Compassionate Care and the Bottom Line

By Rose O. Sherman, EdD, RN, FAAN

Caring and compassion are often considered “soft factors” that while important in healthcare are not what really influences the achievement of performance measures or maintaining financial viability. A study entitled Building-Compassion-into-the-Bottom-Line released this week by the Schwartz Center for Compassionate Care refutes those beliefs. After interviewing executive leaders in 35 health systems known for their compassionate care, the overall finding of the study are that while compassion is not a panacea for what ails the U.S. healthcare system, it can be the foundation for improving patients’ care experiences, patient and caregiver satisfaction, and a hospital’s bottom line.

For the purposes of the study, the following definition was used: “Compassionate care is an important and frequently overlooked component of patient-centered care. It addresses the emotional and psychosocial aspects of the patient experience and the patient’s innate need for human connections and relationships. At its core, it means recognizing the concerns, distress and suffering of patients and their families and taking action to relieve them. It is based on active listening, empathy, strong communication and interpersonal skills, knowledge of the patient as a whole person including his or her life context and perspective, and the ability to work together to relieve distress.”

The following are some key findings from this important research:

• Organizations that place a high priority on delivering compassionate care benefit from lower staff turnover, higher retention, recruitment of more highly qualified staff, greater patient loyalty and reduced costs from shorter lengths of stay, lower rates of rehospitalization, better health outcomes, and fewer costly procedures.

• Caregivers who are able to express compassion for patients, families and each other experience higher job satisfaction, less stress, and a greater sense of teamwork.

• Patients who are treated compassionately benefit from improved quality of care, better health, fewer medical errors, and a deeper human connection with their caregivers.

Researchers found that the leaders in organizations known to deliver compassionate care clearly understand that the employee experience drives the patient experience. Supporting caregivers is critically important. These organizations also had the following characteristics in common:

A commitment to involving patients and families in care improvement activities
Hiring practices and training programs that focus on compassion
A culture of experimentation, compassionate care champions, and units that model compassion and share their strategies with others
An emphasis on continuity of care and teamwork
A willingness to share patient experience data to drive improvement
A belief that simple tactics can make a difference

The researchers note that “caregivers witness suffering, trauma and conflict on a daily basis. Their ability to sustain their compassion and provide compassionate care to patients and families rests on both systemic and individual factors.
Systemic factors, such as excessive workloads, decreased autonomy, lack of rewards, loss of a sense of community with colleagues, and conflict between organizational and individual values contribute to burnout and erode engagement with their work and sense of purpose. Individual factors that sustain compassion include the capacity to recognize, process and manage the daily challenges of patient care.”

Based on their findings, the researchers recommend that “healthcare CEOs and senior leaders are encouraged to view ROI through a different lens. Even a cash-strapped organization can foster compassionate care and a better patient and caregiver experience if it values compassion. Compassion is about improving relationships among caregivers, patients and families, not capital purchases. Intent, mission and values have no dollar cost. Attitudinal and behavioral
changes, while requiring leadership and the investment of time, can result in better health outcomes, lower costs and greater patient and caregiver satisfaction – all of which benefit the bottom line.”

This is important research that supports a major investment in staff even in this challenging economic healthcare environment.