Report from the Charter for Compassion Healthcare Call, June 16, 2015

Report from the Charter for Compassion Healthcare Call, June 16, 2015

Agenda

Welcome and Technical Information (Reed Price)
Introduction of Elizabeth Rider (Reed Price)
Charter Healthcare Sector News & Speaker Introduction (Elizabeth Rider)
Speaker Presentation (Salmaan Sana)
Breakout Groups (All)
Popcorn Session/ Questions & Answers (All)
Final Speaker Comments (Salmaan Sana)
Closing (Reed Price)

Recording of the Call

Welcome and Technical Information

Reed Price: Welcome everyone. It is mission of the Charter for Compassion International to bring together people from every sector (we have 9 of them), to instill compassion in everything we do, and to care for each other and for the well-being of all members of the community.

To that end we sponsor these Global Conference Calls about three times a month, at no charge.

Today, we are using a wonderful conference call platform called “Maestro.” We will be using the Social Webinar feature to view slides that Salmaan Sana has prepared. In your invitation to dial-in to today’s call you’ll see a blue button that reads “ACCESS SOCIAL WEBINAR.” Just click on this button to be able to see the slides.

Also, we’ll be using our phone or Skype keypads to communicate during call. Note: if you called in using Skype, you use the Skype touchpad built into Skype, not the computer keyboard.

In all cases, press ‘1’ on your phone or Skype keypad for a question and press ‘5’ on your phone or Skype keypad for a technical problem.

Introduction of Elizabeth Rider

Reed Price: I would like to introduce Dr. Elizabeth Rider, who is a member of Charter’s Global Compassion Council and the Chair of the Charter’s Healthcare Sector. She will be sharing some exciting news and introducing our speaker.

Healthcare Sector News & Speaker Introduction

Elizabeth Rider: Welcome! We are delighted that you’ve joined us today for the call. There are exciting developments to announce. The International Research Centre for Communication and Health Care, a partner of the Charter, will become the Charter’s new Asia-Pacific healthcare hub. On June 29th in Hong Kong the Hub will be launched at the 3rd International Symposium on Healthcare Communication, “Communicating for Compassionate Healthcare: Mobilizing Values to Practice.” All are welcome. [See more details in the “Additional Information” section at the end of these Call notes.]

Our speaker today is Salmaan Sana. Salmaan Sana is a multi-faceted consultant and facilitator who has a special passion for the field of health care. About 5 years ago, he started the non-profit "Compassion for Care" in the Netherlands, which is committed to recognizing the individual’s soul and spirit as an integral part of treatment and outreach – in both wellness work and treating illness and injury. His work has grown out of his experience as a medical student. He is one of the initiators of the "Healthcare Leadership Schools," a week course that guides medical students and young physicians in becoming aware of their pivotal role within the healthcare system and the influence they can have. He is a co-founder of “Nameshapers,” offering training and coaching on social media strategy and implementation. He consults for the International Association for Medical Education (AMEE) in helping bridge the offline and online learning environments. Currently he is works as a senior consultant for the social enterprise “Better Future,” guiding transformations of organizations into ones working from a more principled-based center and having high positive and influential impact. We are delighted to have Salmaan to talk with us today.

Speaker Presentation

Links to the presentation Powerpoint slides

Salmaan Sana: Thank you for the introduction. Thank you Reed. Welcome everyone. It is great to have you all on the call. As Elizabeth already mentioned, my work has grown from my own experience as a medical student. During that experience, I felt like something was missing about the human side of healthcare. A small group of us starting exploring this issue and gained more understanding. We looked at people who were burning out and could not continue in the medical profession. I will go through the slides of my presentation and will provide more context. In healthcare there is high workload, time pressure, and lack of financing. The question is how to find creative ways in this environment to work with compassion. My presentation builds on 3 key words/themes: awareness, insight, action. My personal dream- after working with many workers- is that they attain a balance of professionalism and spirit in their work. Also, they need to find ways to care for themselves and for departments to connect within and with each other. As a result, patient care is optimized- from the inside out. I worked for a year as the Compassionate Officer in a healthcare institute. I was given authority to build this path. Initially, I got resistance. I did not know how to approach it. I tried to find out what was going on, what people needed, and how to motivate them. It was hard to make compassion tangible. My 3-fold model came from this struggle.

