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Clinical Microsystems, Part 2. Learning from Micro Practices About Providing Patients the Care They Want and Need

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Abstract:

Background: Usual medical care in the United States is frequently not a satisfying experience for either patients or primary care physicians. Whether primary care can be saved and its quality improved is a subject of national concern. An increasing number of physicians are using microsystem principles to radically redesign their practices. Small, independent practices—micro practices—are often able to incorporate into a few people the frontline attributes of successful microsystems such as clear leadership, patient focus, process improvement, performance patterns, and information technology.

Patient Focus, Process Improvement, and Performance Patterns: An exemplary microsystem will (1) have as its primary purpose a focus on the patient—a commitment to meet all patient needs; (2) make fundamental to its work the study, measurement, and improvement of care—a commitment to process improvement; and (3) routinely measure its patterns of performance, "feed back" the data, and make changes based on the data.

Lessons from Micro Practices: The literature and experience with micro practices suggest that they (1) constitute an important group in which to demonstrate the value of microsystem thinking; (2) can become very effective clinical microsystems; (3) can reduce their overhead costs to half that of larger freestanding practices, enabling them to spend more time working with their patients; (4) can develop new tools and approaches without going through layers of clearance; and (5) need not reinvent the wheel.

Conclusions: Patient-reported data demonstrate how micro practices are using patient focus, process improvement, performance patterns, and information technology to improve performance. Patients should be able to report that they receive "exactly the care they want and need exactly when and how they want and need it."

Document Type: Research Article

Publication date: 2008-08-01

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  • The Joint Commission Journal on Quality and Patient Safety will be published by Elsevier beginning in 2017! For readers who receive access to the journal through their institutions, the journal can now be found on ScienceDirect (http://www.sciencedirect.com/science/journal/15537250). For librarians looking to subscribe to the journal for their institutions please contact your Elsevier Account Manager or visit www.myelsevier.com for more information. All other readers, please visit http://www.jointcommissionjournal.com/ to subscribe to the journal or to claim your access for an existing subscription.
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