The Experts below are selected from a list of 39687 Experts worldwide ranked by ideXlab platform
Eugene C Nelson - One of the best experts on this subject based on the ideXlab platform.
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quality by design a clinical Microsystems approach
2010Co-Authors: Eugene C NelsonAbstract:List of Tables, Figures, and Exhibits. Foreword by Donald M. Berwick. Preface. Acknowledgments. Introduction. The Editors. The Contributors. PART ONE: CASES AND PRINCIPLES. 1. Success Characteristics of High-Performing Microsystems: Learning from the Best (Eugene C. Nelson, Paul B. Batalden, Thomas P. Huber, Julie K. Johnson, Marjorie M. Godfrey, Linda A. Headrick,and John H. Wasson). 2. Developing High-Performing Microsystems (Eugene C. Nelson, Paul B. Batalden, William H. Edwards, Marjorie M. Godfrey, and Julie K. Johnson). 3. Leading Microsystems (Paul B. Batalden, Eugene C. Nelson, Julie K. Johnson, Marjorie M. Godfrey, Thomas P. Huber, Linda Kosnik, and Kerri Ashling). 4. Leading Macrosystems and Mesosystems for Microsystem Peak Performance (Paul B. Batalden, Eugene C. Nelson, Paul B. Gardent, and Marjorie M. Godfrey). 5. Developing Professionals and Improving Worklife (Thomas P. Huber, Marjorie M. Godfrey, Eugene C. Nelson, Julie K. Johnson, Christine Campbell, and Paul B. Batalden). 6. Planning Patient-Centered Services (Marjorie M. Godfrey, Eugene C. Nelson, John H. Wasson, Julie K. Johnson, and Paul B. Batalden). 7. Planning Patient-Centered Care (John H. Wasson, Marjorie M. Godfrey, Eugene C. Nelson, Julie K. Johnson, and Paul B. Batalden). 8. Improving Patient Safety (Julie K. Johnson, Paul Barach, Joseph P. Cravero, George T. Blike, Marjorie M. Godfrey, Paul B. Batalden, and Eugene C. Nelson). 9. Creating a Rich Information Environment (Eugene C. Nelson, Paul B. Batalden, Karen Homa, Marjorie M. Godfrey, Christine Campbell, Linda A. Headrick, Thomas P. Huber, Julie K. Johnson, and John H. Wasson). PART TWO: ACTIVATING THE ORGANIZATION AND THE DARTMOUTH Microsystem IMPROVEMENT CURRICULUM. 10. Overview of Path Forward and Introduction to Part Two. 11. Introduction to Microsystem Thinking. 12. Effective Meeting Skills I. 13. Assessing Your Microsystem with the 5 P's. 14. The Model for Improvement: PDSA!!. 15. Selecting Themes for Improvement. 16. Improvement Global Aim. 17. Process Mapping. 18. Specific Aim. 19. Cause and Effect Diagrams. 20. Effective Meeting Skills II: Brainstorming and Multi-Voting. 21. Change Concepts. 22. Measurement and Monitoring. 23. Action Plans and Gantt Charts. 24. Follow Through on Improvement: Storyboards, Data Walls, and Playbooks. 25. Conclusion: Continuing on the Path to Excellence. Appendix A: Primary Care Workbook. Name Index. Subject Index.
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clinical Microsystems part 3 transformation of two hospitals using Microsystem mesosystem and macrosystem strategies
The Joint Commission Journal on Quality and Patient Safety, 2008Co-Authors: Marjorie M. Godfrey, Craig N Melin, Stephen E Muething, Paul B Batalden, Eugene C NelsonAbstract:BACKGROUND: Two hospitals-a large, urban academic medical center and a rural, community hospital-have each chosen a similar Microsystem-based approach to improvement, customizing the engagement of ...