There was a “Stormball” project in the healthcare institute: they wanted to make care efficient and improve patient care. Everything they were doing was measured- outcome based. However, while working on professionalism, there was also a need to focus on the spirit. “Stormball” is a good analogy for us to use in healthcare. We get a crisis and that prompts attention and action to be more efficient, improve care, etc. We often work only at the business level. We miss the importance of people connecting with each other and coming together to tackle these problems. In a storm- people come together to help care for each other. This is not happening in the healthcare system. I saw a lot of fear, frustration, and despair. How can we convert and transform this into something more constructive. Einstein had a good vision on how to do so.

The first focus of my model is “awareness.” I was greatly inspired by the story written by Viktor Frankl (a survivor of the Holocaust)- “Man’s Search for Meaning”. He talks about two types of people in the concentration camps- those who would eat bread immediately and some that would save a little and sometimes share. He concluded that the philosopher Friedrich Nietzsche had it right: “He who has a why to live for can bear with almost any how."

I began to ask healthcare workers the following questions: why are you working here? why are your colleagues working here? what has changed for you since you started? These “why” questions are based on the “Golden Circle”- why, how, what… We start with “why”- our intrinsic motivation. If we just focus on the outcome, we don’t have the energy and resources to actually make the change. There is a wonderful Cleveland Clinc video “Empathy: The Human Connection to Patient Care” which shows all different people who are in the hospital and what they are thinking. What touches people about the video is the story. How would you like to be treated as a patient? This brings us back to the Golden Rule. Paul Gilbert- who also has talk on YouTube – “Strengthening the Mind Through the Power of Self-Compassion”- explains all different aspects of compassion. Compassion becomes much more tangible. We can work on skills.

We need to address “distress tolerance”- how you can empathize and feel what a person (patient) is going through and yet keep yourself strong. I try to use more words to describe compassion. Compassion is the work to alleviate and prevent suffering. It is courage. Dr. Robin Youngson- an anesthesiologist from New Zealand- in “Time to Care” provides research evidence that compassion helps with patient care.

I use examples of research. I often reference the Stanford University- CCARE articles. This helps people who are a little more cognitively-oriented and evidence- based. I try to address the emotional, cognitive, and motivational aspects. Dr. Richard Davidson has worked with different people to identify how compassion tangibly works.

From “awareness,” I transition to “insight.” How do you take care of yourself? How do you stay healty? What does health actually mean?

There is an old World Health Organization definition of health- a state of complete physical, mental, emotional, and social well-being.

There is a new definition of health emerging which involves the ability to adapt to self-management. It is a broader way of looking at health- involving 6 dimensions- body, spiritual, quality of life, daily functioning, etc. We need to address these dimensions – for both patients and healthcare workers. What do you need to stay healthy in an environment that does not often encourage it? When I ask nurses this, they first laugh and then say, “We don’t” care for ourselves.” So, I then give them pointers as to how to start.

The third focus in “action.” What can I do? What can we do? There is time pressure, high workload and no financial or human resources. What can we do together? Many different ideas came from healthcare workers themselves. Examples: 1) Team meetings to get more energy and positive input for the day. Just ask 1 question-What do you need to have a good day today? People spoke their needs and also heard each other’s needs. This process helped build a support network. Much happened from 1 simple question; 2) Weekly meeting. We changed 1 meeting to a “soapbox” session. 6 people from the group were asked to step on a soapbox and tell a personal story-what inspires them, a mistake, etc. Everyone left the room feeling more connected and inspired. The process created an atmosphere of safety; 3) Creating a wall of gratitude. We often see pin boards in hospitals with patient notes, etc.

