Uses Plan-Do-Study-Act (PDSA) as the model for improvement. This begins with making a specific aim statement using numerical goals, specific dates and specific measures. Create an overall theme, or global aim statement to maintain motivation and focus Review the data (including strengths and weaknesses of the system) and select an issue to address. Aims to create an overview of the system under review and identify improvement opportunities For example, fishbone diagram (cause and effect analysis) and data wall (metrics related to problem being addressed). Meets weekly to maintain focus, plan and oversee improvement workĬomplete the ‘5Ps’ assessment of Purpose, Patients, Professionals, Processes and Patterns using practice data and the microsystems workbook with templates. Employ effective meeting skills, including assigning individual roles/tasks. Godfrey et al again set out the five steps to take in order to organise your clinical microsystem:Īssemble a ‘lead team’ to represent all disciplines and roles in the practice (professional and clerical), and patients. Patterns that characterize the microsystem's functioning.’.Processes the microsystem uses to provide services, and.People who work together in the microsystem,.Patient subpopulations that are served by the microsystem,.If you are thinking of designing a clinical microsystem in your own organisation, you would first need to think about evaluating the ‘four P's’, which are: Godfrey et al describe the clinical microsystems approach as identifying a problem and then ‘developing a systematic approach to address it using a ‘toolkit’ of activities and a workbook to lead the team through a process.’ The clinical microsystems approach is used to encourage sustainable improvements in healthcare and the methodology was originally developed by the Dartmouth Institute in the USA: ‘ Clinical microsystems are the building blocks of organisations such as hospitals and can be characterised as the small units where care happens with a group of patients, for example wards, outpatient clinics and diagnostic departments.’ So, clinical microsystems can be made up of clinicians, patients, carers - with information and IT important parts of the process. Also described by Nelson et al as a ‘small-scale team and its local environment: a small group of people (including health professionals and care receiving patients and their families) who work together in a defined setting on a regular basis (or as needed) to create care for discrete subpopulations of patients’. You may be familiar with clinical microsystems from your own organisation, but if not, the Institute for Healthcare Improvement (IHI) describe a clinical microsystem as a ‘small, interdependent group of people who work together regularly to provide care for specific groups of patients.’Ī clinical microsystem is often part of a larger organisation and often has a specific focus or purpose around a certain area of care. The clinical microsystem is a Quality Improvement (QI) approach. In this article, we’re going to take a look at clinical microsystems: what they are, what they consist of, what they do and their value to healthcare, and - more specifically - their value within Quality Improvement (QI).
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