We know that compassion and alleviating pain and symptoms generally feature high on consumers’ wish lists. But do healthcare providers feel that the latter is more useful than the former? There’s plenty of science now that suggests that this is the wrong way around. There are many examples, backed by randomised control trials, of compassion being an essential part of alleviating pain and suffering. And many other great benefits – including $$$ savings. And it’s free!
1. QUALITY QUANDARY: THE SCIENCE OF CARING
‘Compassion is the emotional response to another’s pain and suffering involving an authentic desire to help. In health care, compassion is a basic assumption of the therapeutic relationship, and patients and healthcare workers alike, consider compassion to be a vital element of high-quality care.’
It’s powerful stuff and could form a whole new approach to improvement.
2. TLDR (Too Long Didn’t Read) (time 7:45)
Jones read Compassionomics so you don’t have to – but we recommend you do, anyway! Better outcomes, reduced cost, less staff burnout – and it doesn’t cost a thing to implement, just a little effort.
Stephen Trzeciak and Anthony Mazzarelli. Compassionomics: the revolutionary scientific evidence that caring makes a difference. 2019.
Body language alone can make a difference
- Open posture body facing the patient
- No physical barriers
- Be close enough to touch
- Sit, at at eye level
- Lean in
- No arm or leg crossing
- Touch of hand
- Compassionate concerned facial expression
- Eye contact
- I see you as a person
- I care about you
- I have time for you
- I care about and take time to understand your “why” and purpose
- Don’t interrupt (most doctors interrupt the patient after only 11 seconds).
- I acknowledge your suffering
- This must be very difficult for you
- It sucks to be sick (or your equivalent of this)
- I believe you
- How are you feeling about this?
- I’m so sorry you have to wait.
- What are you most worried about?
- [Any statement that gives hope]
- What is your main worry? [Use the answer to work out their main goal – the patient related goal.]
Compassion when there is bad news
- Whatever we do and however that develops, we will continue to take good care of you
- We will be with you all the way
- We will do and continue to do our very best for you
- Whatever happens we will never abandon you
- You are not facing this on your own
- Together we will have a careful look at decisions you have to make and will keep a close eye on your concerns
3. THE POINT (time 34:00)
Yes, compassion can be measured, by consumers, with validated tools:
Roberts, B.W., Roberts, M.B., Yao, J., Bosire, J., Mazzarelli, A., Trzeciak, S. Development and validity of a tool to measure patient assessment of clinical compassion. JAMA Network Open 2019 May 3;2(5):e193976
CARE (Consultation and Relational Empathy Tool) 2004
4. DRDR (time 39:00)
And it can be taught…
Patel, S., Pelletier-Bui, A., Smith, S., Roberts, M.B., Kilgannon, H., Trzeciak, S., Roberts, B.W. Curricula for empathy and compassion training in medical education: a systematic review. PLOS ONE 2019;14(8): e0221412
The study identified the following 5 behaviors to be effective & trainable:
- (1) sitting (versus standing) during the interview;
- (2) detecting patients’ non-verbal cues of emotion (facial expressions etc);
- (3) recognizing and responding to opportunities for compassion;
- (4) non-verbal communication of caring (e.g. eye contact); and
- (5) verbal statements of acknowledgement, validation, and support.
5. OTHER BITS:
ACSQHC Better Care Everywhere series: https://www.safetyandquality.gov.au/our-work/healthcare-variation/better-care-everywhere-program-series
Looking for a quality ‘tribe’ and resources to help with the challenges of quality and clinical governance roles? The Australasian Institute of Clinical Governance (AICG) membership community is now open! Find it here: https://www.aicg.edu.au/aicg-membership/?ar=CBLD
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