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March 2008 Issue

Paul Wojciechowski, MD, (right) and John Steiner lead a round talk.
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UC, University Hospital Offer Rounds to Discuss Tough Cases

By Katie Pence
Published March 2008

Room 7051 in the Medical Sciences Building (MSB) filled to capacity with UC and University Hospital (UH) employees and students as Paul Wojciechowski, MD, anesthesiology critical care fellow at UH, recounted a difficult day he experienced in January.


This was the day a man accused of murder was brought to UH for treatment.


Sister Jan Brosnan, a UH chaplain, saw the patient that day.


But John Steiner, UH spiritual care supervisor, relayed how difficult a situation like this is for a caregiver.


"It's easy to rush to judgment when we don't know everything that is going on in the other person's life," he said to the audience.


"We have to think about what we're feeling and what we're saying so that our words don't come out incorrectly."


Wojciechowski said he gave some direction on how to handle the emotional state of the patient to the resident handling the case, but he said he doesn't know if his instincts were necessarily right.


"I told the resident attending to the patient to listen to what he had to say and address the medical issues at hand in a professional manner," he said. "Was it difficult to attend to his medical needs? No.


"Was it a different kind of situation? Definitely."


This meeting was only the second time UH and UC professionals convened for the Schwartz Center Rounds, but the response was enormous as members of the audience shared their experiences and struggles as health care providers.


The Schwartz Center Rounds is a collaborative forum where multidisciplinary caregivers from UC and UH discuss their experiences, thoughts and feelings about difficult health care cases.


The rounds are funded by a grant through the Kenneth B. Schwartz Center in Boston, and are held on the second Tuesday of each month from noon to 1 p.m. in the MSB. Lunch is provided.


Over 26,000 clinicians at 129 sites in 26 states participate in these interactive discussions.


According to the Schwartz Center, where the rounds were first developed, the UC-UH series is the first of its kind in Ohio. So far, attendance has been booming.


Steiner, along with Kelly Rabah, administrator of spiritual care in UH's Center for Emergency Care and Office of Decedent Affairs, brought the idea of the rounds to UC and UH when they mentioned it during a team meeting for the UH Cardiac Intensive Care Unit.


"It is a way to evaluate practices and provide a regular avenue for health care professionals to talk about what they face in the field," says Walter Merrill, MD, chief of the cardiothoracic surgery division at UC and cardiothoracic surgeon at UH.


Merrill is one of three members of the task force for the Schwartz Center Rounds, along with Steiner and Rabah.


Merrill says there aren't a lot of programs to assist health care employees, and this is filling a huge need.


"We have all sorts of programs devised to help those receiving care but nothing for our health care workers," he says.


Merrill says the rounds are also a way to keep from losing workers.


"Health care workers deal with many difficult situations on a daily basis which often cause them to burn out quickly," he says.


"When a health care worker leaves a facility, they not only take their skills, but their experiences as well. Wisdom occurs as an accumulation of that experience, and we lose that when we lose an employee.


"We want to be supportive of our health care workers and help them deal with these issues so that they won't burn out."


The rounds involve a 10-minute presentation in which a person involved in a case at hand-whether it is a physician, nurse or social worker-explains his or her take on the medical situation.


"Presenters explain the complicated issues they face," Merrill says. "And in most cases, it seems everyone has a different aspect of the story to tell."


Following the presentation, the audience has a chance to respond to the case, as well as the presenter's actions, and give input.


The rounds are confidential, and the discussion is held in a safe, supporting environment, so that those in attendance are encouraged to speak freely.


But Merrill stresses that the purpose of the rounds is not finding the "right" answer.


"Because there isn't necessarily a 'right' answer," he says. "We discuss the tricky issues and acknowledge a wide variety of opinions to deal with them. Everyone's opinion is valid.


"Not only is this a support tool, but it helps in expanding the minds and practices of today's medical professionals," he says. 

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