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The purpose of this paper is to systematically describe the types of non-clinical rounds implemented in hospital settings.

This scoping review was conducted and reported in accordance with the PRISMA. The review followed the four stages of conducting scoping review as defined by Arskey and O’Malley (2005).

Initially, 978 articles were identified through database search from which only 24 studies were considered relevant and included in the final review. Overall, eight types of non-clinical rounds were identified (death rounds, grand rounds, morbidity and mortality conferences, multidisciplinary rounds, patient safety rounds, patient safety huddles, walkarounds and Schwartz rounds) that independently of their format, goal, participants and type of outcomes aimed to enhance patient safety and improve quality of healthcare delivery in hospital settings, either by focusing on physician, patient or organizational system.

To the authors’ knowledge this is the first review that aims to provide a comprehensive summary to the types of non-clinical rounds that has been applied in clinical settings.

The purpose of this paper is to examine the impact of a structured clinical leadership programme on healthcare professionals working within the British National Health Service (NHS). Clinical leadership is now regarded as essential in addressing the complex challenges in the NHS, yet few trainees of any healthcare discipline receive formal training. The study describes a peer-led evaluation of a year-long, multidisciplinary, experiential programme, the “Darzi Fellowship”, based in London.

An anonymous survey was analysed using a mixed-methods approach. Individual and collective experiences of fellows were evaluated, in particular the perceived impact the fellowship had on: the fellows themselves, their “host” organisation and the NHS as a whole.

A 90 per cent return rate was achieved. In all, 94 per cent reported that the experience had been valuable to them, 85 per cent feeling more empowered to effect change in healthcare systems. Crucial mechanisms to achieve this included increased self-awareness, personal reflection and the freedom to gain a greater understanding of organisations. Particular emphasis was placed on the value of developing clinical networks which promote collaboration across boundaries. Fellows emerged as more reflexive, critical and strategic thinkers.

This paper demonstrates the positive impact that clinical leadership training can have on participants, and the mechanisms by which future leaders can be created.

The novel, non-commissioned, peer-initiated and peer-led evaluation describes the personal experiences of fellows in a unique, multidisciplinary clinical leadership programme. The authors hope this will inform the development of future schemes in the NHS and provide learning for an international healthcare audience.

Schwartz Center Rounds® (SCRs) bring multidisciplinary caregivers together to discuss authentic patient cases from the social and emotional perspective. The monthly sessions provide a forum to share personal thoughts and feelings. The purpose of this paper is to learn why people attend SCR, understand what is gained from the experience, and identify key elements to use in measuring the program’s effectiveness.

This qualitative descriptive study used four focus groups and three telephone interviews for data collection. Purposive sampling resulted in a multidisciplinary sample of 30 participants. Thematic analysis was conducted with complete transcripts by all researchers.

All parties viewed SCR as beneficial. Six themes emerged during data analysis: culture change, exposing emotions, walking in another’s shoes, inequality of topics, influence of rules and boundaries, and personal impact. Institutional culture was positively influenced through SCR.

Limitations include a single institution and restricted data gathered from physicians. Future research should focus on identifying outcome measures to evaluate the long-term impact of SCR on healthcare organizations.

This study confirms that the SCR program should be continued at the study organization, and expanded to increase availability to all staff. The growth of this program in healthcare organizations across the country is encouraged.

This research provides support for healthcare organizations to offer SCR and highlights how the emotional aspects of patient care can be acknowledged, explored, and discussed.

Hospitals must systematically support employees in innovative ways to uphold a culture of care that strengthens the system. At a leading Canadian academic pediatric rehabilitation hospital, over 90 percent of clinicians viewed Schwartz Rounds™ (SR) as a hospital priority, resulting in its formal implementation as a quality improvement initiative. The purpose of this paper is to describe how the hospital implemented SR to support the socio-emotional impact of providing care.

This quantitative descriptive study provides a snapshot of the impact of each SR through online surveys at four assessment points (SR1-SR4). A total of 571 responses were collected.

All four SR addressed needs of staff as 92.9-97.6 percent of attendees reported it had a positive impact, and 96.4-100 percent of attendees reported each SR was relevant. Attendees reported significantly greater communication with co-workers after each SR (p<0.001) and more personal conversations with supervisors after SR2 and SR4 (p<0.05) compared to non-attendees. Attending SR also increased their perspective-taking capacity across the four SR.

As evidenced in this quality improvement initiative, SR addresses staff’s need for time to process the socio-emotional impacts of care and to help reduce those at risk for compassion fatigue. SR supports and manages the emotional healthcare culture, which has important implications for quality patient care.

This research details an organization’s process to implement SR and highlights the importance of taking care of the care provider.

This paper aims to discuss the importance of compassion in health care and experiences of Compassion Circles (CCs) in supporting it, placing this into the national policy context of the National Health Service (NHS), whilst focusing on lessons from using the practice in mental health care.

This conceptual paper is a discussion of the context of compassion in health care and a description of model and related concepts of CCs. This paper also discusses lessons from implementation of CCs in mental health care.

CCs were developed from an initial broad concern with the place of compassion and well-being in communities and organisations, particularly in health and social care after a number of scandals about failures of care. Through experience CCs have been refined into a flexible model of supporting staff in mental health care settings. Experience to date suggests they are a valuable method of increasing compassion for self and others, improving relationships between team members and raising issues of organisational support to enable compassionate practice.

