The art and skills of compassion in practice

Empathy, or the ability to “feel” another person’s experience, evokes strong emotions and activates the neural pathways in the pain region of the brain. Compassion is empathy combined with purposeful action to relieve suffering and impacts the brain’s reward centres. What are the outward impacts of compassion? Compassion is human connection, reciprocity, feeling cared for and caring for another. It reduces stress and cortisol for the receiver and giver. It reduces suffering and impacts all areas of the Quadruple Aim. Yet nearly half of the population of America and 63% of providers believe that the health system is not compassionate.How do you build “compassion skills”? Being a compassionate clinician is not about knowledge, but the quality of communication and relational interactions. Many hold the belief that this ability is naturally acquired or inherent in medical practice, but this ability is technical, rooted in capabilities, intentional, and requires continuous practice and refinement. Healthcare practitioners are at a disadvantage: the rigours clinical learning and the perceived time pressures of practice take precedent, limiting the opportunity for refinement and practice of these interpersonal communication skills. Looking to bridge the gap on continuous professional development and learning from other sectors, the Royal College of Physicians and Surgeons of Canada has been considering approaches for practice improvement in compassion. To make compassion skills tangible, the presenters offered a “coaching skills” program for physicians. Early evidence is pointing towards the positive impacts of this type of communication skills training on the therapeutic alliance

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries