The Healing Healthcare Initiative: Guiding leaders to heal a traumatized workforce.

The COVID-19 pandemic amplified burnout and moral distress among healthcare professionals and accentuated the systemic gaps and limitations of current approaches to workforce well-being. The Schwartz Center for Compassionate Healthcare launched the Healing Healthcare Initiative (HHI) in response to these compounded challenges. Aligned with national recommendations, the HHI framework comprises six key principles and eight implementation domains that foster compassionate and trauma-informed organizational cultures.

Intensivists' perceptions of what is missing in their compassionate care during interactions in the intensive care unit.

Background: We proposed that the behaviors that demonstrate compassionate care in the intensive care unit (ICU) can be self-assessed and improved among ICU clinicians. Literature showing views of intensivists about their own compassionate care attitudes is missing.

Methods: This was an observational, prospective, cross-sectional study.

Do Physicians Have Collective, Not Just Individual, Obligations to Respond to the Opioid Crisis?

Evidence-based clinical guidelines could mitigate variations in care for some patients. However, patient and clinician distress can arise when guidelines are misapplied or mandated by processes that are not evidence based, fail to integrate physician expertise and patient preference, or fail to motivate informed, shared decision making. Physicians can choose to collectively advocate at national, state, and local levels for policy changes.

Beyond Convenience: Patients' Perceptions of Physician Interactional Skills and Compassion via Telemedicine.

Objectives: To understand the interpersonal and communication behaviors that are perceived positively by patients in a video encounter and whether patient-centered relationships can be established virtually.

Patients And Methods: A qualitative analysis of patient visit feedback was performed to build consensus around exemplary interpersonal and communication practices during a virtual urgent care visit. Voluntarily submitted patient comments associated with a 5-star review after a visit were randomly selected from more than 49,000 comments in an 11-month period, from January 1, 2016, through November 30, 2016.

Does Organizational Compassion Matter? A Cross-sectional Survey of Nurses.

Objective: To examine factors that influence nurses' perceptions of organizational compassion and their engagement with the organization.

Background: Despite agreement about the importance of compassionate healthcare, it is difficult for employees to consistently act compassionately when organizational leaders, managers, and systems of care fail to support compassion as a value.

Methods: The study used a cross-sectional design, and quantitative and qualitative data were collected through an online survey of nurses.

Can Organizational Leaders Sustain Compassionate, Patient-Centered Care and Mitigate Burnout?

Organizational leaders are recognizing the urgent need to mitigate clinician burnout. They face difficult choices, knowing that burnout threatens the quality and safety of care and the sustainability of their organizations. Creating cultures and system improvements that support the workforce and diminish burnout are vital leadership skills.

Correction: Measuring compassionate healthcare with the 12-item Schwartz Center Compassionate Care Scale.

[This corrects the article DOI: 10.1371/journal.pone.

Measuring compassionate healthcare with the 12-item Schwartz Center Compassionate Care Scale.

Background: Patients and clinicians endorse the importance of compassionate healthcare but patients report gaps between its perceived importance and its demonstration. Empathy and compassion have been associated with quality of life and significant health outcomes but these characteristics are not optimally measured or used for performance and organizational improvement.

Objective: To address these gaps, we conducted a study with the objective of evaluating the properties of the 12-item Schwartz Center Compassionate Care Scale® using psychometric analysis and cognitive debriefing.

Should a Physician Offer Recommendations Based on Experience but Contrary to Current Practice Guidelines?

This case of a patient whose physician refuses to prescribe statins for high cholesterol raises ethical issues about a physician's decision to offer clinical recommendations contrary to current practice guidelines. Our response summarizes social forces that have led to the rise of evidence-based medicine, the development of clinical guidelines, and the evolution of the roles of physicians and patients in decision making. We conclude that there are times when a physician can justifiably make a recommendation to a patient that contravenes a current clinical guideline.

Utilizing compassion and collaboration to reduce violence in healthcare settings.

Violence in healthcare settings is a global problem and violent acts are more likely to occur in emergency departments (EDs). Significant barriers to reporting workplace violence persist among healthcare workers. This, and lack of shared definitions and metrics, increase the difficulty of assessing its prevalence, understanding its causes, and comparing the impact of interventions to reduce its frequency.

Mission Critical: Nursing Leadership Support for Compassion to Sustain Staff Well-being.

Compassion, the foundation of Nursing, is a source of both healing for those who suffer and of purpose and meaning for those who seek to heal others. Increasingly, however, the fast pace and volume of care and documentation requirements diminish time with patients and families and hinder the enactment of compassion. These issues and other aspects of the work environment decrease the satisfaction and well-being of professional caregivers and are contributing to a rising tide of burnout.

A social neuroscience-informed model for teaching and practising compassion in health care.

Context: Empathy and compassion are important catalysts for the healing process, but some research suggests their decline during training and practice. Compassion involves recognition, understanding, emotional resonance and empathic concern for another's concerns, distress, pain and suffering, coupled with their acknowledgement, and motivation and relational action to ameliorate these conditions.

