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Exploring the adoption of Schwartz Center Rounds as an organisational innovation to improve staff well-being in England, 2009–2015
  1. Glenn Robert1,
  2. Julia Philippou1,
  3. Mary Leamy1,
  4. Ellie Reynolds1,
  5. Shilpa Ross2,
  6. Laura Bennett2,
  7. Cath Taylor1,
  8. Caroline Shuldham3,
  9. Jill Maben1
  1. 1The Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK
  2. 2The King's Fund, London, UK
  3. 3Independent Consultant, London, UK
  1. Correspondence to Professor Glenn Robert; glenn.robert{at}


Objectives Schwartz Center Rounds (‘Rounds’) are a multidisciplinary forum in which healthcare staff within an organisation discuss the psychological, emotional and social challenges associated with their work in a confidential and safe environment. Implemented in over 375 North American organisations, since 2009, they have been increasingly adopted in England. This study aimed to establish how many and what types of organisations have adopted Rounds in England, and to explore why they did so.

Setting Public healthcare organisations in England.

Participants Secondary data analysis was used to map and profile all 116 public healthcare organisations that had adopted Rounds in England by July 2015. Semistructured telephone interviews were conducted with 45 Round coordinators within adopting organisations.

Results The rate of adoption increased after a major national report in 2013. Rounds were typically adopted in order to improve staff well-being. Adopting organisations scored better on staff engagement than non-adopters; among adopting organisations, those performing better on patient experience were more likely to adopt earlier. Most adoption decision-making processes were straightforward. A confluence of factors—a generally favourable set of innovation attributes (including low cost), advocacy from opinion leaders in different professional networks, active dissemination by change agents and a felt need to be seen to be addressing staff well-being—initially led to Rounds being seen as ‘an idea whose time had come’. More recent adoption patterns have been shaped by the timing of charitable and other agency funding in specific geographical areas and sectors, as well as several forms of ‘mimetic pressure’.

Conclusions The innate attributes of Rounds, favourable circumstances and the cumulative impact of a sequence of distinct informal and formal social processes have shaped the pattern of their adoption in England.

  • EDUCATION & TRAINING (see Medical Education & Training)
  • Schwartz Rounds

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  • Twitter Follow Glenn Robert @gbrgsy, Julia Philippou @julia_philippou, Cath Taylor @CathTaylor72, Caroline Shuldham @CMShuldham, Jill Maben @nursingpolicy

  • Contributors JM and CT made substantial contributions to the conception or design of the work; GR, JP, ML, ER, LB, CT, CS and JM all contributed to the acquisition, analysis or interpretation of data for the work; GR, JP, ML, ER, SR, LB, CT, CS and JM all helped draft the work or revised it critically for important intellectual content; GR, JP, ML, ER, SR, LB, CT, CS and JM all gave final approval of the version to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The study reported here was funded by the National Institute for Health Research Health Services and Delivery Research Programme (project number 13/07/49).

  • Disclaimer The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Health Services and Delivery Research Programme, NIHR, NHS or the Department of Health.

  • Competing interests None declared.

  • Ethics approval Ethical approval for the whole evaluation—including participant consent processes—was granted by the ethics committee at King's College London (King's College Research Ethics Review Subcommittee ((PNMRESC RESC)) Ref: PNM/13/14-159).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Extra data relating to the survey responses and audio-recorded interviews are available by emailing GR,