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Microsystems in health care: Part 3. Planning patient-centered services.
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2003 (English)In: Joint Commission journal on quality and safety, ISSN 1549-3741, Vol. 29, no 4, p. 159-170Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Strategic focus on the clinical microsystems--the small, functional, frontline units that provide most health care to most people--is essential to designing the most efficient, population-based services. The starting place for designing or redesigning of clinical microsystems is to evaluate the four P's: the patient subpopulations that are served by the microsystem, the people who work together in the microsystem, the processes the microsystem uses to provide services, and the patterns that characterize the microsystem's functioning.

GETTING STARTED: DIAGNOSING AND TREATING A CLINICAL MICROSYSTEM: Methods and tools have been developed for microsystem leaders and staff to use to evaluate the four P's--to assess their microsystem and design tests of change for improvement and innovation.

PUTTING IT ALL TOGETHER: Based on its assessment--or diagnosis--a microsystem can help itself improve the things that need to be done better. Planning services is designed to decrease unnecessary variation, facilitate informed decision making, promote efficiency by continuously removing waste and rework, create processes and systems that support staff, and design smooth, effective, and safe patient care services that lead to measurably improved patient outcomes.

CONCLUSION: The design of services leads to critical analysis of the resources needed for the right person to deliver the right care, in the right way, at the right time.

Place, publisher, year, edition, pages
2003. Vol. 29, no 4, p. 159-170
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hj:diva-21746PubMedID: 12698806OAI: oai:DiVA.org:hj-21746DiVA, id: diva2:640630
Available from: 2013-08-14 Created: 2013-08-14 Last updated: 2017-01-16Bibliographically approved
In thesis
1. Improvement Capability at the Front Lines of Healthcare: Helping through Leading and Coaching
Open this publication in new window or tab >>Improvement Capability at the Front Lines of Healthcare: Helping through Leading and Coaching
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

SUMMARY

This thesis addresses improvement capability at the front lines of healthcare with a focus on interprofessional health care improvement teams who provide care and improve care. The overall aim is to explore high performing clinical microsystems and evaluate interventions to cultivate health care improvement capabilities of frontline interprofessional teams.

Methods

Descriptive and evaluative study designs were employed in the five studies which comprise this thesis. A total of 495 interprofessional health care providers from a variety of health care contexts in the United States (Study I, II, III & IV) and Sweden (Study V) participated in the studies. The mixed methods research included qualitative observation, interviews, focus groups and surveys analyzed with qualitative manifest content analysis. The quantitative data were analyzed with statistics appropriate for non-parametric data.

Findings

Study I and II describe how leaders who understand health care improvement can create conditions for interprofessional teams to provide care and simultaneously improve care. Study III evaluates adapted clinical microsystem processes and tools successfully adapted in two different hospitals. Frontline staff reported that they needed help to balance providing care and improving care. Study IV and V explored and tested team coaching to help interprofessional teams to increase their improvement capabilities within improvement collaboratives. The participants perceived team coaching mostly positively and identified supportive coaching actions. In Study V an intervention with “The Team Coaching Model” was tested in Sweden and showed increased acquisition of improvement knowledge in the intervention teams compared to teams who did not receive the coaching model.

Conclusions

The thesis findings show leaders can help cultivate health care improvement capability by designing structures, processes and outcomes of their organizational systems to support health care improvement activities, setting clear improvement expectations of all staff, developing the knowledge of every staff member in the microsystem to know their operational processes and systems to promote action learning in their daily work, and providing help with team coaching using a Team Coaching Model.

Place, publisher, year, edition, pages
Jönköping: School of Health Sciences, 2013. p. 165
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 46
Keywords
Health care improvement, interprofessional teams, leadership of improvement, team coaching, clinical microsystem
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-21751 (URN)978-91-85835-45-4 (ISBN)
Public defence
2013-09-05, Originalet, Qulturum, Hus B4, Ryhov County Hospital, Jönköping, 10:00 (English)
Opponent
Available from: 2013-08-14 Created: 2013-08-14 Last updated: 2013-08-14Bibliographically approved

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Godfrey, Marjorie M.Batalden, Paul B.

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