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Maben J, Taylor C, Dawson J, et al. A realist informed mixed-methods evaluation of Schwartz Center Rounds® in England. Southampton (UK): NIHR Journals Library; 2018 Nov. (Health Services and Delivery Research, No. 6.37.)

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A realist informed mixed-methods evaluation of Schwartz Center Rounds® in England.

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Acknowledgements

Our thanks go to all of the staff who participated in this research through completing a survey and/or being interviewed or observed as part of our fieldwork. Without them, this study would not have been possible. We are also grateful to our colleagues at the PoCF – Joanna Goodrich, Bex Wickens, Esther Flanagan, Jocelyn Cornwell and Aggie Rice – for their help and support throughout the study. Grateful thanks to Jo Maybin, Alex Baylis and David Maguire at The King’s Fund. We would also like to thank the staff at the SCCH in Boston, MA, for their support and encouragement, particularly Marjorie Stanzler and Beth Lown. Thank you also to Stephanie Waller, Project Administrator, for her excellent administrative support throughout the study; Jane Hughes, Research Fellow, who supported the mapping qualitative interview data analysis; Emma Scott, Research Fellow, who supported literature reviewing of Rounds mechanisms; Andreas Xyrichis, Lecturer, who supported the scoping review of alternatives to Schwartz Rounds; Michelle Hope, master’s student, who supported the development of the composite definition; and Julia Philippou, lecturer, who supported mapping survey data analysis and secondary analysis. Many thanks also to Justin Jagosh, Centre for Realist Evaluation, who was a source of support, inspiration and wisdom on our realist evaluation journey. Finally, we are grateful to the following members of the Advisory Group and Steering Group for their advice on the study design and support along the way.

Advisory Group

Joanna Goodrich, Head of Evidence, PoCF.

Barbara Wren, Consultant Psychologist and Schwartz Round Lead, Royal Free London NHS Foundation Trust.

Jenny Firth Cozens, Consultant Psychologist.

Michael West, Head of Thought Leadership, The King’s Fund.

John Pepper, Professor of Cardiothoracic Surgery, Royal Brompton and Harefield NHS Foundation Trust.

Glenn Robert, Professor of Health Care Quality and Innovation, King’s College London.

Steering Group

Dean Fathers, Chairperson, United Lincoln Hospitals NHS Trust.

Sharon Fleming, Head of Nursing Research, Royal Brompton and Harefield NHS Foundation Trust.

Nicola Mackintosh, Research Fellow, King’s College London.

Rachel Massey-Chase, Clinical Psychologist, King’s College Hospital.

Katherine Hopkins, Nurse Consultant, Royal Free London NHS Foundation Trust.

Jude Bayly, Midwife, Royal Free London NHS Foundation Trust.

Havi Carel, patient representative.

Christine Chapman, patient representative.

Elisabeth Buggins, Chairperson, Birmingham Women’s and Children’s NHS Foundation Trust.

Jennifer Gardner, Programme Lead, Health and Well-being, NHS Employers.

Ruth Harris, Professor of Nursing Practice and Innovation, King’s College London.

The late Lisl Klein (died 11 December 2015), Director, the Bayswater Institute (September 2014–December 2015).

Patient and public involvement in research

The study owes great thanks to patients and the public who commented on our research design and who supported us as part of the advisory group, notably Christine Chapman and Havi Carel; their insights and understanding helped improve our understanding of Rounds and our interpretation of some of our data.

Contributions of authors

Jill Maben (Professor of Nursing Research; Social and Health Sciences) was the PI. She led the overall study design; led and managed the study team, including the research fellow and research associate; and undertook data collection, analysis and the final writing of the report.

Cath Taylor (Senior Lecturer; Psychology) contributed to the overall study design; led the literature review design, analysis and write-up; contributed to the mapping design; led the analysis and write-up of mapping and costs data; contributed to the case study analysis; and was involved in the overall writing of the report.

Jeremy Dawson (Professor of Health Management; Statistics and Work Psychology) contributed to the overall study design; led the survey study design, analysis and write-up; and was involved in the overall writing of the report.

Mary Leamy (Research Fellow, Psychology) led and conducted the data collection analysis and the write-up of case study qualitative data; undertook the collection of mapping data; undertook literature reviewing; and was involved in the overall writing of the report.