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clinical Microsystems part 1 the building blocks of health systems
The Joint Commission Journal on Quality and Patient Safety, 2008Co-Authors: Marjorie M. Godfrey, Scott A Berry, Albert E Bothe, Karen E Mckinley, Craig N Melin, Paul B Batalden, Eugene C Nelson, Stephen E MuethingAbstract:Article-at-a-Glance Background Wherever, however, and whenever health care is delivered—no matter the setting or population of patients—the body of knowledge on clinical Microsystems can guide and support innovation and peak performance. Many health care leaders and staff at all levels of their organizations in many countries have adapted Microsystem knowledge to their local settings. Clinical Microsystems: A Panoramic View: How Do Clinical Microsystems Fit Together? As the patient's journey of care seeking and care delivery takes place over time, he or she will move into and out of an assortment of clinical Microsystems, such as a family practitioner's office, an emergency department, and an intensive care unit. This assortment of clinical Microsystems—combined with the patient's own actions to improve or maintain health—can be viewed as the patient's unique health system. This patient-centric view of a health system is the foundation of second-generation development for clinical Microsystems. Lessons from the Field These lessons, which are not comprehensive, can be organized under the familiar commands that are used to start a race: On Your Mark, Get Set, Go! … with a fourth category added—Reflect: Reviewing the Race. These insights are intended as guidance to organizations ready to strategically transform themselves. Conclusion Beginning to master and make use of Microsystem principles and methods to attain macrosystem peak performance can help us knit together care in a fragmented health system, eschew archipelago building in favor of nation-building strategies, achieve safe and efficient care with reliable handoffs, and provide the best possible care and attain the best possible health outcomes.
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Microsystems in health care part 4 planning patient centered care
The Joint Commission Journal on Quality and Patient Safety, 2003Co-Authors: John H. Wasson, Julie J. Mohr, Marjorie M. Godfrey, Eugene C Nelson, Paul B BataldenAbstract:Article-at-a-Glance Background Clinical Microsystems are the essential building blocks of all health systems. At the heart of an effective Microsystem is a productive interaction between an informed, activated patient and a prepared, proactive practice staff. Support, which increases the patient's ability for self-management, is an essential result of a productive interaction. This series on high-performing clinical Microsystems is based on interviews and site visits to 20 clinical Microsystems in the United States. This fourth article in the series describes how high-performing Microsystems design and plan patient-centered care. Planning patient-centered care Well-planned, patient-centered care results in improved practice efficiency and better patient outcomes. However, planning this care is not an easy task. Excellent planned care requires that the Microsystem have services that match what really matters to a patient and family and protected time to reflect and plan. Patient self-management support, clinical decision support, delivery system design, and clinical information systems must be planned to be effective, timely, and efficient for each individual patient and for all patients. Conclusion Excellent planned services and planned care are attainable today in Microsystems that understand what really matters to a patient and family and have the capacity to provide services to meet the patient's needs.
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Microsystems in health care part 2 creating a rich information environment
The Joint Commission Journal on Quality and Patient Safety, 2003Co-Authors: Eugene C Nelson, Julie J. Mohr, Marjorie M. Godfrey, Christine M Campbell, Linda A. Headrick, Paul B Batalden, Thomas P. Huber, Karen Homa, John H. WassonAbstract:Article-at-a-Glance Background A rich information environment supports the functioning of the small, functional, frontline units—the Microsystems—that provide most health care to most people. Three settings represent case examples of how clinical Microsystems use data in everyday practice to provide high-quality and cost-effective care. Cases At The Spine Center at Dartmouth, Lebanon, New Hampshire, a patient value compass, a one-page health status report, is used to determine if the provided care and services are meeting the patient's needs. In Summit, New Jersey, Overlook Hospital's emergency department (ED) uses uses real-time process monitoring on patient care cycle times, quality and productivity indicator tracking, and patient and customer satisfaction tracking. These data streams create an information pool that is actively used in this ED icrosystem—minute by minute, hourly, daily, weekly, and annually—to analyze performance patterns and spot flaws that require action. The Shock Trauma Intensive Care Unit (STRICU), Intermountain Health Care, Salt Lake City, uses a data sytstem to monitor the "wired" patient remotely and share information at any time in real time. Staff can complete shift reports in 10minutes. Discussion Information exchange is the interface that connects staff to patients and staff to staff within the Microsystem; Microsystem to Microsystem; and Microsystem to macro-organization.
Paul B Batalden - One of the best experts on this subject based on the ideXlab platform.
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clinical Microsystems part 3 transformation of two hospitals using Microsystem mesosystem and macrosystem strategies
The Joint Commission Journal on Quality and Patient Safety, 2008Co-Authors: Marjorie M. Godfrey, Craig N Melin, Stephen E Muething, Paul B Batalden, Eugene C NelsonAbstract:BACKGROUND: Two hospitals-a large, urban academic medical center and a rural, community hospital-have each chosen a similar Microsystem-based approach to improvement, customizing the engagement of ...
