SlideShare una empresa de Scribd logo
1 de 23
Know your Clinical Setting:
             Microsystem Analysis



Carol Callaway-Lane, DNP, ANCP-BC
   Define a clinical microsystem

   Identify the role of a clinical microsystem within
    the context of a larger healthcare macrosystem

   Distinguish methods of evaluating a clinical
    microsystem using the 5 P‟s; and

   State the importance of evaluating the clinical
    setting before proceeding with quality
    improvement changes.
 UnderstandProcesses and
Organizations of Patient Care
to Improve Patient Care
Outcomes
   Providers need to be able to:
    ◦ Assess the needs of a population of
      patients

    ◦ Give the right care to the right patients at
      the right time for the right cost.

    ◦ Understand the health care system

    ◦ Improve the health of a population
Simple
  Model of Improvement                              model for
                 Aims                               complex
   What are we trying to accomplish?
                                                    issues….
               Measures
   How will we know if a change is an               But what
             improvement?                           happens
           Process Analysis                         before you
What changes can we make that will result           define your
           in improvement?
                                                    specific
                Act             Plan
                                                    aim??
           (Stop or Spread)   Improvement

                                            PDSA
                                            Cycle
                                                    You must
              Study              Do                 evaluate
               Results        Improvement
                                                    your clinical
                                                    setting.
Improvement Idea



       Assembly a Team



  Evaluate the Clinical Setting


      Determine Baseline
        Measurement




Model for Improvement
   Micro-systems are
    the building blocks
    that come together to form the
    macro-organization or the macrosystem




                                            7
Market /
              Geopolitical
Veteran
              system (Fed
Self-care
                 Govt)
 system


                     VA
                Macrosystem
               (Facility/VISN)

Individual
care-giver
& Veteran
  system




                  VA
     VA       Mesosystem
Microsystem
   The combination of a small team of people
    who work together on a regular basis—or as
    needed—to provide care and the individuals
    who receive that care (who can also be
    recognized as members of a discrete
    subpopulation of patients.)




                       Dartmouth Clinical Microsystem
   A clinical microsystem has clinical and
    business aims, linked processes, a shared
    information environment and produces
    services

   Care which can be measured as
    performance outcomes. These systems
    evolve over time and are (often) embedded
    in larger systems organizations.



                     Dartmouth Clinical Microsystem
   Core team of health professionals

   Defined population of people they care for

   Information & information technology

   Support staff, equipment, environment

   Processes, activities specific to accomplishing
    the aim
g new options for future improvements.
   Purpose: What you do

   Patients: Who you care for

   Personnel: who provides the care

   Processes: SOP‟s

   Patterns: safety, functional status,
   What is the primary goal of your clinical area
    or „microsystem‟

   Mission statement or definition of the area

   What is the unique contribution that it makes
    within the overall macrosystem?
   Who is receiving the care?

   What are the characteristics of the
    patients when they enter your
    microsystem?
    ◦ Who are they?
    ◦ How old are they?
    ◦ What are the top diagnoses?
    ◦ What is their state of health?
    ◦ How did they enter your microsystem?
    ◦ What are their “health care needs”
   Who are the people who are a part of your
    microsystem?

   What is their skill level?

   What do they think about their work?

   What are the characteristics of their work time?
   What types of processes does the
    environment do?



   Think of routines or standard operating
    procedures they you do.
Care Delivery Process: Microsystem




                       © Center for the Evaluative Clinical Sciences, Trustees of
                       Dartmouth College
Functional Health
                Status




Clinical
                               Satisfaction
Outcome




                Costs
   Patterns measure the performance of the
    microsystem. Patterns of:
    ◦ leadership, cultural, traditional workflow

   They gauge the value of care.
    ◦ What types of safety mechanisms are in place

    ◦ Are there meetings to discuss outcomes of care on
      a regular basis?


