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      Schwartz Rounds for Staff in an Australian Tertiary Hospital: Protocol for a Pilot Uncontrolled Trial

      research-article
      , MD 1 , 2 , 3 , , , BSocSci, PhD 1 , 2 , , PhD 2 , , MD 4 , , PhD 2 , , BSc (Hons), MBBS, MSc, MRCGP 5 , , MBChB, MD 3
      (Reviewer)
      JMIR Research Protocols
      JMIR Publications
      Schwartz Rounds, compassionate care, health care staff well-being

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          Abstract

          Background

          Schwartz Rounds are a unique, organization-wide interdisciplinary intervention aimed at enhancing staff well-being, compassionate care, teamwork, and organizational culture in health care settings. They provide a safe space wherein both clinical and nonclinical health staff can connect and share their experiences about the social and emotional aspects of health care.

          Objective

          Although Schwartz Rounds have been assessed and widely implemented in the United States and United Kingdom, they are yet to be formally evaluated in Australian health care settings. The purpose of this study is to evaluate the feasibility and impact of Schwartz Rounds on staff well-being, compassionate care, and organizational culture, in a tertiary metropolitan hospital in Brisbane, Australia.

          Methods

          This mixed methods repeated measures pilot study will recruit 24 participants in 2 groups from 2 departments, the intensive care unit and the gastroenterology department. Participants from each group will take part in 3 unit-based Schwartz Rounds. Primary outcomes will include the study and intervention feasibility measures, while secondary outcomes will include scores on the Maslach Burnout Inventory–Human Services Survey, the Schwartz Centre Compassionate Care Scale, and the Culture of Care Barometer. Primary and secondary outcomes will be collected at baseline, after the Rounds, and 3-month follow-up. Two focus groups will be held approximately 2 months after completion of the Schwartz Rounds. Descriptive statistics, paired t tests, chi-square tests, and analysis of variance will be used to compare quantitative data across time points and groups. Qualitative data from focus groups and free-text survey questions will be analyzed using an inductive thematic analysis approach.

          Results

          The study was approved by the Mater Hospital Human Research Ethics Committee (reference number: HREC/MML/71868) and recruitment commenced in July 2021; study completion is anticipated by May 2022.

          Conclusions

          The study will contribute to the assessment of feasibility and preliminary efficacy of the Schwartz Rounds in a tertiary Australian hospital during the COVID-19 pandemic.

          Trial Registration

          Australian New Zealand Clinical Trials Registry ACTRN12621001473853; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=382769&isReview=true

          International Registered Report Identifier (IRRID)

          DERR1-10.2196/35083

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          Most cited references32

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          Occurrence, prevention, and management of the psychological effects of emerging virus outbreaks on healthcare workers: rapid review and meta-analysis

          Abstract Objective To examine the psychological effects on clinicians of working to manage novel viral outbreaks, and successful measures to manage stress and psychological distress. Design Rapid review and meta-analysis. Data sources Cochrane Central Register of Controlled Trials, PubMed/Medline, PsycInfo, Scopus, Web of Science, Embase, and Google Scholar, searched up to late March 2020. Eligibility criteria for study selection Any study that described the psychological reactions of healthcare staff working with patients in an outbreak of any emerging virus in any clinical setting, irrespective of any comparison with other clinicians or the general population. Results 59 papers met the inclusion criteria: 37 were of severe acute respiratory syndrome (SARS), eight of coronavirus disease 2019 (covid-19), seven of Middle East respiratory syndrome (MERS), three each of Ebola virus disease and influenza A virus subtype H1N1, and one of influenza A virus subtype H7N9. Of the 38 studies that compared psychological outcomes of healthcare workers in direct contact with affected patients, 25 contained data that could be combined in a pairwise meta-analysis comparing healthcare workers at high and low risk of exposure. Compared with lower risk controls, staff in contact with affected patients had greater levels of both acute or post-traumatic stress (odds ratio 1.71, 95% confidence interval 1.28 to 2.29) and psychological distress (1.74, 1.50 to 2.03), with similar results for continuous outcomes. These findings were the same as in the other studies not included in the meta-analysis. Risk factors for psychological distress included being younger, being more junior, being the parents of dependent children, or having an infected family member. Longer quarantine, lack of practical support, and stigma also contributed. Clear communication, access to adequate personal protection, adequate rest, and both practical and psychological support were associated with reduced morbidity. Conclusions Effective interventions are available to help mitigate the psychological distress experienced by staff caring for patients in an emerging disease outbreak. These interventions were similar despite the wide range of settings and types of outbreaks covered in this review, and thus could be applicable to the current covid-19 outbreak.
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            Thematic analysis

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              Controlled Interventions to Reduce Burnout in Physicians

              Burnout is prevalent in physicians and can have a negative influence on performance, career continuation, and patient care. Existing evidence does not allow clear recommendations for the management of burnout in physicians.
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                Author and article information

                Contributors
                Journal
                JMIR Res Protoc
                JMIR Res Protoc
                ResProt
                JMIR Research Protocols
                JMIR Publications (Toronto, Canada )
                1929-0748
                April 2022
                27 April 2022
                : 11
                : 4
                : e35083
                Affiliations
                [1 ] Mater Young Adult Health Centre Mater Health Mater Misericordiae Ltd South Brisbane Australia
                [2 ] School of Medicine and Dentistry Griffith University Gold Coast Australia
                [3 ] Mater Clinical School Faculty of Medicine University of Queensland South Brisbane Australia
                [4 ] Mater in Mind Mater Health Mater Misericordiae Ltd South Brisbane Australia
                [5 ] Eastern Health Clinical School Faculty of Medicine, Nursing and Health Sciences Monash University Melbourne Australia
                Author notes
                Corresponding Author: Tatjana Ewais Tatjana.Ewais@ 123456mater.org.au
                Author information
                https://orcid.org/0000-0002-1136-0605
                https://orcid.org/0000-0002-1097-5034
                https://orcid.org/0000-0002-6948-5689
                https://orcid.org/0000-0002-5039-6061
                https://orcid.org/0000-0001-7325-9695
                https://orcid.org/0000-0002-8661-2221
                https://orcid.org/0000-0003-0802-718X
                Article
                v11i4e35083
                10.2196/35083
                9096633
                35475785
                7121ddfc-c6ad-42d4-b68c-afb718ecbf05
                ©Tatjana Ewais, Georgia Hunt, Jonathan Munro, Paul Pun, Christy Hogan, Leeroy William, Andrew Teodorczuk. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 27.04.2022.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on https://www.researchprotocols.org, as well as this copyright and license information must be included.

                History
                : 20 November 2021
                : 11 December 2021
                : 14 March 2022
                : 23 March 2022
                Categories
                Protocol
                Protocol

                schwartz rounds,compassionate care,health care staff well-being

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