KU School of Medicine–Wichita
1010 N. Kansas
Wichita, KS, 67214
April 25, 2019
Sid Sivamurthy, M.D., associate professor in the Department of Pediatrics at KU School of Medicine-Wichita, participates in a discussion during Schwartz Rounds.
By Brian Whepley
An ER doctor treats a patient before moving on to the next urgent case. A child life specialist works with a child with cancer in the playroom on the pediatrics floor. If that patient was their first to die, it's likely the doctor or child life specialist has never forgotten.
Those are just examples of the memories and feelings a new bimonthly program, Schwartz Rounds, seeks to stir with the intent of promoting wellness among doctors, nurses and other caregivers. The rounds - the inaugural one in February was "The First Patient I Lost" - were launched by KU School of Medicine-Wichita's Department of Pediatrics and the pediatrics residency program at Wesley Medical Center and are the local branch of an international program.
The February session drew more than 70 people from 10 disciplines. Melissa Hopper, Psy.D., a clinical assistant professor in the KU Wichita Department of Pediatrics, served as facilitator and four panelists briefly discussed a patient who stuck with them. The goal was to foster discussion, and they did.
"There are patients we have lost that stay with us no matter how many years go by. We carry those with us, even if it was someone we met for only a few moments," said Hopper, who works in pediatrics resident education and treats children and adolescents.
Schwartz Rounds are interdisciplinary, including doctors, nurses, social workers, chaplains, respiratory therapists and others working in health care. The goal is to improve teamwork and communication, increase compassion, better respond to patient and family needs, and reduce the stress and isolation providers sometimes feel. The structure emphasizes confidentiality, both of patients and the feelings about them.
"It really checks a lot of boxes," said Kerri Weeks, M.D., associate program director for the pediatrics residency and physician leader of the rounds. "We want the residents to be able to work in teams and appreciate the interdisciplinary nature of medicine. We also want them to understand the importance of finding ways to process their emotions, of having a healthy outlet for work stress, and we certainly want to promote compassionate care and empathy in our residency."
The Wichita program - Kansas' first - is assisted by the Schwartz Center for Compassionate Healthcare, founded in the name of Ken Schwartz, a Boston attorney who died at 40 from cancer. The rounds occur at more than 600 sites in the U.S., Canada, Australia, New Zealand, United Kingdom and Ireland. They are guided by the vision of Schwartz, who came to believe "the smallest acts of kindness" between patients and caregivers make "the unbearable bearable."
Weeks learned about Schwartz Rounds at a conference last year and thought it was a good fit for what the residency - and Wesley - sought involving wellness. Five people trained in Dallas, and Hopper later underwent special facilitator training. Other residency programs and facilities are interested in the program, and are welcome to participate, but for right now the rounds are focusing on providers and staff who care for pediatric patients at Wesley Children's Hospital while getting the local effort up and running, Weeks said. April's session focused on the struggles and emotions of patient non-compliance.
Amy Claassen, a chaplain whose responsibilities include the Children's Hospital, was a panelist in February. "It was so far out of the ordinary for us to enter in a conversation, especially in a large group, and be more vulnerable and share feelings, anxieties and concerns. I was just amazed in the way the large group engaged and participated in a meaningful way. It definitely showed that people are craving that kind of interaction."
Hopper serves on the rounds' planning committee and is one of two facilitators, along with Adam McClure, M.D., KU Wichita Pediatrics clinical assistant professor. "The feedback I received from some of the other disciplines, like from respiratory therapy and other clinicians, was that ‘we didn't realize that physicians felt these things the way we did.'"
"I think that our caregivers, everyone in the hospital role, often think we don't need to receive the care. When you look around, it looks like everyone is doing just fine. So opening the door and being vulnerable is really a big deal," Claassen said.
Unlike other rounds, there's no didactics. The intent, Hopper said, is to talk about "how do we cope with that, how do we support each other? So it's not to leave them in a place of vulnerability and then send them out, but to bring them to a place of resilience and coping."
"It helps when you have key leaders in the departments speak," Hopper said. "And it was great to have medical students there. For them, to see seasoned physicians talk about how these human issues affect them was really fantastic modeling of compassionate care."
In the spirit of the Schwartz Rounds, organizers have created the KU Wichita Pediatrics Compassionate Caregiver of the Year award. The first award was given out at the April session to Stephanie Binkley, a social worker and case manager who works on the inpatient pediatrics floors at Wesley. Other nominees were Debra Birdwell and Jo Ann Matthews, both who care for children with complex medical needs, and Robert Wittler, M.D., and Sid Sivamurthy, M.D., KU Wichita Pediatrics faculty. With her award, Binkley's name has been submitted for the Schwartz Center's national award.
"Stephanie is a continual example of compassionate care provided in very challenging circumstances," her nomination letter read. "She puts the needs of the patient and the family first in all interactions. ... She handles heart-wrenching discussions with patience, but is always persistent in finding solutions, which protect and support the child in need. Stephanie is a source of joy and support to every other member of the team."
The Schwartz Center for Compassionate Healthcare provides extensive details about the Schwartz Rounds and other programs on its website.
Above, at right: Scott McClure, M.D., and Melissa Hopper, Psy.D., stand with Stephanie Binkley, LBSW, recipient of the KU Wichita Pediatrics Compassionate Caregiver of the Year award.KU School of Medicine-Wichita