A case-based Schwartz Rounds is about one specific patient. Panelists share their experiences caring for that one patient. For example, a case may be about a patient and their impact on the caregiving team, which may include a physician, a respiratory therapist, and a patient transporter. Participants may respond to the panelists’ stories by sharing their own experiences with that patient, or they might share experiences that were similar or related in some other way to the experiences shared.

A topic-based Schwartz Rounds features panelists who speak about related experiences with different patients. For example, Schwartz Rounds about “Patients Who Inspire Us” may include a multidisciplinary panel, each with a unique tale of a patient that inspired them; for example, a panel could include a nurse, a chaplain, and a social worker. Participants then share their own stories of inspiring patients in response to the panel.

There are advantages to both case- and topic-based Schwartz Rounds. A case-based Schwartz Rounds might give colleagues an opportunity to reflect on how deeply affected they were by a single patient or family, while a new team might find topic-based Schwartz Rounds a great way to help colleagues understand and embrace the concept of Schwartz Rounds.

There are many sources for identifying cases and topics:

• The Planning Committee enlists colleagues from across the organization to stay apprised of current events and “ears to the ground.”
• The page on our website includes an interactive search function, which will provide possible titles across many topics.
• Schwartz Rounds participants (via evaluation forms and other interactions)
• Planning Committee or Leadership Team members may create a suggestion box in a common space or online using the organization’s intranet. A place for suggestions will allow people to recommend Schwartz Rounds cases or topics throughout their workdays.
• Department Chiefs, Chairs, and members of the system or organizational leadership team may provide suggestions for topics related to their organizational strategy for Schwartz Rounds.
• Chaplains, case managers, patient experience staff, and representatives from Patient and Family Advisory Committees are great resources for specific cases or recurring themes.

• Rotate through departments in selecting a case or topic, for example, focusing on experiences or patients from Critical Care in September, Pediatrics in October, Oncology in November, etc.
• Walk the floors and ask nursing managers what staff have been struggling with. Let them know the Schwartz Rounds is a source of support and can help them address emotional challenges for their teams.
• Highlight areas of relevant institutional focus.
• Link to current events or holidays. November and December Rounds may be held on “finding gratitude” or “blue holidays.” February is Heart Health Month.
• Consider annual topics, like “Humor in Healthcare” and “Unsung Heroes.”
• Don’t forget to highlight the contributions of allied health professionals and support staff. Schwartz Rounds is a great opportunity to center voices in your organization that aren’t often heard.

Remember to seek out topics that are uplifting alongside more challenging topics. Try to engage with the full spectrum of emotional experiences in healthcare.

Some sessions might benefit from the participation of panelists from outside your organization, such as first responders, patient proxies, or staff from local rehab or long-term care facilities or organ procurement organizations. It is best to wait until your organization has gained familiarity with Schwartz Rounds before bringing in non-staff participants. Please contact your Member Experience Advisor for suggestions on how to bring outside panelists into your Schwartz Rounds successfully.

• Always consult with your legal counsel or risk management if you have concerns about the sensitivity of a specific case or the involvement of a particular panelist. You may wish to engage them early in your planning process to affirm that Schwartz Rounds sessions will observe HIPAA as do other conferences, that patient identifiers will be minimized or avoided, and that the focus of the conversations will be caregivers rather than patients.
• As a general rule, avoid cases or topics that include patients with potential litigation or grievances, currently admitted patients, or patients whose family members are hospital staff.

Note: Schwartz Rounds teams sometimes consider inviting patients or family members to participate as panelists. Because the focus of Schwartz Rounds is caregiver experience and the priority is to offer Schwartz Rounds as a safe space for reflecting on those experiences, the Schwartz Center generally discourages patients and family member involvement. If this is something your team would like to consider, please consult with your Member Experience Advisor.

Asking panelists or participants to recall, recount, or re-experience recent traumatic events may re-traumatize those involved or newly traumatize listeners. The recollection of specific details can increase the risk of acute stress disorder or post-traumatic stress disorder. To avoid causing harm to panelists and participants, we recommend:

• Avoiding cases that relate to currently admitted patients
• Ensuring that Schwartz Rounds are not the first place where exceptionally traumatic events are discussed (for instance, in certain cases grief or other individual counseling might be more appropriate)
• Utilizing, as appropriate, the five evidence-based elements of trauma-informed facilitation:  sense of safety, calm, connection, self-efficacy, and hope

No matter the topic of your Schwartz Rounds, please ensure that – when needed — there has been mental and behavioral health support for those who’ve been exposed to trauma prior to holding Schwartz Rounds. Remember: While Schwartz Rounds may be therapeutic, they are not therapy.

Established Schwartz Rounds programs offer brave spaces where participants can share complex emotional experiences – including those related to racism, discrimination, bias, microaggressions, and other forms of racial trauma and marginalization. We urge teams to be thoughtful and intentional when planning Schwartz Rounds about identity differences. If your team would like to center a Schwartz Rounds on diversity, equity, and inclusion, we encourage you to use this Schwartz Rounds Equity Impact Assessment Tool (EIAT) to help guide your planning.

The EIAT is an internal planning tool to help your Schwartz Rounds Planning Committee convene a conversation about the best ways to center experiences related to racism and racial trauma in the context of your Schwartz Rounds program, and to include key stakeholders in that conversation. This resource will help you assess how and whether your Schwartz Rounds program (and other organizational initiatives) can help shape your approach to addressing topics related to diversity, equity, and inclusion.

The EIAT is one way that your team can assess the impact of your chosen topic and support efforts to prevent the marginalization and tokenization of specific team members during Schwartz Rounds and Schwartz Rounds planning. It will also prompt you to determine if appropriate accountability structures are in place for policy and systems issues that may come to light. With your Schwartz Rounds Planning Committee, please complete the assessment to identify opportunities and gaps in your planning.