Can Schwartz Center Rounds support healthcare staff with emotional challenges at work, and how do they compare with other interventions aimed at providing similar support? A systematic review and scoping reviews

Abstract

Objectives(i) To synthesise the evidence-base for Schwartz Center Rounds (Rounds) to assess any impact on healthcare staff and identify key features; (ii) to scope evidence for interventions with similar aims, and compare effectiveness and key features to Rounds.DesignSystematic review of Rounds literature; scoping reviews of comparator interventions (action learning sets; after action reviews; Balint groups; caregiver support programme; clinical supervision; critical incident stress debriefing; mindfulness-based stress reduction; peer-supported storytelling; psychosocial intervention training; reflective practice groups; resilience training).Data sourcesPsychINFO, CINAHL, MEDLINE and EMBASE, internet search engines; consultation with experts.Eligibility criteriaEmpirical evaluations (qualitative or quantitative); any healthcare staff in any healthcare setting; published in English.ResultsThe overall evidence base for Rounds is limited. We developed a composite definition to aid comparison with other interventions from 41 documents containing a definition of Rounds. Twelve (10 studies) were empirical evaluations. All were of low/moderate quality (weak study designs including lack of control groups). Findings showed the value of Rounds to attenders, with a self-reported positive impact on individuals, their relationships with colleagues and patients and wider cultural changes. The evidence for the comparative interventions was scant and also low/moderate quality. Some features of Rounds were shared by other interventions, but Rounds offer unique features including being open to all staff and having no expectation for verbal contribution by attenders.ConclusionsEvidence of effectiveness for all interventions considered here remains limited. Methods that enable identification of core features related to effectiveness are needed to optimise benefit for individual staff members and organisations as a whole. A systems approach conceptualising workplace well-being arising from both individual and environmental/structural factors, and comprising interventions both for assessing and improving the well-being of healthcare staff, is required. Schwartz Rounds could be considered as one strategy to enhance staff well-being.

Burnout in consultants in child and adolescent mental health services (CAMHS) in Ireland: a cross-sectional study

“…Individually targeted approaches, such as personal engagement in mindfulness, small group discussions and stress reduction programme, have also been identified as being effective 43. Attendance at Schwartz rounds has been associated with a statistically significant improvement in well-being and resulted in positive changes in clinician practice,49 50 and is currently being rolled out in Ireland 51. Balint groups, regular facilitated meetings with physicians, have long been known to improve physician well-being and protect against BO 52.…”

When patients die: patient memorials and group reflection in an internal medicine residency program

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Adapting IAPT services to support frontline NHS staff during the Covid-19 pandemic: the Homerton Covid Psychological Support (HCPS) pathway

“…This includes Schwartz Rounds: an open yet facilitated forum for staff of all clinical and nonclinical roles to reflect on the emotional impact of their work. These have been shown to have positive benefits for the individuals that take part but also for the wider organsiation and its patients (Flanagan et al, 2019;Taylor et al, 2018). Peer support groups have also been beneficial for the psychological and emotional wellbeing of nurses and doctors alike (Gerada, 2016;Jackson, 2018).…”