Elements of Flipped Clinic, Part I: People-Centered

By Flip the Clinic

Over the last two years of working on Flip the Clinic, patients, clinicians, designers, policy-makers—you—have had a lot of really important things to say about what makes Flip the Clinic a powerful idea. Well, we’ve been listening. We’ve diligently bottled all that feedback and taken notes on what has and hasn’t worked within the community, in an effort to distill it. Because at the core of Flip the Clinic is a theory that we should learn-by-doing. Not all things we’ve tried have worked and others have pleasantly surprised us. It is through this experimentation that we’ve been able to get clearer on what’s working. Today, we’re uncorking the result. Below are the five elements of a Flipped Clinic as we see them now.

People-centered

People are the heart of health care—and we’re more complex (and interesting!) than a diagnosis or a decision. Goals and values, interests and experiences are valued.

Nourishing

Patients and clinicians feel welcomed and supported both by the clinic’s design and by the entire clinic community.

Joyful

Providers experience joy and passion in their work daily. Patients find delight in the health care encounter.

Transparent

Communication is clear, information is accessible and useable, and in conversation, clinician and patient voices are given equal value.

Expansive

It values the people and places outside the traditional clinic walls that play an important role in a person’s health.

Over the next few weeks, we’ll be rolling out more detailed explorations of each. Let’s kick it off with the one that’s arguably the most important.

People-centered

It seems obvious: People are the heart of health care. People seek health and people create the conditions where good health happens. People come up with good ideas and have the power to spread them. Sure, we benefit from smart devices and big data, but their primary function is to make life better for us as people. It is through this human lens that so many Flips have come forward.

Some Flips highlight the value of being treated as someone who is more than just a patient with a diagnosis. Dr. Jordan Shlain’s idea for a set of vital signs (See Flip #2), for instance, includes questions about sleep, work, money, neighborhood, and spouse, as well as the standard blood pressure, height and weight assessments. Others, like Flip #50: Flip the Script, attempt to shift the waiting room conversation from a one that’s transactional to one that puts patients first. These Flips welcome conversations outside the traditional narrative. They open up the door to patient-led discussions and provide clinicians with valuable context that can help them better understand and support a patient’s health. A patient’s values, interests, and experiences, struggles, concerns, and hopes are crucially important in how they approach their own health. By asking “What’s your goal today?” instead of “What insurance do you have?” patients have the opportunity to answer a receptionist or nurse’s question like they would a friend: “I want get help with my asthma so I can play basketball with my son” or “I’m taking off for my honeymoon so I’d like to see what can be done about this back pain.” A simple question makes the interaction deeper, more human, and more grounded in the greater context of a patient’s life.

Another people-centered Flip is Flip #35. Initiated by Keith Seidel, this Flip suggests we model the clinic after the Apple Store. But the idea isn’t about design. It’s about the excellent customer service that allows shoppers to feel taken care of, as soon as they walk in the door. Seidel moved a nurse to the health center’s front door so that she could triage patients immediately—and wait time dropped from 20 minutes to four!

In every Flip the Clinic Lab, we routinely answer the question: What ideas are good enough to move forward? The answer comes from a year of observing what Flips take off and what Flips sit without an advocate. We’ve come to feel strongly that Flips should be ideas that you feel passionately about. They’re the ideas that will follow you around until you draw in coworkers and friends and do something about it. A Flipped Clinic is people-centered because people are the engine that get good ideas moving.

To be a Flipped Clinic, or to embrace the principles of a Flipped Clinic, people need to come first.

We’d love to know what you think. How would you expand upon this idea? Is there anything you think we missed?