Since September 2009, Hackensack University Medical Center has been hosting Schwartz Center Rounds, an innovative and effective forum for enhancing relationships between patients and clinicians, improving communication and collaboration within the care team, enhancing insight into clinical challenges, and providing support to caregivers. 

Schwartz Center Rounds consist of monthly sessions open to the entire medical center during which a challenging case is presented by multidisciplinary representatives (physician, nurse, social worker, other care professionals) of the team involved in the patient’s care.  In contrast to medical, M&M, or ethics rounds, SCR discussion focuses on the social, emotional and interpersonal issues raised by the cases and experienced by the caregiving team.  The format is designed to stimulate candid and thoughtful discussion, and the sessions are open to the institution’s entire staff.  More information about SCR content and format is available on the Schwartz Center website.

Developed by the Schwartz Center in Boston and piloted at Massachusetts General Hospital in 1997, Schwartz Center Rounds have expanded across the nation and are offered in 143 hospitals in 30 states, including 5 in New Jersey.  Participating hospitals report increased teamwork, morale, and interdisciplinary collaboration.  A comprehensive study of Schwartz Center Rounds has shown them to help caregivers connect better with patients emotionally; enhance their understanding of the effects of illness on patients and their families; improve communication among caregivers and decrease feelings of caregiver isolation and stress. 

While most rounds focus on medical problems, clinical strategies, or ethical issues, SCR focus on the challenges, emotions, stresses and interpersonal dynamics of caregiving.  The range of typical topics appears below, but a few examples are pain management and the addicted patient, the difficult patient/family, the personal price of caring for seriously ill patients, when medicine and religion conflict, and families that refuse or demand treatment.  SCR are a unique opportunity for caregivers to share experiences and insights, forging more collaborative and effective professional relationships. Although patient identity and confidentiality are strictly protected, these are real cases and, for that reason, the Schwartz Center Rounds are open only to HackensackUMC staff.

Topics discussed at HackensackUMC Schwartz Center rounds include:

  • Setting Limits in the Clinical Setting
  • Don’t Tell Mama: What About Disclosure?
  • The Father Who Couldn’t Let His Son Die: A Case of Medical Futility
  • Getting Beyond First Impressions
  • The Patient Who Gets In Her Own Way
  • Caregivers as Patients
  • Caregiver Fatigue
  • Hospitalization for Non-medical Reasons
  • Working in a Clinical Setting That Puts Staff at Potential Risk
  • Caring for the Manipulative Patient
  • Caring for the Patient Whose Family Cannot Let Go: A Case of Medical Futility
  • The Little Girl Who Couldn’t Die
  • Caring for the Adolescent Patients Who Don’t Care for Themselves
  • Caring for the Patient Whose Family’s Behavior is Controlling and Intimidating 
  • Caring for the Patient Whose Family Refuses Symptom Management
  • Doctor’s Behaving Badly 
  • Caring for the Patient Whose Family Refuses to Communicate or Collaborate 
  • Caring for the Patient Whose Family Creates or Contributes to the Medical Problem
  • Medical Child Abuse
  • Special Quality and Safety Rounds: The Near Miss
  • Difficult Patients and Families: When They Don’t Meet Our Expectations
  • Challenges Faced By Case Managers             
  • We only want positive, hopeful people here – When the Illusion does not match the reality           
  • Bullying: When the Bullies Are Staff, Patients or Families

Since their inception at Hackensack University Medical Center, Schwartz Center Rounds have generated enthusiastic participation and standing-room-only attendance.  Caregivers report that participation enhances the already high quality of patient care and benefits them, their colleagues and, ultimately, their patients.

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