Compassion, Altruism And Reward: Neuroscientists have identified neural networks that generate shared representations of directly experienced and observed feelings, sensations and actions.

Integrating Compassionate, Collaborative Care (the "Triple C") Into Health Professional Education to Advance the Triple Aim of Health Care.

Empathy and compassion provide an important foundation for effective collaboration in health care. Compassion (the recognition of and response to the distress and suffering of others) should be consistently offered by health care professionals to patients, families, staff, and one another. However, compassion without collaboration may result in uncoordinated care, while collaboration without compassion may result in technically correct but depersonalized care that fails to meet the unique emotional and psychosocial needs of all involved.

Measuring the Impact of Longitudinal Faculty Development: A Study of Academic Achievement.

Purpose: Although faculty development programs in medical education have increased over the past two decades, there is a lack of rigorous program evaluation. The aim of this study was to determine quantifiable outcomes of Harvard Medical School's (HMS's) Fellowship in Medical Education and evaluate attainment of its goals.

Method: In 2005 and 2009 the authors collected curricula vitae (CVs) and conducted within-subject analysis of 42 fellowship graduates and also conducted comparison analysis between 12 academic year 2005 fellows and 12 faculty who did not participate in the program.

Compassion Is a Necessity and an Individual and Collective Responsibility Comment on "Why and How Is Compassion Necessary to Provide Good Quality Healthcare?".

Compassion is a complex process that is innate, determined in part by individual traits, and modulated by a myriad of conscious and unconscious factors, immediate context, social structures and expectations, and organizational "culture." Compassion is an ethical foundation of healthcare and a widely shared value; it is not an optional luxury in the healing process. While the interrelations between individual motivation and social structure are complex, we can choose to act individually and collectively to remove barriers to the innate compassion that most healthcare professionals bring to their work.

Can compassionate healthcare be measured? The Schwartz Center Compassionate Care Scale™.

Objective: Assess psychometric characteristics of an instrument to measure patient ratings of treating physicians' compassionate care in a recent hospitalization.

Methods: We used Cronbach's alpha to examine scale reliability, exploratory and confirmatory factor analysis to examine scale structure of two sets of items on compassionate care. We used Mokken analysis to determine if items in each set belonged to a unidimensional scale.

Seven Guiding Commitments: Making the U.S. Healthcare System More Compassionate.

Despite the current focus on patient centeredness, healthcare professionals face numerous challenges that impede their ability to provide compassionate care that ameliorates concerns, distress, or suffering. These include fragmentation and discontinuity of care, technologies that both help and hinder communication and relationship-building, burgeoning operational and administrative requirements, inadequate communication skills training, alarming rates of burnout, and increased cost and market pressures. A compassionate healthcare system begins with compassionate people, but the organizations in which they train and work must reliably enable them to express and act on their compassion rather than impede it.

Toward more compassionate healthcare systems Comment on "Enabling compassionate healthcare: perils, prospects and perspectives".

Compassion is central to the purpose of medicine and the care of patients and their families. Compassionate healthcare begins with compassionate people, but cannot be consistently provided without systemic changes that enable clinicians and staff to collaborate and to care. We propose seven essential commitments to foster more compassionate healthcare organizations and systems: a commitment to compassionate leadership, to teach compassion, to value and reward compassionate care, to support clinical caregivers, to involve and partner with patients and families, to build compassion into the organization of healthcare delivery, and a commitment to deepen our understanding of compassion and its impact through research.

Preferences and decision needs of Boston-area travelers to countries with risk of Yellow fever virus transmission: implications for health care providers.

Background: Yellow fever (YF), a potentially fatal mosquito-borne infection, is preventable with a live-attenuated vaccine, rarely associated with severe adverse events. We surveyed travelers to assess their reasons for pre-travel medical consultation, information they considered important regarding YF disease and vaccination, whether they recalled receiving this information, and whether they were involved in vaccine decision-making.

Methods: Travelers aged 18 years and older were surveyed at three Boston-area travel clinics.

Communicate, don't litigate: The Schwartz Center Connections Program.

Little is known about effective educational approaches intended to reduce malpractice risk by improving communication with patients and among multidisciplinary teams in outpatient settings in order to prevent diagnostic delays and errors. This article discusses a prospective, controlled educational intervention that aimed to open lines of communication among teams in two disciplines: identifying how and why communication lapses occur between disciplines and with patients, and articulating strategies to avert them.

Practical issues in palliative and quality-of-life care.

Although palliative care is not new to health care or to oncology, oncologists still struggle to maximize the value of this type of care across the entire care continuum and across the patient's trajectory of illness. When we don't use what may be the best tools for the job, at the right times in the care path, we miss opportunities to optimize patient and family coping, to limit suffering, and to ensure that our care plans are patient centered. In this article, we look at how we define palliative care and how the tools of palliative medicine can be used to enhance patient care in the outpatient oncology practice setting.