    ◦ Are there faculty/staff meetings to discuss the
      successes/struggles of the environment?
1.   Providers + beneficiaries

2.   People + Information Technology

3.   People, Work in a setting

4.   Purpose
   You cannot effectively change a system that
    you do not fully understand

   Avoid unintended consequences

   Engagement of members of the microsystem
    or environment

   Evaluating your microsystem is the first step
    to quality improvement
Microsystem analysis webinar_feb_21_2013[1]

Más contenido relacionado

La actualidad más candente

Rules for Healthcare Transformation Frameworks and Tools v1
Rules for Healthcare Transformation Frameworks and Tools v1Rules for Healthcare Transformation Frameworks and Tools v1
Rules for Healthcare Transformation Frameworks and Tools v1Imad Hassan
 
Jeff Alexander Regenstrief Conference Slides
Jeff Alexander Regenstrief Conference SlidesJeff Alexander Regenstrief Conference Slides
Jeff Alexander Regenstrief Conference SlidesShawnHoke
 
Health Care Unbound- july 2010 - San Diego
Health Care Unbound- july 2010 - San DiegoHealth Care Unbound- july 2010 - San Diego
Health Care Unbound- july 2010 - San DiegoHAPPYneuron, Inc.
 
What is Normalisation Process Theory?
What is Normalisation Process Theory?What is Normalisation Process Theory?
What is Normalisation Process Theory?NEQOS
 
The Impact of Online Resilience Training for Sales Managers on Wellbeing and...
The Impact of Online Resilience Training for Sales Managers on Wellbeing  and...The Impact of Online Resilience Training for Sales Managers on Wellbeing  and...
The Impact of Online Resilience Training for Sales Managers on Wellbeing and...happier.com
 
Knowledge to Action Cycle: summary handout
Knowledge to Action Cycle: summary handoutKnowledge to Action Cycle: summary handout
Knowledge to Action Cycle: summary handoutNEQOS
 
Doulas to fill the gap: a proposed model of doula delivery of cognitive-behav...
Doulas to fill the gap: a proposed model of doula delivery of cognitive-behav...Doulas to fill the gap: a proposed model of doula delivery of cognitive-behav...
Doulas to fill the gap: a proposed model of doula delivery of cognitive-behav...Leonard Davis Institute of Health Economics
 
Patient's Report Timeliness; Nursing Leadership
Patient's Report Timeliness; Nursing LeadershipPatient's Report Timeliness; Nursing Leadership
Patient's Report Timeliness; Nursing LeadershipPeachy Essay
 
Theory and Measures for Advancing Nursing Shared Governance
Theory and Measures for Advancing Nursing Shared GovernanceTheory and Measures for Advancing Nursing Shared Governance
Theory and Measures for Advancing Nursing Shared GovernanceRichard Bogue
 
A toolkit for complex interventions and health technologies using normalizati...
A toolkit for complex interventions and health technologies using normalizati...A toolkit for complex interventions and health technologies using normalizati...
A toolkit for complex interventions and health technologies using normalizati...Normalizationprocess
 
Ranga Ramanujam Performance Measurement Slides
Ranga Ramanujam Performance Measurement SlidesRanga Ramanujam Performance Measurement Slides
Ranga Ramanujam Performance Measurement SlidesShawnHoke
 
CIS Innovations in Healthcare
CIS Innovations in HealthcareCIS Innovations in Healthcare
CIS Innovations in HealthcareSBUgroup5
 
Complex Adaptive Systems as a Model for Evaluating Organisational Change Caus...
Complex Adaptive Systems as a Model for Evaluating Organisational Change Caus...Complex Adaptive Systems as a Model for Evaluating Organisational Change Caus...
Complex Adaptive Systems as a Model for Evaluating Organisational Change Caus...singingfish
 
Risk based approcah
Risk based approcahRisk based approcah
Risk based approcahPradeepta S
 
Goodwin, Nick - From lean thinking to complex adaptative system
Goodwin, Nick - From lean thinking to complex adaptative systemGoodwin, Nick - From lean thinking to complex adaptative system
Goodwin, Nick - From lean thinking to complex adaptative systemponencias_mihealth2012
 
