Wednesday September 25, 2019
Compassion in healthcare – the evidence?
Each year the Exec team puts aside time to assess progress over the last year, and ensure we have clearly identified priorities for the year ahead. It also provides an opportunity for members of our team to present thought-provoking topics. Our colleague Professor Peter Gilling this year discussed the question: ‘Is compassion really necessary in healthcare?’
Compassion is something I’ve been thinking about recently. As we get busier as an organisation and in our daily lives in general, there is the potential for our capacity for compassion to suffer. Can we somehow be too busy for compassion? I recently heard of an event elsewhere in the country where a small group of patients being discharged were treated with a complete lack of compassion. It brought to mind the events in the Mid Staffordshire Trust in the UK, where amongst other failings a culture lacking compassion and empathy lead to very poor outcomes for patients.
Intuitively everyone would say that having compassion in healthcare and in our values makes sense. Peter spent time robustly researching the evidence base on the role of Compassion in healthcare. He found a huge body of evidence, with many, many very well regarded studies confirming that compassion is an essential element of effective health service delivery.
Some of the key facts and figures make interesting reading:
Physiological and psychological effects of compassion
• causes a rise in oxytocin – the trust/love/bonding hormone
• lowers the receiver’s blood pressure
• promotes healing from trauma – good outcomes four times higher
• is a cornerstone of palliative care – better quality of life, survival increases of 30%
• modulates pain through endogenous opioids - endorphins
• results in better outcomes; patients of ‘high compassion physicians’ had better diabetes control (HbA1c) and 80% higher odds of optimal cholesterol control and 41% lower odds of serious complications.
Compassion and patient self-care
• Self-efficacy (belief in treatment or health goals) increased by 39% if HIV patients felt their healthcare professional knew them as a person.
• Motivation, activation (self-motivated to act) and engagement all improved in groups receiving compassionate care – lead to better self-care. Compassion and healthcare quality
• Physicians within the highest tier for ‘depersonalisation’ had 50% higher odds (compared to those in the lowest tier) of committing a major medical error in the next three months.
Revenue and costs
• Compassionate physicians refer less and order fewer tests.
• A compassionate culture cuts employee absences.
• A compassionate culture decreases physician burnout.
• A compassionate culture lowers malpractice costs - compassion avoids lawsuits.
• A Harvard study revealed that 56% of physicians felt they did not have enough time to treat patients with compassion.
• An ‘Enhanced compassion intervention’ (scripted intervention in an oncology setting, leading to significantly reduced patient anxiety) took 40 seconds.
• Compassion-trained physicians’ consultations took 54 seconds longer than non-trained.
Antidote to burnout
• 50% of US physicians are suffering burnout symptoms.
• High compassion is associated with low burnout and vice versa.
• Compassion matters not only in meaningful ways but also in measurable ways.
• Human connection confers distinct and measurable benefits.
• Compassion is always the right thing to do.
• Compassion matters for patients, for patient care and for those who care for patients.
Many thanks to Peter for showing us the evidence base for this important value. A great reminder to all of us that the compassion we show our patients and our colleagues is truly good for them, and good for us!
Points to ponder
Some comments and quotes which came out of the meeting resonated with me and I thought I would share some of them with you below.
• Our Allied Health Executive Director Sarah Mitchell said, as a way of breaking away from conventional thinking and ways of doing things, she’s planning to have plenty of “constructive, disruptive conversations” in the year ahead.
• Corporate Services General Manager Owen Wallace, who is leading some work around sustainability, said our mindset needs to be one whereby “we find a way to thrive, not just survive.”
• Quality and Patient Safety Clinical Director Jerome Ng and Chief Information Officer Richard Li presented to us on their reflections of being new to the organisation and the opportunities available for improvement. Richard noted that “constraints are the best launchpad for innovation.” The pair signed off their presentation by saying: “We dare you to think differently about thinking differently.”
• Planning and Funding General Manager Simon Everitt, during a talk on the Strategic Health Services Plan, urged people: “When you’ve got a challenge: own it, fix it, learn from it. Step up and be accountable.”
• Surgical Service Medical Leader Troy Browne gave a presentation on the Oxfam Trailwaker event he’s completed five times. He said: “The good old days of yesterday are created today” and “The brain forgets the pain, the heart remembers the love.”
• Our Toi Te Ora Public Health colleagues who oversee workplace wellbeing initiative WorkWell said: “If you want someone to do a good job, give them a good job to do.”
Get to know your colleagues
Linking in with the theme of compassion, having compassion for our colleagues is just as important as having it for our patients. Part of this is simply getting to know those who we work with and with whom we share our working lives.
I encourage you to ask a colleague about what is important to them outside their working lives and share something that is important in yours. It’s a way of connecting with those around you and it’s nice to hear about what’s happening in one another’s worlds outside the DHB.
I have a catch up with our Communications Advisor James Fuller every couple of weeks to talk about what is going to go into this newsletter. In the course of that, over the last nine months or so, I’ve also been kept up to date with the wonderful news that he and his beautiful partner Zipporah were expecting their first baby. The even happier news followed recently that little Alfie is now with us, having been born on Tuesday 6 August. I now get to see the latest photos and watch how their gorgeous little boy is growing.
In the spirit of this I would like to share something which is happening in my life at the moment.
My husband Max is currently biking from Adelaide to Darwin on his own, with just his bike and his tent. He’s making very good progress but it was hard saying goodbye to him. I know it’s a tough slog for him but I’m confident he’ll get there. He’s made it past Alice Springs – so half way there!