Among a variety of Schwartz Center programs that strengthen and enhance the patient-caregiver relationship, the fastest growing and most far-reaching initiative is the innovative and unique Schwartz Center Rounds.

Purpose
To provide a forum where caregivers from diverse disciplines discuss important emotional and social issues that arise in caring for patients.

Audience
A broad range of professionals participate including physicians, nurses, social workers, psychologists, physical therapists and clergy. Depending on the size of the institution, 40-150 caregivers attend including "regulars" who return each month and newcomers.

History
The Schwartz Center started the Rounds at Massachusetts General Hospital in 1997. Currently, the Rounds are held at more than 100 sites, including hospitals, nursing homes, community health centers, and outpatient clinics in 25 states. Schwartz Center Rounds have thrived in diverse environments, can be replicated successfully and are fulfilling a tremendous need. The Schwartz Center is committed to starting Rounds in as many institutions across the country as possible.

Format
The Schwartz Center Rounds offer an open and relaxed forum where caregivers have the opportunity to discuss in depth, explore and reflect upon the difficult social and emotional issues of patient care. Although each institution puts it own stamp on the Rounds, the basic format begins with a brief presentation by two to three clinicians from different disciplines. They present the clinical history of a specific patient including relevant information about the family situation, patient's attitude, special circumstances and the like, and they discuss the psychosocial issue that will be the focus of the Rounds. During the rest of the hour, caregivers ask questions and exchange experiences, thoughts and feelings in relation to the topic. Patient and caregiver confidentiality are maintained.

Benefits
To assess the success of the Rounds, the Schwartz Center utilizes monthly evaluation forms, focus groups and is currently conducting a comprehensive quantitative and qualitative evaluation. The response has been overwhelmingly positive: participants find the sessions helpful and inspiring and they derive great benefit from the feedback and support they receive from colleagues. It is clear by the high level of participation and interaction that caregivers are hungry for an opportunity to express themselves openly in a safe environment. In many instances, Rounds stimulate small and informal follow-up discussions among co-workers. For a glimpse of moving and powerful Rounds discussions at two hospitals, please view the ten-minute video, "Voices of Caregivers," Low (Dial-up) | High (DSL/CABLE), or call 617-724-4746 to receive a copy in VHS, DVD or CD-ROM format.

Generally, participants gain the following skills, knowledge, ideas and understandings:

	Improved communication with patients and among caregivers
	Stronger connections and "sense of team" among caregivers as they realize they are not alone in struggling with difficult patient issues
	Increased knowledge, insight and sensitivity around difficult emotional and social issues that arise in caring for patients
	Improved understanding of the health care needs of patients from different countries and diverse cultures
	Help in meeting the spiritual needs of patients and families by relating to the patient's deepest concerns while carrying out clinical duties
	Increased support and comfort in the often difficult and stressful role of caregiver

Sample topics

	How to tell a patient it may be time to stop treatment
	The difficult and hostile patient/family
	Managing team conflict around how to treat a patient
	When your own issues of mortality come into play
	Humor and healing
	Pain management: comfort versus lucidity
	Timely hospice referrals
	Delivering bad news
	Death during the holidays
	Caring for a colleague
	When a patient cannot afford care
	How it feels when a patient "fires" you
	Pain management in the addicted patient
	Care of the elderly: assumptions and challenges
	Race and the patient-caregiver relationship
	Sexuality and illness: conversation comfort zone
	Losing faith in God: dealing with spiritual crises with patients
	Breakdown in communication between patients and caregivers

The Schwartz Center thanks the following generous funders who have made donations to support the Schwartz Center Rounds since 1997:

Aetna
Amgen
The Amgen Foundation
Analog Devices
AstraZeneca
Dolphin Trust
Eli Lilly and Company
Bank of America, Trustee, Perpetual Trust for Charitable Giving
Genentech BioOncology
Genzyme
GlaxoSmithKline
Harvard Pilgrim Health Care Foundation
OrthoBiotech
Pfizer, Inc.
SanofiAventis
The Sidney and Esther Rabb Family Foundations
Tufts Health Plan