One hospital created pipe structures that could only hold one card on them. The different pipes represented different departments. A card of gratitude was hung on each pipe structure and the card had to be changed each week. This brought more attention to the notes of gratitude. This process started to create a good feeling in people. It was empowering; 4) Working with small working groups- to have more more in-depth discussions about “What can we do?”- trying to take more charge of issues- feedback and feed-forward. Departments started groups intrinsically within themselves. It was proactive movement. All different departments took responsibility. This process was very motivational; 5) Brian Goldman- has brilliant TED talk- started a process of sharing mistakes which allows people to be more and more open; 6) Humans of New York- they have a great Facebook page- medical institutions share why their healthcare workers do what they do- why they have passion. This is an open platform on social media.

I hope this provides a general outline about how to bring compassion to the healthcare workforce. It is very generic but can be made specific.

Thank you. If you have questions, I will be happy to answer them.

Breakout Groups

Elizabeth Rider: We will now go into breakout groups for discussion. Following the breakouts we will have a “popcorn” session in which we can share kernels of wisdom and insights and will have the opportunity to ask questions of Salmaan. In your breakouts groups, first introduce yourselves and then discuss the following 2 questions.

Questions for Breakout Groups

  1. How can we make compassion tangible and practical in a hospital and healthcare institutional level?
  2. How can we help those working within the healthcare systems to connect with themselves, their colleagues, and their patients?

Suggestions Made by Participants

  1. Create a Chief Compassion Officer!- the consensus was this is a good idea (for employees as well). The Medical Model is pathology based- someone suggested the book “A Fearless Heart.”
  2. Med Schools cannot teach compassion in isolation to medical students alone: we need to include medical, dental, etc.
  3. One person shared that after a hospital stay- she received a survey call about her experience but there was nothing asked about compassion.
  4. Compassion is a very personal expression. One thing we could do is to “bring our compassionate hearts to work.”
  5. Reach out to Ombudsmen.
  6. Don’t use the word “compassion” until the group brings it up. There is a stereotype and misguided interpretation of “compassion.”
  7. Before returning to work after a break, take a moment to connect with your breathing and then return to the floor.
  8. We can learn from/be role models.
  9. Compassion starts with us. It is a very personal space- to learn and be aware of those skills. It is important to provide a safe place for people to stop and connect. Everything we have talked about today is applicable to any setting- schools, businesses, etc.
  10. There is solid evidence that compassion skills can be trained, practiced, strengthened, and measured.
  11. As healthcare workers, we miss caring for ourselves and our co-workers in the process of caring for others. Need to take time out for this. Goes back to our premise- it is important to get to know the person and build relationships. We must focus on each other. We spend a lot of time with each other.

Popcorn Session/ Questions and Answers

Elizabeth Rider: Welcome back. Now we will have our popcorn session and share kernels of wisdom. Press “1” on your phone to be recognized. What stood out for you?

Maria: UK- London Medical School- we talked about how to make compassion practical. A hot topic in the UK is inadequate care for patients. Need adequate staffing levels. Need protected time for team teaching. Need to give praise to people- tell them how well they performed- this can be better than financial reward. We need more physician autonomy and less interference from the government to micromanage health care.

Lesa: We are developing a new medical school in Austin. The research about compassion is key- we have a solid case- we need training, practice, and strengthening in compassion skills. We need to have compassion skills training as much as training in biochemistry.

Marion: We need Chief Compassion Officers in medical schools. Laurie: “A Fearless Heart: How the Courage to be Compassionate Can Transform Our Lives”- looks at the philosophical underpinnings of the pathologically based healthcare system.

Jennifer: I am the clinical director for Cultural Transformation in a hospital in Dallas, Texas. I am interested in the concept of a Chief Compassion Officer and teaching Compassion Care training. I would be happy to connect with people on the call.

Reverend Joy Ellen: I also like the idea of the Chief Compassion Officer. We need to think about the employees as well as the patients.

Barbara: Can we share the presentation Powerpoint with the notes?

Elizabeth: I assume there is a way to do that.

Salmaan: Thanks. I’ll be more than happy to share the slides and we can share the link.

Maria: We need to teach compassion to medical students. However, we cannot teach this in isolation and just to medical students alone. We must have inter-professional teaching and have team, group sessions to work on ethical, professional challenges. We need to learn to work together, trust and understand each other.

