We develop a theory to explain how individual compassion in response to human pain in organizations becomes socially coordinated through a process we call compassion organizing. The theory specifies five mechanisms, including contextual enabling of attention, emotion, and trust, agents improvising structures, and symbolic enrichment, that show how the social architecture of an organization interacts with agency and emergent features to affect the extraction, generation, coordination, and calibration of resources. In doing so, our theory of compassion organizing suggests that the same structures designed for the normal work of organizations can be redirected to a new purpose to respond to members' pain. We discuss the implications of the theory for compassion organizing and for collective organizing more generally.

In this article, the authors explore compassion in work organizations. They discuss the prevalence and costs of pain in organizational life, and identify compassion as an important process that can occur in response to suffering. At the individual level, compassion takes place through three subprocesses: noticing another’s pain, experiencing an emotional reaction to the pain, and acting in response to the pain. The authors build on this framework to argue that organizational compassion exists when members of a system collectively notice, feel, and respond to pain experienced by members of that system. These processes become collective as features of an organization’s context legitimate them within the organization, propagate them among organizational members, and coordinate them across individuals.

SummaryThis paper describes two studies that explore core questions about compassion at work. Findings from a pilot survey indicate that compassion occurs with relative frequency among a wide variety of individuals, suggesting a relationship between experienced compassion, positive emotion, and affective commitment. A complementary narrative study reveals a wide range of compassion triggers and illuminates ways that work colleagues respond to suffering. The narrative analysis demonstrates that experienced compassion provides important sensemaking occasions where employees who receive, witness, or participate in the delivery of compassion reshape understandings of their co-workers, themselves, and their organizations. Together these studies map the contours of compassion at work, provide evidence of its powerful consequences, and open a horizon of new research questions.

IntroductionThe provision of HIV treatment and care in sub-Saharan Africa faces multiple challenges, including weak health systems and attrition of trained health workers. One potential response to overcome these challenges has been to engage community health workers (CHWs).MethodologyA systematic literature search for quantitative and qualitative studies describing the role and outcomes of CHWs in HIV care between inception and December 2012 in sub-Saharan Africa was performed in the following databases: PubMed, PsychINFO, Embase, Web of Science, JSTOR, WHOLIS, Google Scholar and SAGE journals online. Bibliographies of included articles were also searched. A narrative synthesis approach was used to analyze common emerging themes on the role and outcomes of CHWs in HIV care in sub-Saharan Africa.ResultsIn total, 21 studies met the inclusion criteria, documenting a range of tasks performed by CHWs. These included patient support (counselling, home-based care, education, adherence support and livelihood support) and health service support (screening, referral and health service organization and surveillance). CHWs were reported to enhance the reach, uptake and quality of HIV services, as well as the dignity, quality of life and retention in care of people living with HIV. The presence of CHWs in clinics was reported to reduce waiting times, streamline patient flow and reduce the workload of health workers. Clinical outcomes appeared not to be compromised, with no differences in virologic failure and mortality comparing patients under community-based and those under facility-based care. Despite these benefits, CHWs faced challenges related to lack of recognition, remuneration and involvement in decision making.ConclusionsCHWs can clearly contribute to HIV services delivery and strengthen human resource capacity in sub-Saharan Africa. For their contribution to be sustained, CHWs need to be recognized, remunerated and integrated in wider health systems. Further research focusing on comparative costs of CHW interventions and successful models for mainstreaming CHWs into wider health systems is needed.