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clinical Microsystems part 1 the building blocks of health systems
The Joint Commission Journal on Quality and Patient Safety, 2008Co-Authors: Marjorie M. Godfrey, Scott A Berry, Albert E Bothe, Karen E Mckinley, Craig N Melin, Paul B Batalden, Eugene C Nelson, Stephen E MuethingAbstract:Article-at-a-Glance Background Wherever, however, and whenever health care is delivered—no matter the setting or population of patients—the body of knowledge on clinical Microsystems can guide and support innovation and peak performance. Many health care leaders and staff at all levels of their organizations in many countries have adapted Microsystem knowledge to their local settings. Clinical Microsystems: A Panoramic View: How Do Clinical Microsystems Fit Together? As the patient's journey of care seeking and care delivery takes place over time, he or she will move into and out of an assortment of clinical Microsystems, such as a family practitioner's office, an emergency department, and an intensive care unit. This assortment of clinical Microsystems—combined with the patient's own actions to improve or maintain health—can be viewed as the patient's unique health system. This patient-centric view of a health system is the foundation of second-generation development for clinical Microsystems. Lessons from the Field These lessons, which are not comprehensive, can be organized under the familiar commands that are used to start a race: On Your Mark, Get Set, Go! … with a fourth category added—Reflect: Reviewing the Race. These insights are intended as guidance to organizations ready to strategically transform themselves. Conclusion Beginning to master and make use of Microsystem principles and methods to attain macrosystem peak performance can help us knit together care in a fragmented health system, eschew archipelago building in favor of nation-building strategies, achieve safe and efficient care with reliable handoffs, and provide the best possible care and attain the best possible health outcomes.
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Microsystems in health care part 4 planning patient centered care
The Joint Commission Journal on Quality and Patient Safety, 2003Co-Authors: John H. Wasson, Julie J. Mohr, Marjorie M. Godfrey, Eugene C Nelson, Paul B BataldenAbstract:Article-at-a-Glance Background Clinical Microsystems are the essential building blocks of all health systems. At the heart of an effective Microsystem is a productive interaction between an informed, activated patient and a prepared, proactive practice staff. Support, which increases the patient's ability for self-management, is an essential result of a productive interaction. This series on high-performing clinical Microsystems is based on interviews and site visits to 20 clinical Microsystems in the United States. This fourth article in the series describes how high-performing Microsystems design and plan patient-centered care. Planning patient-centered care Well-planned, patient-centered care results in improved practice efficiency and better patient outcomes. However, planning this care is not an easy task. Excellent planned care requires that the Microsystem have services that match what really matters to a patient and family and protected time to reflect and plan. Patient self-management support, clinical decision support, delivery system design, and clinical information systems must be planned to be effective, timely, and efficient for each individual patient and for all patients. Conclusion Excellent planned services and planned care are attainable today in Microsystems that understand what really matters to a patient and family and have the capacity to provide services to meet the patient's needs.
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Microsystems in health care part 2 creating a rich information environment
The Joint Commission Journal on Quality and Patient Safety, 2003Co-Authors: Eugene C Nelson, Julie J. Mohr, Marjorie M. Godfrey, Christine M Campbell, Linda A. Headrick, Paul B Batalden, Thomas P. Huber, Karen Homa, John H. WassonAbstract:Article-at-a-Glance Background A rich information environment supports the functioning of the small, functional, frontline units—the Microsystems—that provide most health care to most people. Three settings represent case examples of how clinical Microsystems use data in everyday practice to provide high-quality and cost-effective care. Cases At The Spine Center at Dartmouth, Lebanon, New Hampshire, a patient value compass, a one-page health status report, is used to determine if the provided care and services are meeting the patient's needs. In Summit, New Jersey, Overlook Hospital's emergency department (ED) uses uses real-time process monitoring on patient care cycle times, quality and productivity indicator tracking, and patient and customer satisfaction tracking. These data streams create an information pool that is actively used in this ED icrosystem—minute by minute, hourly, daily, weekly, and annually—to analyze performance patterns and spot flaws that require action. The Shock Trauma Intensive Care Unit (STRICU), Intermountain Health Care, Salt Lake City, uses a data sytstem to monitor the "wired" patient remotely and share information at any time in real time. Staff can complete shift reports in 10minutes. Discussion Information exchange is the interface that connects staff to patients and staff to staff within the Microsystem; Microsystem to Microsystem; and Microsystem to macro-organization.
