An Agenda For Improving Compassionate Care: A Survey Shows About Half Of Patients Say Such Care Is Missing

Schwartz Center for Compassionate Healthcare, Boston, Massachusetts, USA.
Health Affairs (Impact Factor: 4.97). 09/2011; 30(9):1772-8. DOI: 10.1377/hlthaff.2011.0539
Source: PubMed


As the US health care system undergoes restructuring and pressure to reduce costs intensifies, patients worry that they will receive less compassionate care. So do health care providers. Our survey of 800 recently hospitalized patients and 510 physicians found broad agreement that compassionate care is "very important" to successful medical treatment. However, only 53 percent of patients and 58 percent of physicians said that the health care system generally provides compassionate care. Given strong evidence that such care improves health outcomes and patients' care experiences, we recommend that national quality standards include measures of compassionate care; that such care be a priority for comparative effectiveness research to determine which aspects have the most influence on patients' care experiences, health outcomes, and perceptions of health-related quality of life; and that payers reward the provision of such care. We also recommend the development of systematic approaches to help health care professionals improve the skills required for compassionate care.

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    • "Care providers also experience workplace suffering due to their extended exposure to patient suffering and their vulnerability to compassion fatigue and burnout, which can hinder the intimate and particular understanding of a patient needed to provide high-quality care (Benner et al., 1996). To that end, healthcare organizations have developed and implemented compassion practices that allow caregivers to detect and respond to the unique suffering patients and their families experience (i.e., concern for patients), and encourage providers to treat them accordingly (Lown et al., 2011; Von Dietze & Orb, 2000). Prior work finds that organizational practices can foster compassion by enhancing the degree to which an organization and its employees notice, feel, and respond to workplace suffering (Dutton, Worline, Frost, & Lilius, 2006; Lilius, Worline, Dutton, Kanov, & Maitlis, 2011). "

    Human Resource Management Review 01/2016; 26(1):37-49. DOI:10.1016/j.hrmr.2015.09.005 · 2.38 Impact Factor
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    • "In a number of countries, care that is less than compassionate has been identified as a problem in healthcare (Youngson 2010, Lown et al. 2012). In the UK, official reports of poor care in NHS hospitals, home care and care homes have been picked up by national media and policy makers, so that 'compassionate care' has become a policy buzzword. "
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    ABSTRACT: How to promote compassionate care within public services is a concern in several countries; specifically, some British healthcare scandals highlight poor care for service users who may readily be stigmatised as ‘other’. The article therefore aims to understand better the relationship between stigma and compassion. As people bereaved by a drug- or alcohol-related death often experience stigma, the article draws on findings from a major British study, conducted during 2012–2015 by the authors, of people bereaved in this way, in order to see how service provision can be improved. One hundred and six bereaved family members were interviewed in depth about their experiences of loss and support. Thematic analysis developed theoretical understandings of participants’ lived experiences. This article analyses our data on how bereaved people experienced stigma and kindness from practitioners of all kinds. We found that stigma can be mitigated by small acts of kindness from those encountered after the death. Stigma entails stereotyping, othering and disgust, each of which has emotional and cognitive aspects; kindness entails identification and fellow feeling; professionalism has classically entailed emotional detachment, but interviewees found cold professionalism as disturbing as explicit disgust. Drawing on theories concerning the end of life, bereavement and emotional labour, the article analyses the relationship between stigma, kindness and professionalism, and identifies some strategies to counter stigmatisation and foster compassion.
    Health & Social Care in the Community 09/2015; DOI:10.1111/hsc.12273 · 1.15 Impact Factor
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    • "Effective communication is therefore increasingly a critical component to the delivery of quality care. It can also build trust, improve clinical outcomes, and decrease litigation [1] [2] [3] [4] [5]. "
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    ABSTRACT: Objective To assess the educational value of improvisational actors in difficult conversation simulations to teach communication and relational skills to interprofessional learners. Methods Surveys of 192 interprofessional health care professionals, and 33 teaching faculty, and semi-structured interviews of 10 actors. Descriptive statistics, Fisher's Exact Test and Chi-Square Test were used for quantitative analyses, and the Crabtree and Miller approach was used for qualitative analyses. Results 191/192 (99.5%) interprofessional learners (L), and 31/33 (94%) teaching faculty (F) responded to surveys. All 10/10 actors completed interviews. Nearly all participants found the actors realistic (98%L, 96%F), and valuable to the learning (97%L, 100%F). Most felt that role-play with another clinician would not have been as valuable as learning with actors (80%L, 97%F). There were no statistically significant differences in perceived value between learners who participated in the simulations (47%) versus those who observed (53%), or between doctors, nurses, or psychosocial professionals. Qualitative assessment yielded five actor value themes: Realism, Actor Feedback, Layperson Perspective, Depth of Emotion, and Role of Improvisation in Education. Actors independently identified similar themes as goals of their work. Conclusions The value attributed to actors was nearly universal among interprofessional learners and faculty, and independent of enactment participation versus observation. Authenticity, feedback from actors, patient/family perspectives, emotion, and improvisation were key educational elements.
    Patient Education and Counseling 09/2014; 96(3). DOI:10.1016/j.pec.2014.07.001 · 2.20 Impact Factor
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