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Patients and clinicians endorse the importance of compassionate healthcare but patients report gaps between its perceived importance and its demonstration. Empathy and compassion have been associated with quality of life and significant health outcomes but these characteristics are not optimally measured or used for performance and organizational improvement. To address these gaps, we conducted a study with the objective of evaluating the properties of the 12-item Schwartz Center Compassionate Care Scale® using psychometric analysis and cognitive debriefing. Non-hospitalized patients with multiple chronic conditions were sampled using an on-line platform. Classical test theory and Rasch measurement theory were used to evaluate psychometric properties of the scale. Structured questions elicited cognitive responses regarding clarity of each item. Classical test theory analysis confirmed that the 12-item Schwartz Center Compassionate Care Scale is a unidimensional scale with excellent internal consistency and test-retest reliability. Patients' ratings of compassionate behaviors using the Schwartz Center Compassionate Care Scale correlated significantly with a related instrument designed to measure empathy, demonstrating convergent validity. Rasch measurement theory showed that reducing the number of response options on 3 items in the scale would improve respondents' discrimination between responses on these items. Although person-item threshold distribution analysis showed that patients may wish to rate compassionate care at levels both higher and lower than the scale permits, items could be ordered on an interval scale from low to high levels of compassionate care. The current 12-item Schwartz Center Compassionate Care Scale demonstrates excellent psychometric properties by Classical Test Theory and Rasch measurement theory. The 12-item Schwartz Center Compassionate Care Scale adds questions related to understanding and discussing emotional, contextual issues and the needs of the patient and family. Easily completed on-line, it could be used for work-place based assessment and feedback to clinicians and performance or quality improvement.

Organizational leaders are recognizing the urgent need to mitigate clinician burnout. They face difficult choices, knowing that burnout threatens the quality and safety of care and the sustainability of their organizations. Creating cultures and system improvements that support the workforce and diminish burnout are vital leadership skills. The motivation to heal draws many health professionals to their chosen work. Further, research suggests that compassion creates a sense of personal reward and professional satisfaction. Although many organizations stress compassion in mission and vision statements, their strategies to enhance well-being largely ignore compassion as a source of joy and connection to purpose.Passage of the HITECH (Health Information Technology for Economic and Clinical Health) Act in 2009 and the Affordable Care Act in 2010 ushered in a new era in healthcare. Little is known about how changes in the healthcare delivery system related to these legislative milestones have influenced health professionals' capacity to offer compassionate care. Further, advances such as artificial intelligence and virtual care modalities brought more attention to the elements that form the clinician-patient relationship.This study analyzed the views of U.S. healthcare providers on the status of compassionate healthcare compared with 2010. Postulating that compassion is inversely correlated with burnout, we studied this relationship and contributing factors. Our review of evidence-based initiatives suggests that leaders must define the organizational conditions and implement processes that support professionals' innate compassion and contribute to their well-being rather than address burnout later through remedial strategies.

[This corrects the article DOI: 10.1371/journal.pone.0220911.].

Compassion is a complex process that is innate, determined in part by individual traits, and modulated by a myriad of conscious and unconscious factors, immediate context, social structures and expectations, and organizational \"culture.\" Compassion is an ethical foundation of healthcare and a widely shared value; it is not an optional luxury in the healing process. While the interrelations between individual motivation and social structure are complex, we can choose to act individually and collectively to remove barriers to the innate compassion that most healthcare professionals bring to their work. Doing so will reduce professional burnout, improve the well-being of the healthcare workforce, and facilitate our efforts to achieve the triple aim of improving patients' experiences of care and health while lowering costs.

Background We proposed that the behaviors that demonstrate compassionate care in the intensive care unit (ICU) can be self-assessed and improved among ICU clinicians. Literature showing views of intensivists about their own compassionate care attitudes is missing. Methods This was an observational, prospective, cross-sectional study. We surveyed clinicians who are members of professional societies of intensive care using the modified Schwartz Center Compassionate Care Scale® (SCCCS) about their self-reported compassionate care. A modified SCCCS instrument was disseminated via an email sent to the members of the Society of Critical Care Medicine and the European Society of Intensive Care Medicine between March and June 2021. Results Three hundred twenty-three clinicians completed the survey from a cohort of 1000 members who responded (32.3% response rate). The majority (54%) of respondents were male physicians of 49 (+ − 10 SD) years of age and 19 (12 + − SD) years in practice. The mean SCCCS was 88.5 (out of 100) with an average score of 8 for each question (out of 10), showing a high self-assessed physician rating of their compassionate care in the ICU. There was a positive association with age and years in practice with a higher score, especially for women ages 30–50 years ( P  = 0.03). Years in practice was also independently associated with greater compassion scores ( p  < 0.001). Lower scores were given to behaviors that reflect understanding perspectives of families and patients and showing caring and sensitivity. In contrast, the top scores were given to behaviors that included conducting family discussions and showing respect. Conclusion Physicians in the ICU self-score high in compassionate care, especially if they are more experienced, female, and older. Self-identified areas that need improvement are the humanistic qualities requiring sensitivity, such as cognitive empathy, which involves perspective-taking, reflective listening, asking open-ended questions, and understanding the patient’s context and worldview. These can be addressed in further clinical and ICU quality improvement initiatives.