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Microsystems in Health Care
2003Co-Authors: Julie J. Mohr, Marjorie M. Godfrey, Paul B Batalden, Paul Barach, Joseph P. Cravero, George T. Blike, Eugene C NelsonAbstract:As stated at the outset of the Microsystems in Health Care series, the health system is composed of a few basic parts—front-line clinical Microsystems, overarching macrosystems, and patient subpopulations needing care. (Part 1) Microsystems thinking makes several organizational assumptions: 1. Bigger systems (macrosystems) are made of smaller systems 2. These smaller systems (Microsystems) produce quality, safety, and cost outcomes at the front line of care 3. Ultimately the outcomes of the macrosystem can be no better than the Microsystems of which it is composed In addition, the Microsystem is the logical locus for linkage between vision and delivery and therefore can and should act as the “agent for change” within a macrosystem. If strategically driven and if the performance of each individual Microsystem is optimized, the Microsystems within a macrosystem can facilitate systematic transformation at all levels of the system. This article describes how the Microsystem, as an agent for change, plays a critical and essential role in developing and deploying the macrosystem’s strategic plan.
Marjorie M. Godfrey - One of the best experts on this subject based on the ideXlab platform.
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clinical Microsystems part 3 transformation of two hospitals using Microsystem mesosystem and macrosystem strategies
The Joint Commission Journal on Quality and Patient Safety, 2008Co-Authors: Marjorie M. Godfrey, Craig N Melin, Stephen E Muething, Paul B Batalden, Eugene C NelsonAbstract:BACKGROUND: Two hospitals-a large, urban academic medical center and a rural, community hospital-have each chosen a similar Microsystem-based approach to improvement, customizing the engagement of ...
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clinical Microsystems part 1 the building blocks of health systems
The Joint Commission Journal on Quality and Patient Safety, 2008Co-Authors: Marjorie M. Godfrey, Scott A Berry, Albert E Bothe, Karen E Mckinley, Craig N Melin, Paul B Batalden, Eugene C Nelson, Stephen E MuethingAbstract:Article-at-a-Glance Background Wherever, however, and whenever health care is delivered—no matter the setting or population of patients—the body of knowledge on clinical Microsystems can guide and support innovation and peak performance. Many health care leaders and staff at all levels of their organizations in many countries have adapted Microsystem knowledge to their local settings. Clinical Microsystems: A Panoramic View: How Do Clinical Microsystems Fit Together? As the patient's journey of care seeking and care delivery takes place over time, he or she will move into and out of an assortment of clinical Microsystems, such as a family practitioner's office, an emergency department, and an intensive care unit. This assortment of clinical Microsystems—combined with the patient's own actions to improve or maintain health—can be viewed as the patient's unique health system. This patient-centric view of a health system is the foundation of second-generation development for clinical Microsystems. Lessons from the Field These lessons, which are not comprehensive, can be organized under the familiar commands that are used to start a race: On Your Mark, Get Set, Go! … with a fourth category added—Reflect: Reviewing the Race. These insights are intended as guidance to organizations ready to strategically transform themselves. Conclusion Beginning to master and make use of Microsystem principles and methods to attain macrosystem peak performance can help us knit together care in a fragmented health system, eschew archipelago building in favor of nation-building strategies, achieve safe and efficient care with reliable handoffs, and provide the best possible care and attain the best possible health outcomes.
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Microsystems in health care part 4 planning patient centered care
The Joint Commission Journal on Quality and Patient Safety, 2003Co-Authors: John H. Wasson, Julie J. Mohr, Marjorie M. Godfrey, Eugene C Nelson, Paul B BataldenAbstract:Article-at-a-Glance Background Clinical Microsystems are the essential building blocks of all health systems. At the heart of an effective Microsystem is a productive interaction between an informed, activated patient and a prepared, proactive practice staff. Support, which increases the patient's ability for self-management, is an essential result of a productive interaction. This series on high-performing clinical Microsystems is based on interviews and site visits to 20 clinical Microsystems in the United States. This fourth article in the series describes how high-performing Microsystems design and plan patient-centered care. Planning patient-centered care Well-planned, patient-centered care results in improved practice efficiency and better patient outcomes. However, planning this care is not an easy task. Excellent planned care requires that the Microsystem have services that match what really matters to a patient and family and protected time to reflect and plan. Patient self-management support, clinical decision support, delivery system design, and clinical information systems must be planned to be effective, timely, and efficient for each individual patient and for all patients. Conclusion Excellent planned services and planned care are attainable today in Microsystems that understand what really matters to a patient and family and have the capacity to provide services to meet the patient's needs.
