Sugimoto Gynecology Clinic Nurse Reform Program Official

Perhaps the most innovative component is the Psychological Safety Circle. Every Friday, program participants gather for a facilitated 45-minute session where they can debrief emotionally difficult cases without clinical judgment.

For example, if a nurse feels she failed to connect with a sexual assault survivor, she can present the case anonymously to peers. The group then uses the Sugimoto framework to offer alternative approaches. This is not a disciplinary meeting; it is a learning lab.

Dr. Sugimoto notes, "We realized that punishing nurses for emotional mistakes only drives them to suppress empathy. The reform program teaches that emotional risk-taking is a clinical skill." sugimoto gynecology clinic nurse reform program

For decades, many gynecology clinics in Japan operated under a rigid medical hierarchy: doctors diagnosed, nurses assisted. However, Sugimoto Clinic’s leadership identified a critical gap. Patients frequently reported feelings of anxiety, shame, or being rushed—particularly concerning topics like infertility, menopausal changes, and sexual health.

“We realized our nurses had the technical skills but often lacked the structured framework to address the emotional vulnerability of our patients,” says Dr. Yuki Sugimoto, the clinic’s director. “The ‘Reform Program’ was born to dismantle the cold, task-oriented model.” Perhaps the most innovative component is the Psychological

The reform has not been without friction. Some senior nurses initially resisted the expanded scope, fearing liability. Others felt the emotional labor of the “check-in” protocol led to compassion fatigue. In response, the clinic added a mandatory Peer Resilience Circle—a weekly, facilitated debriefing session for nursing staff to process difficult cases.

Reform cannot succeed if the caregivers themselves are not cared for. The program’s third pillar is widely considered its most radical: mandatory nurse wellness infrastructure. The results have been quantifiable

The results have been quantifiable. In the year following the reform’s launch, nursing sick leave dropped by 55%, and staff retention increased from 68% to 92%. Notably, the clinic received the "Best Place to Work in Healthcare" award from Tokyo Medical Journal in 2024.

The clinic abolished the traditional seniority-based hierarchy. In its place, a three-tier clinical ladder was introduced: Associate Gynecology Nurse (AGN) , Certified Gynecology Nurse (CGN) , and Advanced Practice Nurse (APN-GYN) . Each tier requires verified competencies in ultrasound assistance, IUD insertion/removal support, colposcopy assistance, and patient counseling. Promotion is tied to demonstrated skill, not years served, with corresponding salary increases of 15–25% per tier.