As the US health care system undergoes restructuring and pressure to reduce costs intensifies, patients worry that they will receive less compassionate care. So do health care providers. Our survey of 800 recently hospitalized patients and 510 physicians found broad agreement that compassionate care is \"very important\" to successful medical treatment. However, only 53 percent of patients and 58 percent of physicians said that the health care system generally provides compassionate care. Given strong evidence that such care improves health outcomes and patients' care experiences, we recommend that national quality standards include measures of compassionate care; that such care be a priority for comparative effectiveness research to determine which aspects have the most influence on patients' care experiences, health outcomes, and perceptions of health-related quality of life; and that payers reward the provision of such care. We also recommend the development of systematic approaches to help health care professionals improve the skills required for compassionate care. [PUBLICATION ABSTRACT]

Violence in healthcare settings is a global problem and violent acts are more likely to occur in emergency departments (EDs). Significant barriers to reporting workplace violence persist among healthcare workers. This, and lack of shared definitions and metrics, increase the difficulty of assessing its prevalence, understanding its causes, and comparing the impact of interventions to reduce its frequency. While risk factors for violence in EDs have been articulated, less is known about how the perspectives of patients and accompanying persons, and their interactions with ED staff may contribute to violence. We discuss the nature and social context of ED violence and some approaches used to address this problem in the U.S. We argue that perpetrators of violence as well as healthcare staff who experience ED violence suffer when it occurs. While securing safety is paramount, compassionate practices to address this suffering and the social context from which it emerges should be developed and provided for all involved. Collaboration among stakeholders, including patients and family members, may lead to effective approaches to address this problem.

Compassion is central to the purpose of medicine and the care of patients and their families. Compassionate healthcare begins with compassionate people, but cannot be consistently provided without systemic changes that enable clinicians and staff to collaborate and to care. We propose seven essential commitments to foster more compassionate healthcare organizations and systems: a commitment to compassionate leadership, to teach compassion, to value and reward compassionate care, to support clinical caregivers, to involve and partner with patients and families, to build compassion into the organization of healthcare delivery, and a commitment to deepen our understanding of compassion and its impact through research. Acting on these commitments will help us attend with care to the ill, injured, and vulnerable in every interaction.

The resulting moral distress only adds to the mental health burden of caregivers. STRESS FIRST AID FOR HEALTHCARE WORKERS Our first efforts came to fruition in March 2020 when we launched an open-access resource page on our website, www.theschwartzcenter.org, and a complimentary series of webinars to help all frontline caregivers and their leaders face the socioemotional and mental health effects of the pandemic. Since launching the program in the summer of 2020, we have trained more than 30 local teams at a variety of healthcare organizations using a hybrid blend of live and asynchronous learning. Drawing from the input of members and advice from mental health and trauma experts, we created trauma-informed guidance for the conduct of Virtual Schwartz Rounds that can be used for frontline teams and departments throughout an organization.

To examine factors that influence nurses' perceptions of organizational compassion and their engagement with the organization. Despite agreement about the importance of compassionate healthcare, it is difficult for employees to consistently act compassionately when organizational leaders, managers, and systems of care fail to support compassion as a value. The study used a cross-sectional design, and quantitative and qualitative data were collected through an online survey of nurses. Higher individual compassion and team compassion were associated with higher perceived organizational compassion, and higher organizational compassion was associated with greater engagement with the hospital. In contrast, high turnover rates and inadequate staffing were associated with lower perceived organizational compassion and lower engagement with one's organization. Adequate staffing, resource allocation, and practices that contribute to the sense that one is a supported member of a caring team focused on addressing patients' needs build the capacity for compassion within an organization.