The Physician/Clinical Leader or Facilitator can introduce Schwartz Rounds, or it may be a shared responsibility. The components of the Introduction are:

• Welcome
• The Schwartz Center and the Origins of Schwartz Rounds
• A Description of Schwartz Rounds
• Ground Rules for Schwartz Rounds
• Panelist and Topic/Case Introduction

To open your Schwartz Rounds session, extend a warm welcome to everyone present, and acknowledge current events in your organization and globally. Express appreciation and gratitude to all participants. You may consider reading a brief reflective quote or poem. Some organizations open with a moment for a deep breath or a centering reflection to set the tone.

The mission of the Schwartz Center for Compassionate Healthcare — a non-profit organization based in Boston, Mass. — is to put compassion at the heart of healthcare through programs, education, and advocacy. Provide a brief overview of how your organization’s mission and purpose align with the Schwartz Center’s belief that compassion is an essential element of healthcare and explain why your organization has chosen to host Schwartz Rounds.

Many Schwartz Rounds introductions include a mention of the founding of the Schwartz Center as Ken Schwartz’s legacy. Ken Schwartz, a prominent healthcare attorney who died of advanced-stage lung cancer in 1995 at the age of 40, established the Schwartz Center shortly before he died. During his brief ten-month illness, Ken published “A Patient’s Story,” a poignant account of his struggle with cancer, in which he described the exceptional group of caregivers who attended to his medical and emotional needs over the course of his illness. As he wrote, “These acts of kindness — the simple human touch from my caregivers — have made the unbearable bearable.” 

Ken worried that as the healthcare landscape changed, compassionate relationships would become less possible for patients and caregivers. Before his passing, Ken expressed a wish to establish a center that would help sustain compassion, by focusing on patient-caregiver relationships. Schwartz Rounds are a result of that wish.

Read: A Patient’s Story (PDF)

Schwartz Rounds offer an inclusive interprofessional forum where caregivers meet to discuss the challenging emotional and social issues in caring for patients. Unlike other such meetings and conversations in healthcare organizations, Schwartz Rounds are not clinical, problem-solving, or academic in nature. By contrast, Schwartz Rounds provide an opportunity for respite and connection, as a supportive forum where staff members can talk about their emotions and feelings, learning from and finding community and understanding with colleagues.

Schwartz Rounds were piloted at Massachusetts General Hospital in 1997 and have been held there ever since. Currently, Schwartz Rounds are held in hundreds of healthcare organizations — hospitals, long-term care facilities, community health centers, outpatient clinics, organ-procurement organizations, and more — across the United States and in the United Kingdom, Ireland, Canada, Australia, and New Zealand.

As part of your introduction to each Schwartz Rounds session, you’ll share the ground rules for participants.

Confidentiality: The cornerstone of Schwartz Rounds is confidentiality and creating a trusted space where participants can feel safe or brave sharing their feelings and emotions and allowing themselves to show vulnerability. Unsurprisingly, confidentiality is critical to protect patients, families, and colleagues. While specific details of what’s said at Schwartz Rounds should remain in the room, further discussion about the themes explored during Schwartz Rounds sessions is encouraged.

Managing Distractions: We strive to be fully present during Schwartz Rounds and free of distractions and ask respectfully that participants silence all cell phones and pagers during the session, understanding of course that clinical duties might sometimes demand our attention. If Schwartz Rounds are virtual, we ask that participants avoid multitasking in email and other apps during the session.

Offering Empathy and Compassion: Remind participants that this is a time for collective restoration, not a time for problem-solving or addressing the many systemic and national challenges that plague healthcare and our healthcare organizations.

Respectful Listening: The richness of Schwartz Rounds involves welcoming diverse perspectives from colleagues from other roles, departments, and backgrounds – including race, religion, gender identity, and ethnicity. Respectful listening and suspension of judgement is vital. We recognize that colleagues bring different opinions to Schwartz Rounds, and we strive not for agreement but for mutual understanding.

Additional Support Resources: We suggest you identify support resources for your staff, including employee assistance (EAP), pastoral care, and behavioral or mental health professionals, and share these in a handout or PowerPoint slide at the beginning and end of each Schwartz Rounds session.