Rev. Joy Ellen: After my hospital stay, I received a call with a survey. None of the questions were about compassionate care.

Marilyn: We could say that the heart of the Charter is to concentrate on building compassionate communities. This is a grassroots effort. Many people on this call today are involved in healthcare- a key sector for the Charter. If you are not a part of a compassionate community effort- think about how you might use your expertise in trying to put together a grassroots effort to make your community more compassionate. There are ways that people can come together and dialogue and look at the heart of the community and identify needs. Put together an action plan. Share it with the local government. I encourage you to think about doing that. The Charter is applying for CEUs- for California and other states. Dr. Dan Martin has put together compassionate dyads training. The Charter will be sponsoring those courses shortly. Let the Charter know if you are interested. In the Fall, we will launch the Charter for Compassion Education Institute. We will have courses and electives in healthcare. If any of you want to teach in the institute, please contact me at This email address is being protected from spambots. You need JavaScript enabled to view it..

Elizabeth Rider: There are tremendous opportunities to work together.

Louisa: I want to thank the participants in our group breakout. One key message: we as individuals have to bring our compassionate hearts into the workplace. We need to be creative outside of the box while in the box. There are many rules and regulations. We need to think of creative ways to cooperate. One thing we do can create a powerful difference. This is important for people who are so overwhelmed.

Sande Hart: I am the Chief Compassion Officer of Compassionate California – so it is a great title. Kerry in our group reminded us that compassion starts with us. It is a very personal space- to learn and be aware of those skills. It is important to provide a safe place for people to stop and connect. Everything we have talked about today is applicable to any setting- schools, businesses, etc.

Lesa: Hospitals often have ombudsmen. We can reach out to them to help create a more compassionate care environment.

Final Speaker Comments

Salmaan Sana: Thank you for the amazing work you are doing. The Chief Compassion Officer is viable and something we can create. Compassion really starts with each of us- self-compassion and connecting with ourselves. Advice: Don’t talk about compassion. Many people have trouble with the word. Bring it down to terms they can work with- burnout, key performance indicators. How do you translate compassion into different languages and terms so you can reach different levels? Being creative- I agree with this. Start small- very, very small. Just one step. A nurse can take a short break and focus on her breathing. Those small moments are all it takes to get started. We can really learn from role models. Why are they able to do it? What is going right with them? Use the research. There is a lot there and more that can be found.

It really is about the balance between professionalism and the spirit of the work. The “why” is the energy of outcomes. It is the source that is key to the outcomes.

Closing

Reed Price: At this point we want to find out who is willing to share their emails with others on this call. We do not share your email publicly. We will only share it in a pdf sent to others who are participating in this call. Press ‘3’ now on your keypad if you are okay with sharing your email. Thank you.

Calls are sponsored by the Charter for Compassion International. Learn more about the Charter. Calls are free but we welcome donations. You can complete a donation right now on your screens. We will also send a link out to donation page with the notes of the call and a link to the Powerpoint slides. We welcome volunteers for the Charter- please send an email to This email address is being protected from spambots. You need JavaScript enabled to view it. if you are interested in volunteering.

Additional Information

The Asia-Pacific Healthcare Hub of Charter for Compassion International

June 29th will be the formal launch of the International Research Centre for Communication in Healthcare (IRCCH) as the Asia-Pacific Healthcare Hub of Charter for Compassion International. The launch will occur during the 3rd International Symposium on Healthcare Communication, “Communicating for Compassionate Healthcare: Mobilizing Values to Practice.” The Symposium will be held at Hong Kong Polytechnic University, Kowloon, Hong Kong. IRCCH is a Charter partner. The launch address will be given by Prof. Sophia Chan, JP, Undersecretary for Food and Health, Hong Kong.

Marilyn Turkovich, Director of the Charter for Compassion International (CCI), and Elizabeth Rider, member of CCI’s Global Compassion Council, are speakers at the Symposium. This exciting formal collaboration brings together the CCI worldwide alliance of healthcare partners, working to instill compassion in all healthcare relationships and systems, and IRCCH’s ability to translate cutting edge communication research into best practice and training for safe and compassionate healthcare.

