Staff who work together on a regular basis to provide care to discrete subpopulations of patients.1 In the context of health care, a microsystem could be: 2 The concept of microsystems in health care organizations stems from research findings indicating that the most successful of the large service corporations maintain a strong focus on the small, functional units who carry out the core activities that involve interaction with customers. One useful way for health plans and medical groups to approach the process of improvement is to think of the organization as a system, or more specifically, as a collection of interrelated "microsystems." The term "microsystems" refers to the multiple small units of caregivers, administrators, and other staff who produce the "products" of health care-i.e., who deliver care and services on a daily basis. You will be making frequent corrections along the way as you learn from experience with each step and identify other actions to add to your strategy. Keep in mind and remind others that QI is an iterative process. Small-scale demonstrations or small tests of change also allow you to refine the new processes, demonstrate their impact on practices and outcomes, and build increased support by stakeholders. Start your implementation of improvements with small-scale demonstrations, which are easier to manage than large-scale changes. Learn what is most important to the people who make up the microsystem and look for ways to help them embrace the changes and begin to take ownership of them. Place a priority on encouraging communication, engagement, and participation for all of the stakeholders affected by the QI process. Three Tips for Facilitating the Quality Improvement Process This section of the Guide suggests a way to use the concept of microsystems to focus the QI process on the locus of responsibility for patient experience, provides an overview of the process of quality improvement, discusses a few well-known models of quality improvement, and presents a few tools and techniques that organizations can use to address various aspects of patient experience. Health care organizations can take advantage of established principles and approaches to quality improvement, which are already familiar to the many providers involved in clinical quality improvement (QI).
But the process of planning, testing, and eventually spreading those changes does not have to be overwhelming. Health care delivery systems that are working to improve patient experience can face daunting challenges, reflecting the need to align changes in behavior and practices across multiple levels and areas of the organization.
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Download Section 4: Ways To Approach the Quality Improvement Process (PDF, 457 KB)