Evaluations: Always remind participants at the beginning and end of Schwartz Rounds to complete their session evaluation. Note their importance for the Planning Committee, along with the opportunity for participants to share feedback and to suggest topics or cases for future discussions. The Schwartz Center team also asks that you share your evaluations with us so that we can support you appropriately in leading your program. After each Schwartz Rounds, the Program Coordinator emails the session evaluation to rounds@theschwartzcenter.org.

After setting the stage for Schwartz Rounds and establishing a sense of safety or bravery, it’s time to introduce the panelists and the Schwartz Rounds topic or case for discussion. The topic or case synopsis should take no longer than five minutes. Each panelist should speak three to five minutes. The total time allocated to the Introduction should be no more than 10 minutes.

Read: Introducing Schwartz Rounds (PDF)

• Introduce the panelists.
• Ask the panelists to speak for three to five minutes each.
• Allow panelists to share the social and emotional aspects of their experience with the case or topic.
• Ensure that all panelists have finished sharing their stories by 25 minutes past the hour.
• For more details on preparing panelists before the sessions, please visit “Preparing Panelists and Yourself for Schwartz Rounds.”

• Express gratitude to the panel.
• Summarize themes from the panelists’ experiences.
• Offer a moment for participants to reflect silently on what they have heard. Use a reflective question prompt, for example:
  • Shall we take a moment to reflect?
  • How are you feeling at this moment?
  • What feelings did you hear expressed by our panelists?
• Invite participants to share a story, experience, or reflection related to the theme of the session, for example:
  • What is uppermost in your heart and mind as it relates to [today’s theme]?
  • What resonates as you listen to others speak?
  • What are you thinking or feeling right now?
• For more tips on facilitating a robust conversation, please visit “Facilitating Schwartz Rounds.”

• Reflect on what you see and hear from participants.
• Note that while our common humanity and challenges can unite us, we respond to stressful events differently. Stress may look like frustration, anger, sense of moral duty and moral distress, anxiety, or grief.
• Use trauma-informed facilitation skills to reinforce a sense of safety, calm, connection, self-efficacy, and hope.
• Help participants modulate emotions and engage in the cognitive reframing of extreme statements. Use language like:
  • “I wonder if anyone sees that differently…”
  • What would it look like if we considered this perspective?
  • What helped you get through that challenging moment?
• Express and reinforce gestures of compassion, respect, and appreciation.

• Summarize overarching themes as you go. Acknowledge differences in perspectives.
• Manage digressions by:
  • Asking participants to maintain a respectful tone regardless of differences
  • Asking participants to share an experience in which differences were resolved with positive intentions
  • Acknowledging any frustrations related to systemic or organizational processes and respectfully remind participants of the purpose of the Schwartz Rounds forum
• Facilitate with compassionate behaviors, including modeling a non-anxious presence, curiosity, active listening, respect, appreciation, patience, tolerance with uncertainty, and comfort with silence.
• Continue the use of trauma-informed facilitation skills.

• Ask the participants to voice how they find support and solace for themselves.
  • Who do they turn to?
  • How have they found support in the workplace? What has helped?
  • How have they supported others?
• Share resources for supporting the community including information related to services like EAP, Behavioral Health, and Pastoral Care at your organization.
• Consider providing additional resources that are related to the specific topic or case.

• “Signpost” the end of the conversation. For example, you can say, “I’m going to ask one more question before we wrap up.”
• Summarize key themes that have emerged from participants’ comments.
• Thank those present, panelists, Leadership Team members, and co-facilitators.
• Offer a closing reflection related to the theme of the session. Some examples might be:
  • “Compassion can come from anyone at any time.”
  • “We have to be kind to ourselves so that we can be kind to others.”
  • “We are grateful for the multiple perspectives, experiences, and stories of colleagues.”
  • “We value teamwork, connection, and supporting each other; none of us can do this alone.”
• Encourage conversations to continue but remind participants to maintain confidentiality.
• Consider developing a ritual for closing, such as reading a poem or offering a silent moment of reflection; this will help people feel a sense of continuity with the past and create space between the session and whatever the rest of the day might hold.
• Remind participants of resources for mental health and well-being support.
• If you can, let participants know when the next Schwartz Rounds will take place.
• Remind participants to complete session evaluations.