A series of service development workshops in 2017-2018; part of the AHRC-funded Compassion in Healthcare: Practical Policy for Civic Life project.
One of the OUH NHS Foundation Trust’s strategic objectives is ‘delivering compassionate excellence’. As part of the AHRC Compassion in healthcare project, the OHVP wanted to examine how this translates into practice for OUH NHS Trust departments’ multidisciplinary teams (MDTs). This should generate service development recommendations to fit in with each department’s existing practice.
Knowledge exchange forms the core of the workshops. It enables OHVP explore how compassion is understood by people working across healthcare, to ground the philosophical and theological research in healthcare practice. In turn, OHVP provide the workshops’ framework based around accessible ways of looking at traditions of thought about compassion to help healthcare workers think creatively about what compassion means to them in their work.
Each OUH department is different, so co-design with the department head is an important part of the process. This ensures that materials used and approach to the topics covered are geared towards the department’s specific concerns.
Representatives from across the breadth of the MDT attend a series of three workshops to explore what compassion means, how stories and beliefs inform compassion, and responsibility, candour and criticism within compassionate care. OHVP facilitate these workshops to help staff discuss compassion in the context of their professional roles, the department and the Trust. Religious and philosophical examples are used to open up debate about how compassion can be better understood and practiced.
Use of Findings
Once all of the findings and feedback have been analysed, OHVP provides a themed summary of the agreed practice changes generated by the department. This is also written into a brief report for the department to use with other colleagues, new starters and other departments within the Trust as needed. Plans for implementation and follow-up are then agreed with the department. For further information about the compassion workshops, see reports below.
Understanding ‘Compassionate Excellence’ in Practice: Haematology Report
Understanding ‘Compassionate Excellence’ in Practice: Obstetrics and Gynaecology Report
To date, two departments – Vascular Services and Haematology Department – have participated, and both have provided vital insight and positive feedback. Two more departments will be taking part in 2018. At the end of all four series of workshops, it is hoped that the research can be extended to a follow-up session and an overall report for the contributing departments.
Further reading/research underpinning this Knowledge Exchange activity
Dewar, B., Adamson, E., Smith, S., Surfleet, J., King, L. (2015). Clarifying Misconceptions about Compassionate Care. Journal of Advanced Nursing70(8): 1738-1747. https://www.ncbi.nlm.nih.gov/pubmed/24283294
Hordern J (2013). What's Wrong with ‘Compassion’? Towards a Political, Philosophical and Theological Context. Clinical Ethics 8(4): 91-7. http://journals.sagepub.com/doi/10.1177/1477750913502613
Hordern, J. (2016). Religion and Culture. Medicine 44:10: 589-592. http://dx.doi.org/10.1016/j.mpmed.2016.07.011
Hordern J. (2017). Compassion in primary and community healthcare. In A handbook of primary care ethics. Papanikitas A., J. Spicer (eds.). Abingdon: Radcliffe/Taylor & Francis.
Sinclair et al. (2016). Compassion: a scoping review of the healthcare literature. BMC Palliative Care 15:6. http://dx.doi.org/10.1186/s12904-016-0080-http://valuesbasedpractice.org/
Thanks to members of the vascular service and haematology department for their participation. This service development activity is part of a research project funded by the Arts and Humanities Research Council project entitled Compassion in Healthcare: Practical Policy for Civic Life. We are grateful for this funding and for the support of Professor Peter Sullivan and Dr Claire Pulford both in the initial application and in the implementation. This project has had the approval of the University of Oxford/OUH Clinical Trials Research Governance team and the University of Oxford Central University Research Ethics Committee.
Background: Pilot workshops 2015
Details of workshops that took place in autumn 2015 exploring compassion in relation to patients, time, colleagues, and the market. These workshops formed the basis for pursuing further work in 2017-2018.
Dr Claire Pulford, Divisional Education Lead (Medicine), Consultant Physician, Trauma/Geratology, Oxford University Hospitals NHS Trust.
Dr Joshua Hordern, Associate Professor of Christian Ethics, Faculty of Theology and Religion, Harris Manchester College, University of Oxford
Dr Andrew Papanikitas, NIHR Clinical Lecturer in General Practice, Harris Manchester College, University of Oxford.
The partnership between OUH NHS Trust and the Oxford Healthcare Values Partnership emerged from conversation between Dr Pulford, Dr Hordern and Dr Papanikitas at ‘Compassion in Healthcare’ Knowledge Exchange seminars funded by The Oxford Research Centre in the Humanities (TORCH). During the course of these seminars, a need was identified to provide opportunities for humanities and social science researchers to explore values important to healthcare, especially compassion, in partnership with doctors, nurses and others involved in healthcare in OUH. Conversations led to a series of seminars in autumn 2015.
Dr Hordern and Dr Papanikitas obtained funding for this initiative from the Wellcome Trust Institutional Strategic Support Fund.The initiative was assisted by a post-doctoral researcher funded by the Wellcome Trust grant, Dr Therese Feiler.
Outline of Seminars
Drawing on the Healthcare Values Partnership’s strengths in humanities, healthcare and social sciences, a set of four seminars exploring different dimensions of compassion are briefly outlined below:
Compassion for Patients: Personal, Public and Practical
This seminar explored several key ways of thinking about compassion which are vital for the patient-professional relationship. Key themes included personal convictions and patient narratives; public responsibility and citizenship; practical guidance and lifelong resilience.
Compassion and Time: Exploring the Fourth Dimension
This seminar focused on the many significances of time for the patient-professional relationship: the professional experiences of ‘no time’ or ‘very little time’; threats to compassion in our current time; the dangers of perceiving people as ‘out of time’; patient time as ‘weighty’ time; the importance of conceiving patients and healthcare workers in terms of their life-course; and ways of navigating the challenges which the many experiences of time present.
Compassion for Colleagues: Core Values for Healthy Teams
This seminar explored this often under-recognised aspect of compassion in healthcare. Why is it important to care for colleagues and what does it mean in practice? When the ethos of healthcare is ‘patient-centred’, what does that mean for a focus on those you work with? What role might criticism have in either developing or demolishing an ethos of compassion? What is ‘self-compassion’ and why might it be important for sustaining healthy teams?
Compassion and the Market: Friends or Foes?
This seminar examined whether private involvement in healthcare and social care necessarily causes damage to the spirit of service and compassion which is meant to characterise the NHS and the caring professions. This is a pressing question for patients, practitioners and the public in general. This seminar explored this by examining core issues of trust and risk that go to the roots of the social contract which exists between healthcare professionals and the population at large.
Conference: The Caring Organisation: Enabling Compassion to Flourish
With the Point of Care Foundation, Dr Papanikitas organised a conference on Wednesday December 16th 2015 at the Royal Society of Medicine at which the HVP presented posters on its work. Details are available here.