This paper is a discussion of CCs and their conceptual underpinnings and of insights and lessons from their adoption to date, and more robust evaluation is required.

As an emergent area of practice CCs have been seen to present a powerful and practical approach to supporting individual members of staff and teams. Organisations and individuals might wish to join the community of practice that exists around CCs to consider the potential of this intervention in their workplaces and add to the growing body of learning about it. It is worth further investigation to examine the impact of CCs on current concerns with maintaining staff well-being and engagement, and, hence, on stress, absence and the sustainability of work environments over time.

CCs present a promising means of developing a culture and practice of more compassion in mental health care and other care contexts.

CCs have become supported in national NHS guidance and more support to adopt, evaluate and learn from this model is warranted. This paper is a contribution to developing a better understanding of the CCs model, implementation lessons and early insights into impact.

The purpose of this paper is to discuss the underlying assumption that social workers need reflective supervision specifically, as opposed to managerial or any other form of supervision or support, and to consider whether our focus on the provision of reflective supervision may be preventing us from thinking more broadly and creatively about what support local authority child and family social workers need and how best to provide it.

The paper provides an argument based on the author’s own research and a selective review of the literature.

Reflective supervision has no future in local authority child and family social work because: first, there is no clear understanding of what reflective supervision is; second, there is no clear evidence for its effectiveness; and third, sizeable proportion of local authority child and family social workers in England do not receive reflective supervision and many never have.

The paper challenges the received wisdom about the value of reflective supervision and advocates exploring alternative models for supporting best practice in child and family social work.

The purpose of this paper is to examine the effect of authentic leadership (AL) on employees' health via employees' perception of climate of authenticity (PCA) across two studies. In study 2, the authors additionally explore the moderating role of employees' neuroticism.

The hypotheses were tested across two studies using two-wave survey data. In study 1 (n = 104), the mediation hypothesis was tested. Study 2 (n = 146) extended study 1 and examined the moderated mediation model.

Across both studies, AL is positively related to employee health, and employees' perceived climate of authenticity mediates this relationship. Study 2 additionally shows that employees' neuroticism moderates this indirect effect such that perceived climate of authenticity instigated by AL is particularly conducive for employees high in neuroticism as opposed to those low in neuroticism.

Findings emphasize the health-promoting effect of AL. It is recommended that organizations cascade, through their leaders, emotional display rules that encourage genuine emotional expression.

This paper addresses gaps in the leadership literature through investigating perceived climate of authenticity, a mediating variable that lies at the heart of AL, and integrating the role of employees' personality in the leadership process.

The aim of this article is to report some of the work undertaken by a nursing “think tank”, focussed on examining the causes of poor nursing care in hospitals, and potential solutions.

A “think tank” was convened which incorporated widespread discussion with national, regional and local stakeholders, a critical literature review, and a focus group of senior nurses.

It was found that there are no widespread systems of staff support that help nurses working in hospitals to cope with the emotional component of their work. This is one element that contributes to nurses providing poor care. A number of approaches to staff support have been developed that warrant further study.

If episodes of poor care are to be prevented it is necessary for hospital boards to recognise the importance of supporting nurses in managing the emotional labour of caring. The introduction of routine systems of staff support should be considered.

In addition to highlighting and condemning poor care, it is important to seek solutions. This article offers a new perspective on an enduring problem and identifies approaches that can be part of the solution.

Health care delivery is experiencing a multi-faceted epidemic of suffering among patients and care providers. Compassion is defined as noticing, feeling and responding to suffering. However, compassion is typically seen as an individual rather than a more systemic response to suffering and cannot match the scale of the problem as a result. The authors develop a model of a compassion system and details its antecedents (leader behaviors and a compassionate human resource (HR) bundle), its climate or the extent that the organization values, supports and rewards expression of compassion and the behaviors and practices through which it is enacted (standardization and customization) and its effects on efficiently reducing suffering and delivering high quality care.

This paper uses a conceptual approach that synthesizes the literature in health services, HR management, organizational behavior and service operations to develop a new conceptual model.

The paper makes three key contributions. First, the authors theorize the central importance of compassion and a collective commitment to compassion (compassion system) to reducing pervasive patient and care provider suffering in health care. Second, the authors develop a model of an organizational compassion system that details its antecedents of leader behaviors and values as well as a compassionate HR bundle. Third, the authors theorize how compassion climate enhances collective employee well-being and increases standardization and customization behaviors that reduce suffering through more efficient and higher quality care, respectively.

This paper develops a novel model of how health care organizations can simultaneously achieve efficiency and quality through a compassion system. Specific leader behaviors and practices that enable compassion climate and the processes through which it achieves efficiency and quality are detailed. Future directions for how other service organizations can replicate a compassion system are discussed.

The purpose of this paper is to identify the centrality of anxiety in health care, especially in the context of leading change. It identifies the importance of emotional labour for clinical professionals and the resultant development of defensive routines. The idea of containment is central to addressing anxiety.

The approach involves identification of anxiety as a key factor in leading change in health care, but one which is often ignored.

Anxiety is the elephant in the room vis-a-vis leading change in health care. To address the use of defensive routines, a range of activities can act as “containers” for anxiety and help with leading change.

To lead change in health care implies addressing the existence and importance of anxiety and the emotional labour which health-care professionals undertake.

The existence of anxiety and the profound impact it has on leading change in health care has typically been under-estimated or avoided. The paper aims to remedy this.