Background

A microsystem in health care delivery can be defined as a small group of people who work together on a regular basis to provide care to discrete subpopulations including the patients. It has clinical and business aims, linked processes, shared information environment and produces performance outcomes. They evolve over time and are (often) embedded in larger organizations. As a type of complex adaptive system, they must: (1) do the work, (2) meet staff needs, (3) maintain themselves as a clinical unit.

Clinical microsystems are the front-line units that provide most health care to most people. They are the places where patients, families and care teams meet. Microsystems also include support staff, processes, technology and recurring patterns of information, behavior and results. Central to every clinical microsystem is the patient.

The microsystem is the place where:

Microsystems are the building blocks that form hospitals. The quality of hospital care can be no better than the quality produced by the small systems that come together to provide care. Here is the hospital quality equation:

Hospital Quality = Quality of Microsystem 1 + Quality of Microsystem 2 + Quality of Microsystem 3 - n

All health care professionals—and we believe all front line clinical and support staff are professionals—have 2 jobs.

Job 1 is to provide care. Job 2 is to improve care.

Finding time to improve care can be difficult, but the only way to improve and maintain quality, safety, efficiency and flexibility is by blending analysis, change, measuring and redesigning into the regular patterns and the daily habits of front-line clinicians and staff. Absent the intelligent and dedicated improvement work by all staff in all units, the quality, efficiency and pride in work will not be made nor sustained.

We are eager to share our current knowledge of Clinical Microsystems and methodology to help you improve your practice care and outcomes.