Osteoporosis guideline
Osteoporosis guidelineOsteoporosis guideline
Osteoporosis guidelineStingray67
 
Supporting therapists to integrate virtual reality systems within clinical pr...
Supporting therapists to integrate virtual reality systems within clinical pr...Supporting therapists to integrate virtual reality systems within clinical pr...
Supporting therapists to integrate virtual reality systems within clinical pr...Stephanie Glegg
 
NPT visual summary
NPT visual summaryNPT visual summary
NPT visual summaryNEQOS
 
Brad Doebbeling Slides for AHRQ Kick-Off Event
Brad Doebbeling Slides for AHRQ Kick-Off EventBrad Doebbeling Slides for AHRQ Kick-Off Event
Brad Doebbeling Slides for AHRQ Kick-Off EventShawnHoke
 

La actualidad más candente (20)

Rules for Healthcare Transformation Frameworks and Tools v1
Rules for Healthcare Transformation Frameworks and Tools v1Rules for Healthcare Transformation Frameworks and Tools v1
Rules for Healthcare Transformation Frameworks and Tools v1
 
Jeff Alexander Regenstrief Conference Slides
Jeff Alexander Regenstrief Conference SlidesJeff Alexander Regenstrief Conference Slides
Jeff Alexander Regenstrief Conference Slides
 
Health Care Unbound- july 2010 - San Diego
Health Care Unbound- july 2010 - San DiegoHealth Care Unbound- july 2010 - San Diego
Health Care Unbound- july 2010 - San Diego
 
What is Normalisation Process Theory?
What is Normalisation Process Theory?What is Normalisation Process Theory?
What is Normalisation Process Theory?
 
The Impact of Online Resilience Training for Sales Managers on Wellbeing and...
The Impact of Online Resilience Training for Sales Managers on Wellbeing  and...The Impact of Online Resilience Training for Sales Managers on Wellbeing  and...
The Impact of Online Resilience Training for Sales Managers on Wellbeing and...
 
Knowledge to Action Cycle: summary handout
Knowledge to Action Cycle: summary handoutKnowledge to Action Cycle: summary handout
Knowledge to Action Cycle: summary handout
 
Doulas to fill the gap: a proposed model of doula delivery of cognitive-behav...
Doulas to fill the gap: a proposed model of doula delivery of cognitive-behav...Doulas to fill the gap: a proposed model of doula delivery of cognitive-behav...
Doulas to fill the gap: a proposed model of doula delivery of cognitive-behav...
 
Patient's Report Timeliness; Nursing Leadership
Patient's Report Timeliness; Nursing LeadershipPatient's Report Timeliness; Nursing Leadership
Patient's Report Timeliness; Nursing Leadership
 
Theory and Measures for Advancing Nursing Shared Governance
Theory and Measures for Advancing Nursing Shared GovernanceTheory and Measures for Advancing Nursing Shared Governance
Theory and Measures for Advancing Nursing Shared Governance
 
A toolkit for complex interventions and health technologies using normalizati...
A toolkit for complex interventions and health technologies using normalizati...A toolkit for complex interventions and health technologies using normalizati...
A toolkit for complex interventions and health technologies using normalizati...
 
Ranga Ramanujam Performance Measurement Slides
Ranga Ramanujam Performance Measurement SlidesRanga Ramanujam Performance Measurement Slides
Ranga Ramanujam Performance Measurement Slides
 
CIS Innovations in Healthcare
CIS Innovations in HealthcareCIS Innovations in Healthcare
CIS Innovations in Healthcare
 
Complex Adaptive Systems as a Model for Evaluating Organisational Change Caus...
Complex Adaptive Systems as a Model for Evaluating Organisational Change Caus...Complex Adaptive Systems as a Model for Evaluating Organisational Change Caus...
Complex Adaptive Systems as a Model for Evaluating Organisational Change Caus...
 
