Civic Reflection with Hospice and Palliative Care Teams
CCR's partners in year one of this three-year initiative were six Chicago-area hospitals and hospices: Stroger Hospital of Cook County, Northwestern Memorial Hospital, University of Chicago Medical Center, Rush University Medical Center, Midwest Palliative and Hospice CareCenter, and Rainbow Hospice and Palliative Care.
I don’t think I could have facilitated without having attended that workshop...Really having a chance to talk about how to prepare... and then also just tips on facilitating—how to act as a facilitator rather than a group member; learning how to be quiet and listen; learning how to let a group conversation flow in whatever direction it’s going to go… I don’t think I would have thought to do some of those things without the workshop."
Assistant Professor, Rush University Medical Center
The opportunity to participate in reflective reading within our palliative care program has provided an amazing opportunity for our clinicians to briefly step outside their day-to-day each month and reflect on the tremendous impact of their work. Our staff have reported this experience has led to greater job satisfaction and they have requested that it continue beyond the pilot phase into the next year."
Midwest Palliative & Hospice CareCenter
If you have an activity that helps open your mind and your heart and your emotions, as well as intellectually, with a group of people whom you care for and respect, it spills over into your raw satisfaction with your job. We looked forward to [civic reflection] each time."
It’s a good reminder to me of why we need an interdisciplinary team: that we’re all looking through different lenses and that my way of seeing reality is certainly not the only or the authoritative way."
Reading poems and short stories and literature... is not something I pursue regularly and so it’s really mind-opening for me to do this in a very intentional way. It opens me up to different kinds of thinking, which is helpful for us because oftentimes in medicine we tend to be more analytical and less reflective."
I feel like I’m on the receiving end of care in the reflective reading [program]. That it’s time for me. That I’m not functioning as a chaplain in that time, that I’m functioning as a human being who needs support and needs time to reflect on my work. And needs time to hear what other people have to say and take that in and see how my perspective might be changed... how I might be strengthened to keep doing what I’m doing."
The more supported I feel in what I’m doing, the more available I am to my patients and families. If I’m feeling a lot of internal distress, I think that there’s no way that that doesn’t impact my presence with people. So in that way [civic reflection] has been very supportive, and I’ve often taken it with me for days and thought about it again."
I would say in the hospital itself, outside of the readings, I think I felt more comfortable with the other team members because I felt I had a greater appreciation for who they were, which I didn’t previously have… a greater appreciation of the whole person who’s helping provide care for patients."
[Civic reflection] has strengthened my bond with every member of the palliative care team."
Interdisciplinary hospice and palliative care teams at hospices and hospitals in the Chicago area.
- Provide hospice and palliative care teams with a means of reflecting on core values, thinking more deeply about choices, and responding more imaginatively to the challenges of shared work.
- Offer a regular opportunity for self-care, a core competency for healthcare professionals.
- Enhance communication among interdisciplinary teams and provide an opportunity for team-building.
- Provide facilitators with an opportunity for leadership development.
With the support of a generous grant from Prince Charitable Trusts, a family foundation with the mission of improving the morale of healthcare professionals, five hospitals and hospices in the Chicago area launched civic reflection programs in the fall of 2011. Called "Strengthening Those Who Serve: Reflective Reading and Discussion Programs for Palliative Care and Hospice Teams," the project is designed to allow interdisciplinary teams the opportunity to step back from the pressure of daily work and reflect together on their values, choices and challenges.
Representatives from each of the participating sites attended a facilitation training workshop in September 2011 at Rush University led by CCR director, Adam Davis, and humanities facilitator and CCR partner, Emily Archer. Each site held six civic reflection discussions with doctors, nurses, social workers, chaplains and other staff members between October 2011 and June 2012. Most sites held these discussions monthly as part of a regular educational series or schedule of team meetings. Each site also participated in the research and evaluation component of the project, directed by Dr. Joshua Hauser of Northwestern University's Feinberg School of Medicine. "Strengthening Those Who Serve" grew out of the two-year Reflective Reading pilot series run by the palliative care team at Stroger Hospital from 2007-2009, under the leadership of Dr. Jennifer Smith and Dr. Catherine Deamant.
- Participants interviewed in the spring of 2012 reported several positive impacts, primarily in the areas of self-care, team dynamics, and patient care. Research is ongoing and a report on the findings will be made available when complete.