About Schwartz Rounds

What is a Schwartz Round?

Schwartz Rounds provide 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.

The underlying premise for Rounds is that the 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.

Find an information pack here.

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In this video Chief Executive Suzanne Rankin discusses reasons for bringing Schwartz Rounds into her organisation:

Origins of Schwartz Rounds

In 1994 a health attorney called Ken Schwartz was diagnosed with terminal lung cancer. During his treatment, he found that what mattered to him most as a patient were the simple acts of kindness from his caregivers, which he said made “the unbearable bearable.”

Before his death, he left a legacy for the establishment of the Schwartz Center in Boston, to help to foster compassion in healthcare.

I have learned that medicine is not merely about performing tests or surgeries, or administering drugs… For as skilled and knowledgeable as my caregivers are, what matters most is that they have empathized with me in a way that gives me hope and makes me feel like a human being, not just an illness.”

Boston Globe article

In 2009, Schwartz Rounds were brought to the UK by the Point of Care programme at The King’s Fund and continue to be implemented by The Point of Care Foundation.

Format of Rounds

Rounds follow a standard model to ensure that they are replicable across settings.

Rounds normally take place once a month for an hour at a time with catering provided before the Round.

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

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; 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.

Who is running Rounds?

Schwartz Rounds began in relatively large organisations providing acute care, but have now been introduced in a range of different clinical settings in the UK including:

community and mental health trusts
hospices
primary care
educational settings.

To see a full list of organisations who are running Rounds see this interactive map