Risk based approcah
Risk based approcahRisk based approcah
Risk based approcah
 
Goodwin, Nick - From lean thinking to complex adaptative system
Goodwin, Nick - From lean thinking to complex adaptative systemGoodwin, Nick - From lean thinking to complex adaptative system
Goodwin, Nick - From lean thinking to complex adaptative system
 
Osteoporosis guideline
Osteoporosis guidelineOsteoporosis guideline
Osteoporosis guideline
 
Supporting therapists to integrate virtual reality systems within clinical pr...
Supporting therapists to integrate virtual reality systems within clinical pr...Supporting therapists to integrate virtual reality systems within clinical pr...
Supporting therapists to integrate virtual reality systems within clinical pr...
 
NPT visual summary
NPT visual summaryNPT visual summary
NPT visual summary
 
Brad Doebbeling Slides for AHRQ Kick-Off Event
Brad Doebbeling Slides for AHRQ Kick-Off EventBrad Doebbeling Slides for AHRQ Kick-Off Event
Brad Doebbeling Slides for AHRQ Kick-Off Event
 
RN Training: Procedural Sedation
RN Training: Procedural SedationRN Training: Procedural Sedation
RN Training: Procedural Sedation
 

Similar a Microsystem analysis webinar_feb_21_2013[1]

Quality improvement healthcare final
Quality improvement healthcare finalQuality improvement healthcare final
Quality improvement healthcare finalEvanvs
 
Quality Improvement Models: PDSA
Quality Improvement Models: PDSAQuality Improvement Models: PDSA
Quality Improvement Models: PDSAljmcneill33
 
Improving Your Practice1
Improving Your Practice1Improving Your Practice1
Improving Your Practice1primary
 
Diagnosing Healthcare
Diagnosing HealthcareDiagnosing Healthcare
Diagnosing HealthcareMartin Hedley
 
Quality improvement and patient safety in anesthesia
Quality improvement and patient safety in anesthesiaQuality improvement and patient safety in anesthesia
Quality improvement and patient safety in anesthesiaDr. Ravikiran H M Gowda
 
Measure the Improvement
Measure the  ImprovementMeasure the  Improvement
Measure the ImprovementMusa Abu Sbeih
 
Measure For Improvement
Measure For ImprovementMeasure For Improvement
Measure For ImprovementMusa Abu Sbeih
 
Organizational performance
Organizational performanceOrganizational performance
Organizational performanceMahmoud Shaqria
 
Maintenance of Certification, Quality Improvement and Your EMR
Maintenance of Certification, Quality Improvement and Your EMRMaintenance of Certification, Quality Improvement and Your EMR
Maintenance of Certification, Quality Improvement and Your EMRdsandro1
 
Improving clinical care_through_quality_improvement_april_23_2012_final
Improving clinical care_through_quality_improvement_april_23_2012_finalImproving clinical care_through_quality_improvement_april_23_2012_final
Improving clinical care_through_quality_improvement_april_23_2012_finalCarol Callaway-Lane
 
Dr Ayman Ewies - Clinical audit made easy
Dr Ayman Ewies - Clinical audit made easyDr Ayman Ewies - Clinical audit made easy
Dr Ayman Ewies - Clinical audit made easyAymanEwies
 
Biopsychosocial Concepts for Advanced Nursing Practice Essay Assignment Paper...
Biopsychosocial Concepts for Advanced Nursing Practice Essay Assignment Paper...Biopsychosocial Concepts for Advanced Nursing Practice Essay Assignment Paper...
Biopsychosocial Concepts for Advanced Nursing Practice Essay Assignment Paper...write31
 
Improving clinical services: no magic bullet... some things work better than ...
Improving clinical services: no magic bullet... some things work better than ...Improving clinical services: no magic bullet... some things work better than ...
Improving clinical services: no magic bullet... some things work better than ...NIHR CLAHRC West Midlands
 
7 s4 i model for improvement final
7 s4 i model for improvement final7 s4 i model for improvement final
7 s4 i model for improvement finalABCiABUHB
 
Criteria for Performance Excellence to Improve Pharmacy Services
Criteria for Performance Excellence to Improve Pharmacy ServicesCriteria for Performance Excellence to Improve Pharmacy Services
Criteria for Performance Excellence to Improve Pharmacy ServicesCompleteRx
 
ACO = HIE + Analytics: Enabling Population Health Management
ACO = HIE + Analytics: Enabling Population Health ManagementACO = HIE + Analytics: Enabling Population Health Management
ACO = HIE + Analytics: Enabling Population Health ManagementPerficient, Inc.
 

