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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.
Document Type: Research Article
Publication date: April 1, 2003
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Published monthly, The Joint Commission Journal on Quality and Patient Safety is a peer-reviewed publication dedicated to providing health professionals with the information they need to promote the quality and safety of health care. The Joint Commission Journal on Quality and Patient Safety invites original manuscripts on the development, adaptation, and/or implementation of innovative thinking, strategies, and practices in improving quality and safety in health care. Case studies, program or project reports, reports of new methodologies or new applications of methodologies, research studies on the effectiveness of improvement interventions, and commentaries on issues and practices are all considered.
Also known as Joint Commission Journal on Quality Improvement and Joint Commission Journal on Quality and Safety