Research shows that kindness can lead to better health care

One researcher has defined kindness and believes it could be the key to better communication within healthcare teams and better care for patients.

Nicki Macklin came up with a definition of kindness through a structured analysis of published research articles, and found it to be action-oriented, positively oriented, and goal-oriented in nature.

“The foundation of kindness is politeness and choosing actions that demonstrate respect, generosity, openness and inclusivity,” says Macklin, a doctoral student at the School of Population Health at Waipapa Taumata Rau, University of Auckland.

“When we get into conflict, which is common in healthcare, but also in the rest of the world, it is a mindset and an approach where you actively maintain the other person’s respect through the ways you choose to respond.”

Macklin found that researchers often confuse kindness with compassion and empathy. Her new article, with her supervisors Dr. Laura Wilkinson-Meyers and Prof Tony Dowell, as co-authors, has been published in BMJ leader.

However, it is important to distinguish the terms because kindness exists regardless of the emotional state of others and can be taught in medical education.

Empathy is an internal, emotional response of wanting to share another person’s feelings or situation, whether suffering or joy, and forms the basis for action, rather than being an action itself.

Compassion is responding to the suffering of others with a desire to alleviate that suffering, but that may or may not result in outward action.

Kindness is a set of actions in response to a desire to help others thrive, whether based on an empathetic response or proactively chosen.

Macklin sees potential for embedding more kindness into the culture of teams and organizations, which would improve communication within healthcare teams and with patients, as well as patients’ experiences with safety and trust.

“This is something practical that we can measure and expect, for example in medical education, in policy or in organizations,” she says.

Kindness can exist when doctors are too burned out to be compassionate.

However, organizations must create environments and cultures where individuals and teams foster kindness before they can expect it from employees, Macklin adds.

Macklin has a background in quality improvement and is trained as an occupational therapist.

However, it was dealing with the healthcare system when she had an unwell child that sparked her interest in kindness and led to her patient advocacy work.

“It wasn’t so much the kindness or the absence of kindness towards us that affected us most. What had the biggest impact on our results was the kindness shown within the healthcare teams.

“Seeing our healthcare team undermine each other, not communicate respectfully during conflicts, give us conflicting treatment recommendations, and not work together had the greatest impact on us.

“And on the other hand, we witnessed really effective healthcare teams.

“In terms of patient safety and trust, watching the interactions between our healthcare teams had a greater impact on our sense of safety and trust than how we ourselves were treated.”

Macklin’s next planned publications will report on her subsequent Ph.D. studies involving surveys and interviews with people working in healthcare systems worldwide and those specializing in patient-centered care, in the hope that kindness becomes a principle of healthcare at every level.

The reason this is so important, she says, is that it improves patient care.

“Kindness is strongly linked to patient experience and outcome measures, including safety, better engagement with healthcare services and reduced hospital readmissions,” says Macklin.

“On the other hand, large studies have found that incivility within healthcare teams (rude manners, unclear or abrasive communication) is the root cause of three out of four cases of patient injury in hospitals.

“So while kindness may sound like a nice, gentle concept, it is actually a very serious tool for improving patient safety, experiences and outcome measures.”