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Designing the careful and kind clinic: an evidence-based approach
  1. Sara Poplau1,
  2. Mark Linzer1,
  3. Dominique Allwood2,
  4. Victor Montori3,4,
  5. Ryan Armbruster5,
  6. Sreenivas Koka6
  1. 1General Internal Medicine, Hennepin Healthcare, Minneapolis, Minnesota, USA
  2. 2Medical Directors Office, Imperial College Healthcare NHS Trust, London, UK
  3. 3Knowledge and Evaluation Research Unit, Mayo Clinic Rochester, Rochester, Minnesota, USA
  4. 4Patient Revolution Clinic, Rochester, Minnesota, USA
  5. 5University of Minnesota System, Minneapolis, Minnesota, USA
  6. 6Care Planning and Restorative Sciences, University of Mississippi School of Dentistry, Jackson, Mississippi, USA
  1. Correspondence to Dr Sreenivas Koka, University of Mississippi School of Dentistry, Jackson, MS 39216, USA; skoka{at}umc.edu

Abstract

Background There is evidence that creating a ‘healthy workplace’ can be of profound importance for clinicians, team members and patients. Yet there have been few papers that have proposed mechanisms to take decades of research and translate this into a practical list of options for leaders and managers to take into account when structuring a clinic based on care and kindness to achieve optimal health.

Evidence We bring together 20 years of scholarship linking care of the caregivers with outcomes for caregivers and patients. The data are used to support both structures and cultures that will result in satisfied and thriving healthcare team members, as well as satisfied and healthy patients.

Results The clinic based on care of the caregivers will be structured to address key aspects of worklife that are known to cause either satisfaction or burnout. Aspects of care, such as time pressure, chaotic environments and worker control of their workplace, will be taken into account in clinical design; organisational culture will be supportive and cohesive, emphasising quality, values and communication. Experiences based on gender and race will be measured and continuously improved; and performance will be evaluated in a new, human-centred manner.

Outcomes The careful and kind clinic will be a remarkable place to work; in contrast to industrialised healthcare, this will be an environment where health can indeed be optimised, for both workers and patients.

  • patient-centred care
  • clinical leadership
  • engagement
  • learning organisation

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Footnotes

  • Twitter @DrDominiqueAllw

  • Contributors SP, ML and SK: Substantial contributions to the conception or design of the work and the acquisition, analysis or interpretation of data for the work; AND Drafting the work; AND Final approval of the version to be published; AND Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. DA, VM and RA: Substantial contributions to the conception or design of the work; AND Revising it critically for important intellectual content; AND Final approval of the version to be published; AND Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests ML is supported in part through Hennepin Healthcare for his work in burnout reduction and training wellness champions by the American College of Physicians (ACP), the American Medical Association (AMA), Optum Office of Provider Advancement, the Institute for Healthcare Improvement and the American Board of Internal Medicine. He is also supported by the NIH and AHRQ for other research studies and training, and consults for Harvard University on a grant assessing diagnostic accuracy and clinician work conditions. SP has been supported by the AMA and ACP for this type of work in burnout reduction and wellness champion training. Neither received funding for their work on this paper.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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