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So we focus on frontline systems because the only way to design and deliver care that consistently and efficiently meets people's needs is to grow the capability of the microsystems to realize their mission by providing high quality to each person they serve. Improving requires learning grounded in the experience and daily reality of the work of health care in that frontline context.
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These microsystems make health care real, and they vary widely in their ability to do the job-to give all patients what they want and need exactly when they want and need it (Institute for Healthcare Improvement, 2000). , 2001).Īll large health systems (macroorganizations) have microsystems as their basic building blocks. Donald Berwick and the Institute of Medicine (IOM) subcommittee responsible for the report Crossing the (Quality Chasm depicted the pivotal and determinate position of the microsystem when they made the health care "chain of effect" diagram (Institute of Medicine. This relationship is shown in Figure 1.1 in Chapter One. It follows then, that if a health care wishes to produce high-quality health care, care that meets the needs of the individual, then it must have high-quality microsystems that are always on-perpetually able to discern what a person wants and needs and able to design and deliver the care that best matches that person's needs. Microsystems are the unit of action-the sharp end of the health care system. Microsystems are the places where patients and families and health care teams meet.
Clinical microsystem greenbooks professional#
When and where a person with a health need interacts with a health care professional and supporting staff, a clinical microsystem is at work. Patients and families invite these health professionals- physicians, nurses, clinicians-into their lives to provide needed assistance. They wish to have a healing relationship or a relationship that protects or promotes their health.
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IMPROVEMENT RAMP: ASSESSMENT.When people are sick or injured or have a health condition that they cannot manage on their own, they often seek health care from educated and trained professionals. Through the assessment described in this chapter, the interdisciplinary lead improvement team will learn new information and data about the microsystem and use that material to inform their selection of improvement themes and aims. The assessment of your clinical microsystem is the beginning of that system's improvement journey. Identify strengths and opportunities for improvement based on the 5 P's assessment. Review, analyze, and draw conclusions about the relationships among the 5 P's. Engage all members of your clinical microsystem in the process of assessment and awareness building. Identify key tools and methods for gaining deeper knowledge. Describe your deeper knowledge of your microsystem's purpose, patients, professionals, processes, and patterns.Organize your microsystem assessment so it is systematic.At the completion of this unit, you will be able to To do an assessment of your clinical microsystem using the 5 P's framework, a tested analytical method that focuses on purpose, patients, professionals, processes, and patterns.