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Microsystems in health care part 2 creating a rich information environment
The Joint Commission Journal on Quality and Patient Safety, 2003Co-Authors: Eugene C Nelson, Julie J. Mohr, Marjorie M. Godfrey, Christine M Campbell, Linda A. Headrick, Paul B Batalden, Thomas P. Huber, Karen Homa, John H. WassonAbstract:Article-at-a-Glance Background A rich information environment supports the functioning of the small, functional, frontline units—the Microsystems—that provide most health care to most people. Three settings represent case examples of how clinical Microsystems use data in everyday practice to provide high-quality and cost-effective care. Cases At The Spine Center at Dartmouth, Lebanon, New Hampshire, a patient value compass, a one-page health status report, is used to determine if the provided care and services are meeting the patient's needs. In Summit, New Jersey, Overlook Hospital's emergency department (ED) uses uses real-time process monitoring on patient care cycle times, quality and productivity indicator tracking, and patient and customer satisfaction tracking. These data streams create an information pool that is actively used in this ED icrosystem—minute by minute, hourly, daily, weekly, and annually—to analyze performance patterns and spot flaws that require action. The Shock Trauma Intensive Care Unit (STRICU), Intermountain Health Care, Salt Lake City, uses a data sytstem to monitor the "wired" patient remotely and share information at any time in real time. Staff can complete shift reports in 10minutes. Discussion Information exchange is the interface that connects staff to patients and staff to staff within the Microsystem; Microsystem to Microsystem; and Microsystem to macro-organization.
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Microsystems in Health Care
2003Co-Authors: Julie J. Mohr, Marjorie M. Godfrey, Paul B Batalden, Paul Barach, Joseph P. Cravero, George T. Blike, Eugene C NelsonAbstract:As stated at the outset of the Microsystems in Health Care series, the health system is composed of a few basic parts—front-line clinical Microsystems, overarching macrosystems, and patient subpopulations needing care. (Part 1) Microsystems thinking makes several organizational assumptions: 1. Bigger systems (macrosystems) are made of smaller systems 2. These smaller systems (Microsystems) produce quality, safety, and cost outcomes at the front line of care 3. Ultimately the outcomes of the macrosystem can be no better than the Microsystems of which it is composed In addition, the Microsystem is the logical locus for linkage between vision and delivery and therefore can and should act as the “agent for change” within a macrosystem. If strategically driven and if the performance of each individual Microsystem is optimized, the Microsystems within a macrosystem can facilitate systematic transformation at all levels of the system. This article describes how the Microsystem, as an agent for change, plays a critical and essential role in developing and deploying the macrosystem’s strategic plan.
Julie J. Mohr - One of the best experts on this subject based on the ideXlab platform.
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Microsystems in health care part 4 planning patient centered care
The Joint Commission Journal on Quality and Patient Safety, 2003Co-Authors: John H. Wasson, Julie J. Mohr, Marjorie M. Godfrey, Eugene C Nelson, Paul B BataldenAbstract:Article-at-a-Glance Background Clinical Microsystems are the essential building blocks of all health systems. At the heart of an effective Microsystem is a productive interaction between an informed, activated patient and a prepared, proactive practice staff. Support, which increases the patient's ability for self-management, is an essential result of a productive interaction. This series on high-performing clinical Microsystems is based on interviews and site visits to 20 clinical Microsystems in the United States. This fourth article in the series describes how high-performing Microsystems design and plan patient-centered care. Planning patient-centered care Well-planned, patient-centered care results in improved practice efficiency and better patient outcomes. However, planning this care is not an easy task. Excellent planned care requires that the Microsystem have services that match what really matters to a patient and family and protected time to reflect and plan. Patient self-management support, clinical decision support, delivery system design, and clinical information systems must be planned to be effective, timely, and efficient for each individual patient and for all patients. Conclusion Excellent planned services and planned care are attainable today in Microsystems that understand what really matters to a patient and family and have the capacity to provide services to meet the patient's needs.