Imelda McCarthy (Research Associate, Psychology) led and conducted the collection and analysis of survey data; led the analysis and write-up of key players’ experiences interview data; and was involved in the overall writing of the report.

Ellie Reynolds (Research Associate, Anthropology and Nursing) led and conducted the collection and analysis of case study qualitative data; undertook the collection of mapping data; undertook literature reviewing; and was involved in the overall writing of the report.

Shilpa Ross (Senior Researcher, Health and Social Care Policy) led and conducted the collection of mapping survey and interview data, and contributed to analysis and to the writing of the report.

Caroline Shuldham (Independent Consultant and Visiting Professor, Buckinghamshire New University, formerly Director of Nursing and Clinical Governance Royal Brompton and Harefield NHS Foundation Trust: Health Sciences) contributed to the overall study design, contributed to the survey data collection and analysis and the costs data analysis, and was involved in the overall writing of the report.

Laura Bennett (Researcher, Health and Social Care Policy) contributed to the collection and analysis of mapping survey and interview data, and contributed to the writing of the report.

Catherine Foot (Director, Centre for Ageing Better, formerly Assistant Director of Policy, The King’s Fund: Health Policy) led the collection of mapping survey and interview data, contributed to analysis and contributed to the writing of the report.

Publications

Journal publications

Taylor C, Xyrichis A, Leamy MC, Reynolds E, Maben J. 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. BMJ Open 2018;8:e024254.

Robert G, Philippou J, Leamy M, Reynolds E, Ross S, Bennett L, et al. Exploring the adoption of Schwartz Center Rounds as an organisational innovation in England to improve staff wellbeing in England 2009–2015. BMJ Open 2017;7:e014326.

Oral conference presentations

Leamy M, Maben J, Taylor C, Reynolds E. Supporting NHS Staff at Work: What are Schwartz Rounds and How do They Work? Early Findings from a National Research Study, The Caring Organisation: Enabling Compassion to Flourish. Point of Care Conference, Royal Society of Medicine, London, 16 December 2015.

Robert G, Philippou J, Ross S, Bennett L, Taylor C, Reynolds E, et al. Supporting the Wellbeing of Staff and Improving Compassionate Care: Exploring the Adoption of Schwartz Centre Rounds in the United Kingdom, 2009–2015. National Institute for Health Research Health Services and Delivery Research Conference, Nottingham, 13–14 July 2016.

Maben J. The Links Between Staff and Patient Experience of Hospital Care: A UK Perspective. Invited presentation. Presentation to Faculty of Health Sciences, Murdoch University, Perth, WA, 25 August 2016.

Maben J. Schwartz Rounds. Presentation to Sir Charles Gairdner Hospital. Invited presentation. Perth, WA, 31 August 2016.

Leamy M, Reynolds E, Taylor C, Maben J. Ongoing Learning and Reflections from Undertaking a Realist Evaluation of Schwartz Rounds: A Health-Care Intervention to Promote Compassionate Care. Invited presentation. Second International conference on Realist Evaluation and Synthesis: Advancing Principles, Strengthening Practice, London, 2–6 October 2016.

Leamy M, Maben J. Schwartz Rounds: Origins, Early Development and Implementation in the USA and UK. Point of Care Foundation Conference, Senate House, London, 27 October 2016.

Maben J, Leamy M. Schwartz Rounds: Realist Evaluation Draft Findings from National Research Study. Point of Care Foundation Conference, Science Museum, Manchester, 24 November 2016.

Taylor C, Maben J. Schwartz Center Rounds to Enhance Compassionate Care: Results from a UK Mapping Survey. European Oncology Nursing Society conference, European Cancer Congress, Amsterdam, 27–30 January 2017.

McCarthy I, Dawson J, Maben J, Taylor C, Leamy M, Reynolds E, Shulham C. Schwartz Center Rounds®: An Intervention to Support Employee Well-being. British Psychological Society Division of Occupational Psychology Annual Conference, Stratford-upon-Avon, 10–12 January 2018.

Maben J, Taylor C. (On behalf of the project team.) UK National Evaluation of Schwartz Rounds: Launch of Film and Organisational Guide. Invited presentation. Point of Care Schwartz Conference, London, 23 January 2018.

Maben J, Taylor C. (On behalf of the project team.) UK National Evaluation of Schwartz Rounds: Launch of Film and Organisational Guide. Invited presentation. Point of Care Schwartz Conference, Manchester, 6 February 2018.

