Medical decluttering: what it is and why it is important.

Area of Science:

• Healthcare Improvement Science
• Medical Ethics
• Health Systems Management

Background:

• Healthcare systems face proliferation of low-value tests, treatments, and documentation.
• Factors contributing to medical clutter include decision fatigue, cognitive biases, overdiagnosis, and bureaucratic drift.
• This clutter leads to patient harm, moral distress, and erosion of trust.

Purpose of the Study:

• To introduce and operationalize medical decluttering as a strategy to improve healthcare value.
• To provide a framework for reducing unnecessary medical interventions and administrative burden.
• To enhance patient safety, dignity, and outcomes that matter.

Main Methods:

• Proposes a five-step cycle: Scan, Sort, Select, Safeguard, Sustain.
• Employs category-first review, explicit thresholds, safety nets, and reassessment.
• Integrates clinical applications like deprescribing and appropriateness-based testing.
• Incorporates professional practices such as digital minimalism and indication-based telemedicine.
• Relies on co-designed indicators, governance, audit-and-feedback, and rapid learning cycles.

Main Results:

• Medical decluttering offers a coherent method to reduce diagnostic and treatment cascades.
• Prioritizes value per unit effort and transparent measurement of burden and harms.
• Aims to restore focus on essential care, making it simpler, safer, and more humane.
• Balances overuse and underuse of medical interventions while safeguarding equity.

Conclusions:

• Medical decluttering is an ethics-anchored approach to optimize healthcare delivery.
• Aligns ethics, evidence, and attention to reduce waste and improve care quality.
• Facilitates a shift towards higher-value, patient-centered internal medicine practice.