CCI, IRCCH and the new Asia-Pacific Healthcare Hub of CCI commit to raising awareness of the importance of focusing on and addressing the central role of compassion, made visible through skillful communication, in all healthcare interactions.

All are invited! You can also follow the conference on Twitter at #IRCCH15

Resources Shared

A Fearless Heart: How the Courage to Be Compassionate Can Transform Our Lives by Thupten Jingpa (Hudson Street Press, 2015)

The Buddhist practice of mindfulness caught on in the west when we began to understand the everyday, personal benefits it brought us. Now, in this extraordinary book, the highly acclaimed thought leader and longtime English translator of His Holiness the Dalai Lama shows us that compassion can bring us even more.

Based on the landmark course in compassion training Jinpa helped create at Stanford Medical School, A Fearless Heart shows us that we actually fear compassion. We worry that if we are too compassionate with others we will be taken advantage of, and if we are too compassionate with ourselves we will turn into slackers. Using science, insights from both classical Buddhist and western psychology, and stories both from others and from his own extraordinary life, Jinpa shows us how to train our compassion muscle to relieve stress, fight depression, improve our health, achieve our goals, and change our world.

ALIVE INSIDE is a joyous cinematic exploration of music’s capacity to reawaken our souls and uncover the deepest parts of our humanity. Filmmaker Michael Rossato-Bennett chronicles the astonishing experiences of individuals around the country who have been revitalized through the simple experience of listening to music. His camera reveals the uniquely human connection we find in music and how its healing power can triumph where prescription medication falls short.

This stirring documentary follows social worker Dan Cohen, founder of the nonprofit organization Music & Memory, as he fights against a broken healthcare system to demonstrate music’s ability to combat memory loss and restore a deep sense of self to those suffering from it. Rossato-Bennett visits family members who have witnessed the miraculous effects of personalized music on their loved ones, and offers illuminating interviews with experts including renowned neurologist and best-selling author Oliver Sacks (Musicophilia: Tales of Music and the Brain) and musician Bobby McFerrin (“Don’t Worry, Be Happy”).

The Forgiveness Project is an award-winning, secular organisation that collects and shares real stories of forgiveness to build understanding, encourage reflection and enable people to reconcile with the pain and move forward from the trauma in their own lives.

Our exhibitions, events, and programmes use narrative learning techniques to present alternatives to cycles of conflict, violence, crime and injustice. The over 140 real-life stories of forgiveness on our website demonstrate that forgiveness is first and foremost a personal journey: a visceral process with no set rules or time limits. It is not dependent on faith and it is often just “as mysterious as love”.

Check out these resources that are linked to The Forgiveness Project:
Phyllis Rodriguez's story and that of Aicha el Wafi can be found as part of the story archive at The Forgiveness Project

IN OUR SON'S NAME is an intimate portrait of Phyllis and Orlando Rodríguez, whose son, Greg, dies with thousands of others in the World Trade Center on September 11, 2001. The bereaved parents choose reconciliation and nonviolence over vengeance and begin a transformative journey that both confirms and challenges their convictions.

Father Michael Lapsley is an Anglican priest who was sent to South Africa during the institutionalized racial segregation of apartheid. He became a chaplain to Nelson Mandela’s African National Congress and a target of the white supremacy government. One day Lapsley opened a package that turned out to be a bomb. He lost both hands and one eye in the attack on his life, but his faith survived. He now uses his wounds to connect with those who have experienced trauma and help them find healing.

The Institute for the Healing of Memories seeks to contribute to the healing journey of individuals, communities and nations.

