What makes for a compassionate patient-caregiver relationship?

BACKGROUND During Summer 2005, the Kenneth B. Schwartz Center asked hospitals to hold rounds to discuss the topic, "What Makes for a Compassionate Patient-Caregiver Relationship?" Review of questionnaires and transcripts of the rounds held at 54 hospitals in 21 states yielded three major categories: communication, common ground, and respect for individuality. COMMUNICATION Suggestions to improve compassionate care often focused on style and content. Rounds attendees felt that compassionate care also depends on imparting medical facts in a clear and useful manner to patients--often difficult for complex medical issues. COMMON GROUND Compassionate care depends on showing empathy for a patient's illness experience no matter what his or her background. Rounds participants felt that caregivers could make a conscious choice to care deeply for patients. Sharing personal information with patients and admitting mistakes were key methods for identifying common ground. TREATING THE PATIENT AS AN INDIVIDUAL Compassionate care requires striking an individualized balance between providing guidance and allowing autonomy to achieve shared consensus, especially with complex information. A PRESCRIPTION FOR CHANGE Most interventions target students yet do not continually reinforce compassion. Advocates for compassionate care should instead treat lack of compassion not as an acute trauma but as a chronic condition requiring a lifetime of continuous support, regular guidance, repeated reinforcement, specific targeted outcomes, and more innovative care programs.