New study on compassion in Alberta emergency departments linked to quality care

The news is rife these days about the quality of health care in Alberta. This includes increased wait times in emergency departments (ED), with some physicians referring to these and other quality-care issues as a capacity crisis. But how does a small act of kindness, an encouraging word or human touch impact patients’ experiences of quality care? According to the results from a recent study of over 4,500 ED patients in Alberta, published in the online journal, BMC Emergency Medicine, compassion was identified as the greatest predictor of patients’ overall quality care ratings.  

UCalgary Nursing professor and director of the Compassion Research Lab Dr. Shane Sinclair, PhD, in partnership with the Health Quality Council of Alberta (HQCA) and Innovate Calgary, completed a large study measuring the impact of compassion in the 14 busiest provincial EDs. Compassion was measured using the SCQ (Sinclair Compassion Questionnaire), a valid and reliable tool developed by Sinclair and his team which includes UCalgary Department of Psychology, Faculty of Arts doctoral candidate Harrison Boss, MSc’19, and Dr. Cara MacInnis, PhD, adjunct associate professor, UCalgary and professor, Acadia University.  

Compassion was identified as the greatest predictor of quality ratings among the respondents, surpassing other traditional factors of quality care such as wait times, clinical communication, and pain and symptom management.  

"Compassion can no longer be dismissed as an optional extra,” says Sinclair, who is also an adjunct professor with UCalgary’s Cumming School of Medicine and an international expert on the topic of compassion.

“We now have, for the first time, empirical evidence that compassion is inextricably linked to quality care. Patients have told us that, if we want to assess and improve their experiences of quality care, it’s not just about improving wait times or enhancing the technical services available to them; it’s about the way that care is given, namely compassion."

The study participants were surveyed shortly after being discharged from the ED where 50 per cent of them went home and 50 per cent were admitted to hospital. They all completed a version of the Emergency Department Patient Experience of Care survey by the HQCA along with 15 additional questions from the SCQ. 

“We found through our analyses that compassion outpaced all other measured variables in terms of its ability to predict patients’ perceptions of quality care,” says Boss. “We also critically identified that certain demographics of people varied in their experiences of compassion in the emergency department. Women and Indigenous patients scored lower on their experiences of compassion than men and white patients, respectively.  

“It solidifies the need for new and continued relationships with Indigenous and gender-diverse communities, to understand and improve their experiences of compassion in the emergency department.” 

Sinclair admits to being “blown away” by the results. “While we all thought compassion would have some relationship to quality-care ratings, we were astonished that it was the single greatest predictor of quality-care ratings,” he says. “And not just marginally, but significantly. In other words, you take away compassion from the mix and quality-care ratings drop considerably.” 

This study adds to an increasing body of evidence on the power of compassion, which has motivated some researchers to advocate for the inclusion of compassion as a Key Performance Indicator within our fast-paced health-care system.  

“This work has not only advanced our understanding of compassion but also affirmed it as a key indicator of health service quality and people-centred care,” says Dr. Markus Lahtinen, PhD’09, HQCA’s senior director of health system analytics.  

“Measuring compassion fosters a more empathetic and supportive environment, which can enhance the overall quality of care provided. As well, quantifying compassion helps identify areas for improvement, ensuring that health-care professionals maintain high standards of patient interaction and emotional support.” 

The study results, says Sinclair, will inform future studies by the Compassion Research Lab and other researchers within the field. 

BMC Emergency Medicine is an open access, peer-reviewed journal that considers articles on all urgent and emergency aspects of medicine, in both practice and basic research.