A non-profit organisation committed to:

facilitating the healing process of individuals and communities in South Africa and internationally
remembering the apartheid years and healing the wounds
redeeming the past by celebrating that which is life giving and laying to rest that which is destructive
working in partnership with others who share our vision

To realise goals, the Institute:

Offers healing of memories workshops, seminars and talks.
Uses our learning and experience to develop methods and processes for dealing with potentially destructive emotions such as anger, hatred and guilt and for making possible reconciliation and forgiveness and seeks to be fully inclusive and respectful of diversity and of different cultures, faith communities and belief systems

On Killing: The Psychological Cost of Learning to Kill in War and Society by Dave Grossman (Back Bay Books, revised, 2009).

The good news is that most soldiers are loath to kill. But armies have developed sophisticated ways of overcoming this instinctive aversion. And contemporary civilian society, particularly the media, replicates the army's conditioning techniques, and, according to Lt. Col. Dave Grossman's thesis, is responsible for our rising rate of murder among the young.

Upon its initial publication, ON KILLING was hailed as a landmark study of the techniques the military uses to overcome the powerful reluctance to kill, of how killing affects soldiers, and of the societal implications of escalating violence. Now, Grossman has updated this classic work to include information on 21st-century military conflicts, recent trends in crime, suicide bombings, school shootings, and more. The result is a work certain to be relevant and important for decades to come.

Opus Peace is a 501(c)3 non-profit organization committed to creating an Opus of Peace in our personal lives, while supporting others to do so as well. Our mission is to respond to the soul injury generated by unmourned grief and unforgiven guilt that occurs during trauma, abuse, and neglect. “Opus” is a Latin noun that means “a work,” and is commonly used to describe a complex masterpiece. “Opus” is an old word that captures the ageless, artful complexity of creating a true “masterpeace” — pervasive peace that penetrates beyond comforting facades.  The word “opus” reminds us that authentic peace requires work, courageous work, to heal scattered pieces of self. It also requires work to penetrate defensive, intimidating inner terrain that often prevents us from encountering our loving, grace-filled, compassionate self that hides its vulnerability in our depths. Once we are able to do this, however, we move from sole to soul.

Deborah Grassman’s book, The Hero Within: Redeeming the Destiny We Were Born to Fulfill, is used by book circles around the country. The book is a guide for how to create and achieve genuine peace. The opening paragraph depicts her recognition of the personal need for re-owning and re-homing pieces of self, foreshadowing the subsequent process of healing. She writes: “No one taught me how to fail. No one showed me how to lose, and because I never learned these things, I felt alone when they occurred. Sometimes, I felt more than alone. I felt incompetent if I didn’t win; I felt rejected if I wasn’t the chosen favorite. I felt worthless or guilty if I couldn’t please someone. Certainly, I never considered opening my heart for a class on how to experience losing and failing.”

PlaneTree. A very common adage asserts that where there’s a will, there’s a way. If only good intentions were enough to achieve a patient-centered healthcare system, but experience has proven time and time again that desire alone does not generate change. Planetree provides the pathway to change, a structured methodology for humanizing, personalizing and demystifying the patient experience, customized to your organization’s culture and needs. Powered by the stories and insights of patients, long-term care residents, family members and healthcare professionals, the Planetree approach guides organizations in making patient-centered care the centerpiece of a cohesive strategy that accelerates quality improvement and positions your organization to create change that will last through:

Development of infrastructures to support change
Implementation of patient-preferred practices
Transformation of organizational culture

Resilient Nurses. With six nurses for every physician, nursing is the heart of American health care. Nurses spend the most time with patients and are typically very dedicated. They entered their profession primarily to care for people. But nurses face significant change and challenge in today’s medical environment. In this special series, you’ll hear the voices and perspectives of nurses in different regions and a variety of clinical settings.

Segment 1 takes a no-holds-barred look at the stressful conditions in which many nurses work: the long hours, the emotional toll, the rapid pace, and the way that technology and institutional practices can make it hard to form a caring bond with patients.

Segment 2 presents inspiring stories of how active nurses use self-care techniques that help them manage—and transcend—the stresses of their essential work life, both on the job and after hours.

About Us

  • charter brand transp blue mediumCharter for Compassion provides an umbrella for people to engage in collaborative partnerships worldwide. Our mission is to bring to life the principles articulated in the Charter for Compassion through concrete, practical action in a myriad of sectors.

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