the context of the specific topic chosen for that session. During the remainder of the hour, anyone in the audience can ask questions and exchange related experiences, thoughts, and feelings. A professional facilitator provided by the Schwartz Center leads the discussion and summarizes key points at the end. The sessions often take place early in the morning or at noon and include a healthy meal, which not only serves as an incentive for busy caregivers to attend but also as a way to nurture them. The Schwartz Center covers the cost of the meals. “We’re trying to enhance communication among team members by breaking down barriers and giving caregivers the chance to feel supported by their colleagues,” says Marjorie Stanzler, director of programs at the Schwartz Center and Ken Schwartz’s sister-in-law. “The Rounds put everyone on an equal playing field and demonstrate that everyone struggles with the same kinds of issues.” Stanzler says that the Rounds can go a long way to improving morale and lead to new insights and ideas in how to handle a wide variety of patient situations. She also believes that the forum helps promote multidisciplinary cohesion and decreases stress levels for caregivers. Third-party survey data supports her assertions. (See “Meaningful Results From Rounds” on page 20) “This is a novel program that allows care providers to discuss the human side of what we do every day,” explains Jon DuBois, MD, who helped implement the Schwartz Center Rounds eight years ago at Emerson Hospital, a 130-bed community hospital in Concord, Mass. Emerson was the third hospital in the country to offer the Rounds to its caregivers. A Non-Clinical Focus The Rounds provide a scheduled time and place where caregivers focus on the social, emotional, and personal issues in providing patient care. The Schwartz Center has a sample topic list that includes more than 50 themes, all of which are non-clinical. Here are just a few: • How to tell a patient it may be time to stop treatment • When your own issues of mortality come into play • Caring for a colleague • When cultural and religious beliefs interfere with your ability to communicate • Are we connecting with our patients, or are we too busy? • Delivering bad news • Children dealing with the death of a parent • Losing faith in God: dealing with spiritual crises with patients • Medical mistakes • Dealing with unexpected loss • Maintaining boundaries when the patient is your friend • Putting compassion to the test: what to do when you do not want to walk into the room. “The sessions really do stir up a lot of emotions, good and bad,” says Ann Snow, a unit nurse leader in radiation oncology at Emerson Hospital. “They’re things you can relate to because you’ve experienced them yourself. It could be something you wish you’d done differently or a case that particularly wore you down. Hearing other people’s experiences reminds you that we’ve all been there.” Snow attends Rounds regularly, has shared her own experiences out loud, and finds it very cathartic, but she says some people attend on a regular basis and never speak. “You don’t ever have to talk. I know some people who have been coming for years and have never said a word. Just listening helps them.” DuBois echoes Snow’s appreciation of the opportunity to address emotional issues. “It’s amazing to see people walk out of sessions with the sense of ‘Gee, I’m not the only one 19 HR Pulse Spring 2008 >>
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