Unleashing the Power

of Compassionate
Leadership

Beth A. Lown, MD, FACH. Chief Medical Officer,

The Schwartz Center for Compassionate Healthcare
Associate Professor of Medicine, Harvard Medical School 1
Presenter’s Disclosure

• Relationships with commercial interests: None.

• Dr. Lown is the Chief Medical Officer of the
Schwartz Center for Compassionate Healthcare,
a non-profit organization dedicated to putting
compassion at the heart of healthcare through
our programs, education and advocacy.

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 1. Refine our understanding
of what it means to be a
compassionate leader
2. Discuss what
Goals compassionate leaders do
3. Provide examples
4. Share outcomes

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 1. Compassion is hard-wired but
must be enabled and
supported
2. Compassionate leadership can
Key take- be learned
homes 3. Positive outcomes of
compassionate leadership
abound
4. Each of us can lead with
compassion
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Emotional Cognitive Compassion
empathy empathy
Weisz E, Zaki J. Curr Opin Psychol. 2018;24:67-71. 6
Compassion is rewarding

Jensen et al. Mol Psychiatry. 2014;19:392-8.

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 • Trait empathy
• Implicit bias
• Repetitive exposure
Compassion • Emotion regulation
mediators • Perspective taking
• Organizational
culture, local climate,
context
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 9
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Lown BA. Med Educ. 2016;50:332-42.
 Professional Quality of Life

Compassion Compassion
Fatigue Satisfaction

Secondary
Burnout
Traumatic Stress

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 Canadian HPC mean compassion
satisfaction, fatigue and burnout scores
Max score = 50 Compassion Compassion Burnout
Satisfaction Fatigue
Full time (n=333) 43.7 19.1 21.8
Part-time (n=128) 45 16.9 17.6
Medicine (n=33) 44.6 17.6 22.4
Nursing (n=203) 43.4 20.1 22.3
Allied health (n=77) 44.1 18.8 21.4
Administration (n=38) 42.1 16.7 21.0

Slocum-Gori S, et al. Pall Med.2011;27:172-8 11

 Rates and correlates of burnout among
U.S. HPC providers
• 60% high EE; 24% high DP
• Higher rates of burnout:
• Non-MD clinicians
• Work >50 hours per week
• Weekends
• Fewer colleagues around
• Age < 50
• Time pressure
• Lack of confidence in comm skills
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Kamal et al. J Pain Symptom Manage.2016;51:690-6
 What causes burnout and moral distress?
• Emotional intensity • Regulatory restrictions
• Conflict with • Conflicts between state
others’ values and federal laws
• Individual vs. • Inadequate or
population needs maldistribution of
• Life/work imbalance resources

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So what does
compassionate
leadership
have to do
with this?

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What is compassionate leadership?
An orientation to one’s work and others that is
inherently relational and embodies:
• Sensitivity to others’ needs and preferences
• Caring and connection
• Mutual support
• Collaboration, inclusivity and respect
• Ways of working that are facilitative and empowering
• Courage and commitment
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 Compassionate Collaborative Care (“CCC”) Framework
Focus attention Demonstrate trustworthiness
Recognize verbal and nonverbal cues Communicate with colleagues, adjust plans

Listen actively Practice self-reflection and emotion

regulation
Elicit information about the “whole Build relationships, partnerships and teams
person”
Value others with nonjudgment positive Practice self-monitoring and behavioral self-
regard regulation
Ask about and respond to emotions, Practice self-care, attend to personal,
concerns, distress, suffering professional development and wellbeing
Share information and decision-making Practice self-compassion
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http://www.theschwartzcenter.org/media/Triple-C-Conference-Framework-Tables_FINAL.pdf
Compassion may be offered at
any level of leadership

Self Others Team

Manager Organization System

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 Are you a compassionate leader?
1. Do I promote a culture of nonjudgmental respect?
2. Do I show care and concern to people on my team?
3. Do I encourage others to respond to a colleague’s suffering?
4. Does my team know I’ll try to help them if they have a problem?
5. Do people on my team feel joined, felt, seen, not alone?
6. Is it the norm in my team to know about each others’ lives?
7. Do I create ways for people to connect regularly and openly to
express their emotional pain?

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Adapted from: https://www.roffeypark.com/wp-content-uploads2/Compassionate-Leadership
 Set the culture
Co-create vision and values
What do Know and value staff
compassionate
Align the workload
leaders do?
Support relationships
Target the interventions

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 • Articulate need
• Partner with QI/PS, data
gatherers
• Create a guiding coalition
What do • Envision success: “AI”
compassionate • Align messages with key
concerns
change agents
• Implement small, multifocal
do? initiatives
• Collect data
• Broadcast success, learn from
what failed
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https://lovetotherescue.org/shriners-hospitals-for-children 21
 The Schwartz Center’s National
Compassionate Caregiver of the Year® Award
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 Foster effective teamwork
• High expectations, high support
• Clear, values-informed objectives, feedback, coaching
• “Relational Coordination of Care”*
• Shared goals
• Shared knowledge of others’ work processes, needs
• Mutual respect
• Frequent, timely and accurate communication
• No-blame problem solving when problems arise

* https://www.rchcweb.com/ 23
Mount Auburn Hospital Transport Team, MA, USA
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Implement targeted
interventions
• Cultivate community
• Reward & recognition
• Respond to suffering
• Shared safe space

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Schwartz Rounds® - Saskatoon Health Region
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 What are Schwartz Rounds®?
A structured forum for interdisciplinary
conversation about the social and emotional
experience of caregiving
• One-hour sessions held 6 to 12 times a year
• Case-based multidisciplinary panel
presentation followed by facilitated
discussion
• Confidential and open to all
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Where in the world are Schwartz Rounds?

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 Schwartz Rounds impact
• Enhanced self-reported empathy and compassion
• Increased appreciation of the roles and contributions
of colleagues and teamwork
• Improved ability to cope with the psychosocial
demands of care
• Changes in institutional culture and processes
• Significant reductions in poor psychological well-being
(GHQ-12) in Rounds attenders (25% to 12%)
compared with non-attenders (37% to 34%)
Lown, Manning. Acad Med. 2010; 85:1073–1081.
Maben, et al. https://doi.org/10.3310/hsdr06370
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 Compassionate leadership impact
• Organizational and leaders’ compassion linked to
• Compassion for others
• Team compassion (understanding, coordinating
responses to suffering)
• Organizational commitment, retention
• Less burnout and psychological distress
• Staff satisfaction
• Improved patient satisfaction and experiences
• Innovation, creativity
Lown, Manning. In peer review. 2019
West, et al. Caring to change. 2017; Kings Fund
Shanafelt, et al. Mayo Clin Proc. 2017;92:129-146
McLelland, et al. Health Serv Res. 2014;49:1670-83
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Nourish yourself
• Mentors, role models
• Support networks,
relationships
• Cultivate compassion,
positivity
• Self-care, self-
compassion

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“One of the essential qualities of the clinician is
interest in humanity, for the secret of the care of the
patient is in caring for the patient.”
Francis W. Peabody, 1927

“… for the secret of the care of the patient is in caring

for oneself while caring for the patient.”
Lucy Candib, Medicine and the Family: A Feminist
Perspective. 1995

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Unleashing the Power
of Compassionate
Leadership

Beth A. Lown, MD, FACH

balown@theschwartzcenter.org
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