Ringing in the New Year with Compassion

This quote recently appeared on the blog of Advance Publications, a publisher that addresses the career and information needs of healthcare professionals. I couldn't have said it better!

"We know many of you will make New Year's resolutions to improve your practice and the care you provide to your patients. Consider making compassionate care one of your goals to benefit both your patients and yourself."

Thanks to Advance Publications, as well as participants in the Schwartz Center Rounds and all our programs, for recognizing the importance and value of compassion in healthcare. I wish you all a happy and healthy New Year!

What are your New Year's resolutions?

Is it compassionate to accept patient gifts?

This week's post is written by Elizabeth Steinmiller (MSN, PMHCNS-BC, Clinical Nurse Specialist in Mental Health), The Children's Hospital of Philadelphia. Children's is one of eight pediatric hospitals named to U.S. News & World Report's Honor Roll of America's "Best Children's Hospitals" for 2010-2011 and a participant in the Schwartz Center Rounds.

Many people express their gratitude during the holiday season by giving a gift to their healthcare providers. Gift exchanges between clinicians and patients and their families can be wonderful interactions or create uncomfortable moments that impact the patient-caregiver relationship.

As noted in an American Medical Association (AMA) article, the motives underlying patient gift-giving can be as innocent as sharing cultural traditions and expressing appreciation or as complicated as the desire to overcome guilt for non-adherence, curry favors from the healthcare provider, or move the relationship from professional to social.

Clinicians can turn to various professional organizations (American Medical Association, American Academy of Pediatrics, National Council of State Boards of Nursing, American Psychological Association) for guidance about patient gift-giving. The AMA, for example, advises that the acceptance of a gift by a care provider, if not handled sensitively and thoughtfully, can negatively impact the professional relationship with the patient and their family members.

Ultimately the best policy may be to discuss the issue with patients before it arises. Several years ago New York Times columnist Tara Parker-Pope wrote a thought-provoking piece about patient gifts. The comments from clinicians were especially informative. Clinicians consistently mentioned that notes of thanks or gratitude were the items they cherished most. By communicating these sentiments to patients in advance, clinicians may be able to avoid the ethical and emotional dilemmas surrounding gifts yet still provide a way for patients to express their gratitude.

How do you communicate with patients about gift-giving?

Beyond legal challenges: the promise of healthcare reform

We shouldn't get distracted by the recent court decision opposing the federal requirement that individuals purchase health insurance. There are many aspects of health reform which are important and scheduled for implementation. Among the key provisions in the new law is one that provides $150 billion in funding for evidence-based care. That's on top of $1.1 billion of federal stimulus spending for new research comparing medical treatments, drugs and devices to evaluate which are most effective.

On the face of it, evidence-based care is straightforward: use research to develop sound evidence on how medical problems can be most effectively prevented, diagnosed, treated, monitored and managed. Good news right? After all, studies have shown that patients who are involved in their healthcare decisions are better able to understand and follow their doctors' treatment plans and are more satisfied with their care. But in practice, it's not so simple.

The success of evidence-based care requires that patients be engaged in their care, trust the information source and understand the evidence. A 2010 study published in Health Affairs found that even among the savviest patients, few understood terms such as "medical evidence." The research concluded that since patients have relied on physicians to make treatment decisions, patients may find it difficult to work with clinicians to evaluate complex and conflicting medical evidence. Clinicians need to work with their patients to help them play a more active role in their own care.

As Barbara Ficarra recently blogged, "by listening and communicating we can understand and guide our patients. Empathy enhances patient-physician communication and trust, and therefore treatment effectiveness."

In the absence of open, empathic communication and strong caregiver-patient relationships, evidence-based medicine will fall far short of its potential to improve the effectiveness of care.

How can we help patients and clinicians understand and evaluate medical evidence?

Grand Rounds Vol. 7, No. 12 is up at Dr. John M!

Please visit today's Grand Rounds for a wonderful sampling of the best healthcare blogs:

http://www.drjohnm.org/2010/12/grand-rounds-december-14th-2010.html

Enjoy!

Communication Skills Get Front Page Treatment

Good communication skills are considered essential to healthcare. They can enhance patient and caregiver satisfaction, reduce errors, and even improve health outcomes. This week communication skills finally got the attention they deserve.

On Dec. 6, 2010, USA Today featured survey results, sponsored by the Schwartz Center for Compassionate Healthcare, of doctors and hospitalized patients on the front page of the print edition. The poll was also prominently featured in the Health section of the online edition.

With daily print circulation of approximately 2.3 million, USA Today is one of the largest-selling newspapers in the nation. I can't think of a better way to publicize the importance of effective communication between patients and caregivers.

Despite the increased emphasis on better communication in the medical community, USA Today highlighted the need for continued improvement in doctor-patient communication based on the survey results. This message couldn't have come at a more crucial time; especially as pressures to reduce healthcare costs and increase efficiency have increased due to healthcare reform.

Over the past 15 years, the Schwartz Center has worked diligently to promote communication skills in the face of intensifying pressures. We currently reach 60,000 caregivers annually through the Schwartz Center Rounds. Though this number is growing, there are still many caregivers who we haven't reached. What's exciting about the USA Today article is that it allows us to connect with the widest possible audience of caregivers and patients, reinforcing the message that enhanced communication is a necessity not a luxury.

In your opinion, what's the most effective way to promote communication in healthcare?

Grand Rounds Vol. 7, No. 11 is up at Highlight Health

Please visit Highlight Health today to read about the impact of health reform from the perspective of leading healthcare bloggers.

(The Schwartz Center's recent post about the results of national poll of doctors and patients was also included!)

Hey - Do I Look Like I Care?

This was the catchy title of a recent educational forum about compassionate caregiving. The forum, sponsored by the Schwartz Center, was held at the Massachusetts College of Pharmacy and Health Sciences (MCPHS). Greg Fenton, MD and Barbara Moscowitz, MSW, LICSW along with two students, led a panel discussion attended by nearly 200 MCPHS students. (Dr. Fenton and Ms. Moscowitz are recipients of the Schwartz Center Compassionate Caregiver Award: Dr. Fenton was a finalist in 2009 and Ms. Moscowitz was the winner of the award in 2007.)

These gifted clinicians shared the following insights about the art of compassionate caregiving:

• Compassion is about understanding what your patients are experiencing, not just saying the right thing
• Don't delay: show compassion by asking a patient or family member what you can do right now
• Everyone has the capacity to be compassionate and empathic
• Compassionate care is not judgmental
• Moments of compassion are not heroic, they're found in our daily actions

To reinforce these lessons, students were asked to share their own "compassionate moments." One student related a memorable encounter while working as an emergency medical technician (EMT). The student and two others were assigned to transport an elderly patient from the hospital to a rehabilitation facility. The hospital staff warned them that this woman was a "feisty curmudgeon." To his dismay, the student was stuck making the trip in the back of the transport vehicle with the patient. He recalls repeatedly trying to break the ice with the difficult woman. Eventually, by getting her talk about herself and her family, he was able to bond with her--even getting her to smile and hold his hand! I'd say this student earned an A+ in Compassionate Caregiving 101.

Do you have a compassionate moment to share?