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.