November 5, 2004

New rounds focuses on more than medical care

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photo by Dana Johnson

New rounds focuses on more than medical care

A new kind of medical rounds will begin at Vanderbilt Medical Center this month, bringing doctors, nurses, social workers and other health care providers together to focus on the needs of patients and families beyond their medical care.

The program is called Schwartz Rounds, created in 1997 in honor of a young cancer patient, Kenneth B. Schwartz, who founded The Schwartz Center at Massachusetts General Hospital. VUMC’s former director of health policy development, Marilyn Yager, served as the Schwartz Center’s director from 1999-2003.

The program supports compassionate health care delivery and works to strengthen the relationship between patients and caregivers. Since the Schwartz Rounds program began, it has branched out to nearly 60 medical institutions across the country. Vanderbilt now joins that list, as an interdisciplinary team works to implement the program here.

A. Scott Pearson, M.D., assistant professor of Surgery, is the physician leader of the Schwartz Rounds program at VUMC. He said the program will focus on the care of cancer patients, but the concepts will be applicable to a larger population. “What it provides, which may be lacking in our day-to-day care, is the opportunity to closely examine the overall needs of cancer patients and their families as they move from diagnosis to treatment and beyond,” Pearson said.

Schwartz Rounds won't take place at the patients' bedside, but in a conference room beginning with a 10-minute presentation of a difficult case, followed by an open discussion among colleagues and peers from multiple disciplines.

“The Rounds will provide a safe place for health care providers to express their personal experiences with health care delivery,” said Linda Riley, Ph.D., research associate, postdoctoral fellow in Oncology Nursing, and a member of the Schwartz Rounds implementation team. “I think we will learn from each other how to better provide quality care to the patients and families coping with illness,” she added.

Riley said research studies have shown the program can have a positive impact. “What they found is an improvement in the relationship between patients, families and health care providers, because it improves their ability to communicate.”

Barbara Murphy, M.D., associate professor of Medicine and director of the Vanderbilt-Ingram Cancer Center's Pain and Symptom Management Program agrees. “As health care providers, we are faced with many difficult, emotionally draining circumstances. It is important that we have the opportunity to discuss these challenges with each other in an open and non-threatening forum. Through opportunities such as Schwartz Rounds, we can garner support from our peers as well as learn new ways to cope with challenging issues,” Murphy said.

The Schwartz Center offers suggested topics of discussion such as provider burnout and end-of-life issues, but Riley and Pearson said Schwartz Rounds at VUMC will also incorporate some topics already being addressed here. “We're establishing a program of Narrative Medicine, which emphasizes the patient's perspective,” said Pearson. “It's based on recognizing that each patient comes with their own story and what is most important to them in their health care. In Schwartz Rounds we'll talk about that in each scenario,” he added.

Pearson said the program makes an important statement that Vanderbilt cares about the psycho-social issues facing patients in addition to their medical needs. “Vanderbilt is at the forefront of recognizing that we've got to provide services to the patient beyond just treatment. This is another way that we're reaching out and trying to provide a larger sphere of care to cancer patients.”

Schwartz Rounds will be held on the third Wednesday of each month, beginning in November, from 12-1p.m. in room 1951 of The Vanderbilt Clinic. Lunch will be provided. For more information on the program contact Linda Riley at 343-3316 or Lisa Liles at 322-7463.