Schwartz Centre Rounds: qualitative exploration of panel members' experiences within a forensic mental health service.

Schwartz Centre Rounds (SCRs) provide a structured forum for staff from all disciplines to meet and discuss the difficult emotional and social challenges that arise in caring for patients. Research into the implementation of SCRs has shown that staff who attend report increased insight into the emotional and social aspects of care; greater understanding of the roles of their colleagues; improved teamworking and decreased feelings of isolation and stress. However, little research has explored the implementation of SCRs within forensic settings, and no research has focused solely on the experiences of panel members. Three focus groups were facilitated with participants who had participated in a SCR panel within a forensic mental health service. Semi-structured interviews were carried out, audio-recorded and subsequently transcribed. Interpretive phenomenological analysis was utilised to analyse the transcripts, and four key themes were identified. These themes were: feeling vulnerable, the importance of validation, exposure to intense emotional experiences and improved understanding and connection. We conclude that SCRs can be an emotionally challenging but rewarding experience, with the potential to enhance teamworking and general well-being. Limitations and recommendations for future research are also discussed.

Disability and medical management of natural latex sensitivity claims.

In 1995 a latex allergy case incurred a cost of $220,000 within the first year of the claim. A number of factors were thought to contribute to the cost of these claims. In 1996 Michigan Health & Hospital Association Service Corporation identified and implemented protocols to intervene early with latex sensitivity claims. The average cost per case has decreased dramatically since the implementation of the protocols. Decreasing the frequency and the average cost of latex sensitivity claims through the identification, treatment, and return to work of legitimate latex sensitivity cases has been the focus. Equally important was to minimize the impact of latex sensitivity on the life of the health care worker. In 1999 and subsequent years, data from glove- or latex-related claims that began from 1996 were analyzed. Latex sensitivity-related claims were sorted as lost-time claims and medical-only claims from the Michigan Health & Hospital Association Service Corporation claims database. The average cost per claim and the frequency of latex-related claims were identified. The average cost of latex-related lost-time claims has decreased significantly; however, the frequency in lost-time claims has been consistent. Health care workers consistently were returned to work successfully. Implementation of latex-sensitivity protocols is effective in the reduction of the average cost of latex-related claims and the impact of those claims on the lives of health care workers. This has been afforded through the confirmation of the diagnosis of latex sensitivity, followed by the implementation of a method to evaluate the physiologic response to the workplace objectively.