In their joint keynote session titled “I have changed my mind” at the IHI International Forum in Glasgow, both Don Berwick and Maureen Bisognano focused on compassion as an issue they have changed their way of thinking about.
One example was the white board of information maintained by a long stay facility for the elderly. The white board displays, for staff, not only the patient/resident’s picture, age, resuscitation status, and medical issues, but also “what matters to you” for each person:
- “2 Scotches every night at 5pm”
- “never take me out without my hair done”
Do we really need a book to tell us that compassion makes a difference? Well apparently yes, because scientific evidence now proves it is so! “Compassionomics” discusses how compassion improves clinical outcomes such as diabetes control, and use of pain medication…
- The anesthesiologist who introduces herself to the patient and says: “I’m your doctor for the next 2 hours, this is the journey we’re on together”.
- Kids driving themselves in toy cars to the operating theatre!!
The power of placebo effects as a form of care is further proof of the impact of compassion. Sham surgery for angina proved that internal mammary artery ligation did not work but a high percentage of patients in both study arms had their pain relieved.
Great things happen when patients feel their physician is compassionate. Kindness can lead to faster wound healing, reduced pain, anxiety, and blood pressure, even a shorter hospital stay.
But do we have the time? Pressured by productivity requirements, the average time to a physician interrupting their patient at the beginning of a consultation may be as short as 11 seconds. We should try, and a Kindness Bundle may help:
- Opening and closing interactions with patients in a structured way
- A warm personal introduction – “what would you like me to call you?”
- Shared decision making – ask “what matters to you?”, “what about today would make it a good day?”
- A warm close-out – “is there anything we can do to make you more comfortable?”
We need deep listening, empathy, generous acts, gentle honesty, and support for family caregivers. Compassion is not an amenity – it is the source of healing. Berwick and Bisognano point out: when you treat the disease you may win or lose, but treat the person and you’ll win, no matter the clinical outcome; relationships heal.