Maben J (Keynote.) Enhancing Compassion in Relationships Between Staff and Patients: A National Evaluation of Schwartz Rounds in the UK 2014–2017. National Schwartz Rounds Conference, Dublin, 28 February 2018.

Maben J. (Keynote) Enabling and Supporting Staff to Care Well. Humanising HealthCare conference, Point of Care Foundation, London, 28 March 2018.

Maben J, Dawson J, Leamy M, Taylor C, Reynolds E, Shuldham C, et al. Schwartz Center Rounds®: A UK Evaluation of a Complex Intervention to Support Health-care Staff Deliver Compassionate Care. Royal College of Nursing International Research Society conference, Birmingham, 16–18 April 2018.

Maben J, Leamy M, Taylor C, Reynolds E, Shuldham C, McCarthy I. Learning and Reflections From a Realist Evaluation of Schwartz Rounds® – An Intervention to Promote Compassionate Care. Royal College of Nursing International Research Society conference, Birmingham, 16–18 April 2018.

Maben J, Dawson J, Leamy M, Taylor C, Reynolds E, Shuldham C. A Realist Evaluation of Schwartz Center Rounds®: An Intervention To Support Compassionate Care in Health-care Staff. WELL-Med 3 Conference, Thessaloniki, 9–13 May 2018.

Taylor C, Ross S, Phillipou J, Robert G, Leamy M, Reynolds E, et al. The UK Implementation of Schwartz Rounds: An Intervention to Improve Care Through Enhancing Staff Well-being. WELL-Med 3 Conference, Thessaloniki, 9–13 May 2018.

McCarthy I, Dawson J, Maben J, Taylor C, Shuldham C, Leamy M, Reynolds E. The Impact of a Social and Emotional Workplace Intervention on Employee Psychological Well-being. Institute of Work Psychology Conference, University of Sheffield, Sheffield, 19–21 June 2018.

Maben J, Dawson J, Leamy M, Taylor C, Reynolds E, Shuldham C, et al. (Keynote.) Schwartz Rounds as Response to Moral Distress. What is Moral Distress in Nursing? How, Can and Should we respond to it? Public engagement event, Wellcome Trust, 21 June 2018.

Taylor C, Maben J, Dawson J, Shuldham C, Foot C, et al. The Emotional Impact of Care. ‘Time to Talk’ conference, Hampshire Hospitals NHS Foundation Trust, 25 June 2018.

Poster conference presentation

Leamy M, Reynolds E, Taylor C, Maben J. Ongoing Learning and Reflections from Undertaking a Realist Evaluation of Schwartz Rounds: A Healthcare Intervention to Promote Compassionate Care. Poster presentation. 2nd International Conference on Realist Evaluation and Synthesis: Advancing Principles, Strengthening Practice, London, October 2016.

Blogs

Maben J. How Can we Support Healthcare Staff to Care Well? A National Evaluation of Schwartz Center Rounds®. National Institute for Health Research; 23 January 2018. URL: www.nihr.ac.uk/blogs/how-can-we-support-healthcare-staff-to-care-well-a-national-evaluation-of-schwartz-center-rounds/7765

Maben J. Enabling and Supporting Staff to Care Well. The Point of Care Foundation; 30 April 2018. URL: www.pointofcarefoundation.org.uk/blog/enabling-and-supporting-staff-to-care-well/

Organisational guide

Maben J, Leamy M, Taylor C, Reynolds E, Shuldham C, Dawson J. Understanding, Implementing and Sustaining Schwartz Rounds: An Organisational Guide to Implementation. London: King’s College London; 2018. URL: www.surrey.ac.uk/content/schwartz-organisational-guide-questionnaire

Media output: 9-minute research film

Maben J, Taylor C, Leamy M, Shuldham C. (On behalf of the project team.) Understanding Schwartz Rounds: Findings from a National Evaluation. © 2018 King’s College London. URL: https://youtu.be/C34ygCIdjCo

Data-sharing statement

All data requests should be submitted to the corresponding author for consideration. Access to anonymised data may be granted following review. Exclusive use will be retained until the publication of major outputs.

Disclaimers

This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department of Health and Social Care. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department of Health and Social Care.

Copyright © Queen’s Printer and Controller of HMSO 2018. This work was produced by Maben et al. under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK.
Bookshelf ID: NBK533107
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