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Microsystems in health care part 2 creating a rich information environment
The Joint Commission Journal on Quality and Patient Safety, 2003Co-Authors: Eugene C Nelson, Julie J. Mohr, Marjorie M. Godfrey, Christine M Campbell, Linda A. Headrick, Paul B Batalden, Thomas P. Huber, Karen Homa, John H. WassonAbstract:Article-at-a-Glance Background A rich information environment supports the functioning of the small, functional, frontline units—the Microsystems—that provide most health care to most people. Three settings represent case examples of how clinical Microsystems use data in everyday practice to provide high-quality and cost-effective care. Cases At The Spine Center at Dartmouth, Lebanon, New Hampshire, a patient value compass, a one-page health status report, is used to determine if the provided care and services are meeting the patient's needs. In Summit, New Jersey, Overlook Hospital's emergency department (ED) uses uses real-time process monitoring on patient care cycle times, quality and productivity indicator tracking, and patient and customer satisfaction tracking. These data streams create an information pool that is actively used in this ED icrosystem—minute by minute, hourly, daily, weekly, and annually—to analyze performance patterns and spot flaws that require action. The Shock Trauma Intensive Care Unit (STRICU), Intermountain Health Care, Salt Lake City, uses a data sytstem to monitor the "wired" patient remotely and share information at any time in real time. Staff can complete shift reports in 10minutes. Discussion Information exchange is the interface that connects staff to patients and staff to staff within the Microsystem; Microsystem to Microsystem; and Microsystem to macro-organization.
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Microsystems in Health Care
2003Co-Authors: Julie J. Mohr, Marjorie M. Godfrey, Paul B Batalden, Paul Barach, Joseph P. Cravero, George T. Blike, Eugene C NelsonAbstract:As stated at the outset of the Microsystems in Health Care series, the health system is composed of a few basic parts—front-line clinical Microsystems, overarching macrosystems, and patient subpopulations needing care. (Part 1) Microsystems thinking makes several organizational assumptions: 1. Bigger systems (macrosystems) are made of smaller systems 2. These smaller systems (Microsystems) produce quality, safety, and cost outcomes at the front line of care 3. Ultimately the outcomes of the macrosystem can be no better than the Microsystems of which it is composed In addition, the Microsystem is the logical locus for linkage between vision and delivery and therefore can and should act as the “agent for change” within a macrosystem. If strategically driven and if the performance of each individual Microsystem is optimized, the Microsystems within a macrosystem can facilitate systematic transformation at all levels of the system. This article describes how the Microsystem, as an agent for change, plays a critical and essential role in developing and deploying the macrosystem’s strategic plan.
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Microsystems in Health Care: Part 9. Developing Small Clinical Units to Attain Peak Performance Microsystems in Health Care
2003Co-Authors: Paul B Batalden, Marjorie M. Godfrey, Eugene C Nelson, William H. Edwards, Julie J. MohrAbstract:This article, the last one in the nine-part Microsystems in Health Care series, focuses on what it takes, in the short term and long term, for clinical Microsystems—the small, functional, front-line units that provide the most health care to the most people—to realize their potential and to attain peak performance. To achieve long-term gains, it may be important to have a sense of how actual clinical Microsystems can grow, learn, adapt, and improve over extended periods of time. We provide a case study to highlight one Microsystem’s 10-year journey toward excellence and offer a framework that reflects a clinical Microsystem’s developmental journey toward high performance. This case study, like the other case studies presented in this series (see Sidebar 1, page 576), contributes to the evolution of clinical Microsystem theory. To make swift progress in the short term, it may be wise for the leaders of health systems to sponsor an action-learning program to catalyze development of clinical Microsystems. We describe a “green belt curriculum” on Microsystems fundamentals that can be used to initiate forward progress and to begin to anchor strategic and operational Microsystems thinking in the local culture. The article concludes with a summary of important points, including what leaders can do to foster effective progress toward best performance. Background: This last Microsystems in Health Care series article focuses on what it takes, in the short term and long term, for clinical Microsystems—the small, functional, front-line units that provide the most health care to the most people—to attain peak performance. Case Study: A case study featuring the intensive care nursery at Dartmouth-Hitchcock Medical Center illustrates the 10-year evolution of a clinical Microsystem. Related evolutionary principles begin with the intention to excel, involve all the players, use measurement and feedback, and create a learning system. Discussion: A Microsystem’s