What are compassion practices, and can they play a part in improving healthcare?

Working in the healthcare profession can be both physically and emotionally draining for anyone, no matter their role or job title. Over half of physicians in the US [PDF] experience symptoms of burnout, and studies estimate a large percentage of nurses experience emotional exhaustion and have a higher prevalence of depression when compared to other US workers.  Exhaustion and burnout not only negatively affect healthcare workers, they are also detrimental to patients and can result in staff becoming more error-prone and likely to deliver substandard care.

A way to combat this is through using compassion practices.  A 2014 article from Health Services Research describes compassion practices as “a measure of the extent to which a hospital rewards compassionate acts and compassionately supports its employees.”  An example of compassion practices would be providing compassionate employee awards to staff or providing pastoral care for healthcare employees.  These are organizational practices that help workers better cope with the stressors of their workplace.

An article recently published ahead-of-print in Medical Care discusses the importance of compassion practices and examines the impact of compassion practices on ambulatory nursing staff well-being as well as patient experience ratings.  To evaluate the effect of compassion practices, 177 nurse surveys were collected from 30 different ambulatory clinics in January and February of 2015 and clinic-level patient ratings were collected from April to June of 2015. All ambulatory clinics used in the surveys were non-psychiatric, non-pediatric, and affiliated with an academic medical center.

The authors identified the presence of compassion practices to be significantly associated with less emotional exhaustion and greater psychological vitality among nurses.  Compassion practices were also associated with better patient ratings of their care for nurses and clinics.

In the 2014 article mentioned above, which examined the effects of compassion practices on patient perceptions of care quality in hospital settings, researchers collected 269 surveys from hospital executives between January and March 2011 as well as Hospital Consumer Assessment of Healthcare Providers and systems (HCAHPS) data released in October 2012 (collected between January and December of 2011). The surveys assessed how much hospitals used employee recognition programs to reward acts of caring shown to patients, families and other employees. The HCAHPS data was used to determine two outcomes: overall ratings and willingness to recommend the hospital.

The results of that study identified an association between patient perceptions of care quality and the presence of organizational compassion practices.  Hospitals that reward compassionate acts and offer employees support have higher patient ratings and are more likely be recommended to others.

Research has shown the benefits of compassion practices for both healthcare workers and patients, but more research is needed to examine the effects of compassion practices in more specialized areas of medicine.  Specifically, the Medical Care article didn’t include pediatric or psychiatric medicine, high stress fields where implementing compassion practices might have even greater benefits.

Thinking more broadly, the benefits of compassion practices might even be helpful for workers outside of the healthcare field.  For instance, police work, teaching, and social work are all stressful professions where burnout is a real possibility.  Implementing compassion practices in just about any stressful profession could have widespread positive impacts on employee job performance, job satisfaction and possibly even encourage better employee retention.

Interested in reading more about burnout in healthcare? Check out this Medical Care Blog post from the archives.

Catherine Gupta

Catherine Gupta

Catherine Gupta graduated in 2011 from the University at Buffalo with a Bachelor of Science in Pharmaceutical Sciences. In 2015, she received her PhD from the University of North Carolina at Chapel Hill Eshelman School of Pharmacy. Presently, Dr. Gupta is working at RTI International as a health communication research scientist. Her research focuses on patient-provider communication, direct-to-consumer advertising of prescription medications, and the development and evaluation of decisions aids for HIV prevention and management and informed consent.
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Alexa Ortiz

Alexa Ortiz

Health IT Scientist at RTI International
Alexa Ortiz graduated from the University of North Carolina at Charlotte in 2009 with a Bachelor of Science in Nursing. Before receiving her graduate degree she was a practicing nurse for five years and has clinical experience in the field of both Cardiology and Neurology. In 2014 she received a Master of Science in Nursing specializing in nursing informatics from Duke University. Presently, she works as a Health IT Scientist at RTI International in the Center for Digital Health and Clinical Informatics. Despite no longer working in a clinical setting, she continues to maintain an active nurse license in the state of North Carolina. Her primary areas of research at RTI International focus on the clinical implementation of health information technology and the evaluation of consumer wearable devices.
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About Catherine Gupta and Alexa Ortiz

Catherine Gupta graduated in 2011 from the University at Buffalo with a Bachelor of Science in Pharmaceutical Sciences. In 2015, she received her PhD from the University of North Carolina at Chapel Hill Eshelman School of Pharmacy. Presently, Dr. Gupta is working at RTI International as a health communication research scientist. Her research focuses on patient-provider communication, direct-to-consumer advertising of prescription medications, and the development and evaluation of decisions aids for HIV prevention and management and informed consent.