Background:  The rapidly changing and increasingly complex hospitalist work environment has placed new focus on provider burnout and resilience. As hospitalist leaders seek tools to address these issues, the design thinking process offers a novel user-centered approach. Initially developed in the tech industry, design thinking moves quickly and iteratively through five stages: Empathize, Define, Ideate, Prototype, and Test. The empathy stage invites user perspectives that better define the problem. Ideation expands and explores proposed solutions, ultimately generating prototypes for testing. As prototypes are tested, user engagement is gained through empathic interviewing and hands-on prototype interaction thus repeating the cycle, and ultimately converging on a user-focused solution.

Purpose: Employ design thinking concepts within a hospitalist group to generate novel solutions for workplace satisfaction and provider resilience.

Description:  We assembled a four-person team of clinical hospitalists trained in design thinking to address provider resilience among an 80-person hospitalist group. The team initially assumed that hospitalist resilience and burnout could be best addressed by mitigating clinical responsibilities and task burden. Per design thinking methodology, these assumptions were tested with a diverse set of hospital system employees (physicians, chaplain, phone operator, etc.) through empathic interviews centered on “How can sustainable high level performance be promoted at work?” These interviews illuminated important themes including: increased professional validation, tools to perform better, and assistance in personal growth. Based on those insights, the team developed several physical interview prompts (prototypes) that facilitated the next set of end-user interactions. Iterative prototype cycles generated the unanticipated question: “Can the hospitalist workplace itself promote rejuvenation?” Armed with this question, the design team engaged clinical hospitalists through additional design cycles to build further prototype solutions that focused on improved physical, cognitive, and social well-being rather than simply removing clinical responsibilities. The team identified three specific design targets that were integrated into the hospital medicine group’s formal annual strategic plan: 1) Provision of accessible nutrition daily, 2) Flexible workspace that allows for quiet focus and team collaboration, and 3) A clinical scheduling system that explicitly addresses “recovery.”

Conclusions: Implementing a user-centered design process such as design thinking can be valuable when seeking solutions to complex problems like burnout and resilience. Here, engagement of end-user hospitalists generated unanticipated insights that were different from initial assumptions about sources of workplace satisfaction. This approach also provided a unique way to engage and validate fellow clinicians’ desires to find rejuvenation in their day-to-day work environment.