typical developmental journey toward excellence entails five stages of growth—awareness as an interdependent group with the capacity to make changes, connecting routine daily work to the high purpose of benefiting patients, responding successfully to strategic challenges, measuring the Microsystem’s performance as a system, and juggling improvements while taking care of patients. A Model Curriculum: Health system leaders can sponsor an action-learning program to catalyze development of clinical Microsystems. A “green-belt curriculum” can help clinical staff members acquire the fundamental knowledge and skills that they will need to master if they are to increase their capacity to attain higher levels of performance; uses action-learning theory and sound education principles to provide the opportunity to learn, test, and gain some degree of mastery; and involves people in the challenging real work of improving. Article-at-a-Glance
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improving safety on the front lines the role of clinical Microsystems
Quality & Safety in Health Care, 2002Co-Authors: Julie J. Mohr, Paul B BataldenAbstract:Qual Saf Health Care 2002;11:45‐50 The clinical Microsystem puts medical error and harm reduction into the broader context of safety and quality of care by providing a framework to assess and evaluate the structure, process, and outcomes of care. Eight characteristics of clinical Microsystems emerged from a qualitative analysis of interviews with representatives from 43 Microsystems across North America. These characteristics were used to develop a tool for assessing the function of Microsystems. Further research is needed to assess Microsystem performance, outcomes, and safety, and how to replicate “best practices” in other settings.
John H. Wasson - One of the best experts on this subject based on the ideXlab platform.
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Microsystems in health care part 4 planning patient centered care
The Joint Commission Journal on Quality and Patient Safety, 2003Co-Authors: John H. Wasson, Julie J. Mohr, Marjorie M. Godfrey, Eugene C Nelson, Paul B BataldenAbstract:Article-at-a-Glance Background Clinical Microsystems are the essential building blocks of all health systems. At the heart of an effective Microsystem is a productive interaction between an informed, activated patient and a prepared, proactive practice staff. Support, which increases the patient's ability for self-management, is an essential result of a productive interaction. This series on high-performing clinical Microsystems is based on interviews and site visits to 20 clinical Microsystems in the United States. This fourth article in the series describes how high-performing Microsystems design and plan patient-centered care. Planning patient-centered care Well-planned, patient-centered care results in improved practice efficiency and better patient outcomes. However, planning this care is not an easy task. Excellent planned care requires that the Microsystem have services that match what really matters to a patient and family and protected time to reflect and plan. Patient self-management support, clinical decision support, delivery system design, and clinical information systems must be planned to be effective, timely, and efficient for each individual patient and for all patients. Conclusion Excellent planned services and planned care are attainable today in Microsystems that understand what really matters to a patient and family and have the capacity to provide services to meet the patient's needs.
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Microsystems in health care part 2 creating a rich information environment
The Joint Commission Journal on Quality and Patient Safety, 2003Co-Authors: Eugene C Nelson, Julie J. Mohr, Marjorie M. Godfrey, Christine M Campbell, Linda A. Headrick, Paul B Batalden, Thomas P. Huber, Karen Homa, John H. WassonAbstract:Article-at-a-Glance Background A rich information environment supports the functioning of the small, functional, frontline units—the Microsystems—that provide most health care to most people. Three settings represent case examples of how clinical Microsystems use data in everyday practice to provide high-quality and cost-effective care. Cases At The Spine Center at Dartmouth, Lebanon, New Hampshire, a patient value compass, a one-page health status report, is used to determine if the provided care and services are meeting the patient's needs. In Summit, New Jersey, Overlook Hospital's emergency department (ED) uses uses real-time process monitoring on patient care cycle times, quality and productivity indicator tracking, and patient and customer satisfaction tracking. These data streams create an information pool that is actively used in this ED icrosystem—minute by minute, hourly, daily, weekly, and annually—to analyze performance patterns and spot flaws that require action. The Shock Trauma Intensive Care Unit (STRICU), Intermountain Health Care, Salt Lake City, uses a data sytstem to monitor the "wired" patient remotely and share information at any time in real time. Staff can complete shift reports in 10minutes. Discussion Information exchange is the interface that connects staff to patients and staff to staff within the Microsystem; Microsystem to Microsystem; and Microsystem to macro-organization.
