Schwartz Rounds roles
When recruiting the team it is important that everyone is aware of the time commitment of working on Schwartz Rounds. Managers should ensure that their staff are given adequate time to do their tasks.
The facilitator undertakes a very skilled role, so it helps if they have experience of working with groups and managing difficult emotions. Often people with psychological or social work backgrounds suit this role.
They will also need to have good knowledge of staff experience issues, the structure and the culture of the organisation.
The facilitator role requires approximately 1.5 days of work per month.
This time is taken up primarily by panel preparation, as well as steering group meetings and the Round itself.
- To help panellists prepare their stories
- To help panellists and the audience share personal experiences in a public setting
- To ensure the Round is safe, confidential and given workable boundaries
- To open up a reflective discussion and attend to emotional aspects of care
- To help move away from the participants’ natural desire to problem-solve
- To draw out meaning and themes underlying the stories
- To feel comfortable with silence
- To confidently manage challenge and uncertainty that can arise
- To maintain a neutral, curious and compassionate position.
The clinical lead
The clinical lead plays an important symbolic role, demonstrating the importance of attending to the emotional impact of care to the medical or clinical community. It helps if the clinical lead is a respected senior member of staff, with experience of working in pressured clinical settings (they will use this experience to engage the medical community at various levels and share their own experiences).
The type of professional selected for this role will vary with setting; in an acute trust the clinical lead is likely to be a senior medic, whilst in a community trust they should be chosen to reflect the particular staff profile.
The clinical lead works closely with the facilitator and undertakes a skilled co-facilitation role. It helps if they have some group work experience and an interest in staff experience.
The clinical lead role requires approximately half a day a month.
This time is taken up by finding panellists, attending the steering group meeting and facilitating the Round itself.
- To help find cases and panellists
- To co-facilitate the Rounds and ensure that they are run in accordance with the Schwartz model
- To draw on personal experience and demonstrate a reflective stance
- To champion the Rounds and represent them at senior levels in the organisation
- To remain neutral and compassionate when faced with controversy in the Round.
The steering group
The steering group is comprised of 8-12 staff from multiple clinical and non-clinical disciplines. The steering group may be smaller depending on the size of the organisation.
It helps if the group represents a wide range of departments within the organisation from different levels of seniority. The diversity of the steering group is an important factor in promoting Rounds and ensuring that attendance is strong. Examples include:
- board members and senior clinicians
- junior nurses
- chaplaincy staff
- staff engagement leads
- patient experience leads
- operational or facilities managers
- representatives from junior medicine
- heads of some medical specialities (cardiology, orthopaedics, oncology etc)
- marketing and communication professionals
- HR managers
You might want to map out your steering group using this mapping exercise.
Each steering group member requires approximately half a day per month. This time is taken up primarily by attending a monthly meeting and the Round itself.
- To raise the profile of Rounds
- To share ownership of the Rounds
- To attend monthly steering group meetings
- To help find cases and panellists
- To support the facilitator and clinical lead in their roles
- Debriefing the Round with the clinical lead and facilitator
- To offer contributions in the Rounds to help encourage the discussion, and be available if challenging issues arise
- To ensure that Schwartz Rounds remain relevant over time
The administrator plays an important organisational role, so they will need to be efficient.
It helps if they have a genuine interest in staff experience and take ownership of the Schwartz Rounds. The smooth running of Rounds is important to them becoming embedded in the organisation.
The administrator role requires approximately one day per month.
This time is taken up primarily by preparing for the Rounds, helping to collate data and writing up feedback reports.
- To enable the efficient running of rounds
- To book rooms and organise the lunch
- To liaise with communications team about promoting the Rounds
- To co-ordinate steering group meetings and write up minutes
- To ensure the paperwork is ready for each Round
- To ensure that only staff attend and that they sign the confidentiality agreement
- To collect feedback sheets after each Round
- To enter the feedback into a database and help to populate a report.