Similar a Microsystem analysis webinar_feb_21_2013[1] (20)

Quality improvement healthcare final
Quality improvement healthcare finalQuality improvement healthcare final
Quality improvement healthcare final
 
Quality Improvement Models: PDSA
Quality Improvement Models: PDSAQuality Improvement Models: PDSA
Quality Improvement Models: PDSA
 
Improving Your Practice1
Improving Your Practice1Improving Your Practice1
Improving Your Practice1
 
1 the science of patient safety
1 the science of patient safety1 the science of patient safety
1 the science of patient safety
 
Diagnosing Healthcare
Diagnosing HealthcareDiagnosing Healthcare
Diagnosing Healthcare
 
Microsystem3
Microsystem3Microsystem3
Microsystem3
 
Quality improvement and patient safety in anesthesia
Quality improvement and patient safety in anesthesiaQuality improvement and patient safety in anesthesia
Quality improvement and patient safety in anesthesia
 
Measure the Improvement
Measure the  ImprovementMeasure the  Improvement
Measure the Improvement
 
Measure For Improvement
Measure For ImprovementMeasure For Improvement
Measure For Improvement
 
Organizational performance
Organizational performanceOrganizational performance
Organizational performance
 
Maintenance of Certification, Quality Improvement and Your EMR
Maintenance of Certification, Quality Improvement and Your EMRMaintenance of Certification, Quality Improvement and Your EMR
Maintenance of Certification, Quality Improvement and Your EMR
 
Improving clinical care_through_quality_improvement_april_23_2012_final
Improving clinical care_through_quality_improvement_april_23_2012_finalImproving clinical care_through_quality_improvement_april_23_2012_final
Improving clinical care_through_quality_improvement_april_23_2012_final
 
Dr Ayman Ewies - Clinical audit made easy
Dr Ayman Ewies - Clinical audit made easyDr Ayman Ewies - Clinical audit made easy
Dr Ayman Ewies - Clinical audit made easy
 
Strategic management
Strategic managementStrategic management
Strategic management
 
Biopsychosocial Concepts for Advanced Nursing Practice Essay Assignment Paper...
Biopsychosocial Concepts for Advanced Nursing Practice Essay Assignment Paper...Biopsychosocial Concepts for Advanced Nursing Practice Essay Assignment Paper...
Biopsychosocial Concepts for Advanced Nursing Practice Essay Assignment Paper...
 
Improving clinical services: no magic bullet... some things work better than ...
Improving clinical services: no magic bullet... some things work better than ...Improving clinical services: no magic bullet... some things work better than ...
Improving clinical services: no magic bullet... some things work better than ...
 
7 s4 i model for improvement final
7 s4 i model for improvement final7 s4 i model for improvement final
7 s4 i model for improvement final
 
Criteria for Performance Excellence to Improve Pharmacy Services
Criteria for Performance Excellence to Improve Pharmacy ServicesCriteria for Performance Excellence to Improve Pharmacy Services
Criteria for Performance Excellence to Improve Pharmacy Services
 
ACO = HIE + Analytics: Enabling Population Health Management
ACO = HIE + Analytics: Enabling Population Health ManagementACO = HIE + Analytics: Enabling Population Health Management
ACO = HIE + Analytics: Enabling Population Health Management
 
Health manag lecture
Health manag lectureHealth manag lecture
Health manag lecture
 

Último

pA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologypA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologyDeepakDaniel9
 
AORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectionAORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectiondrhanifmohdali
 
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptxANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptxWINCY THIRUMURUGAN
 
Male Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondMale Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondSujoy Dasgupta
 
Adenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisAdenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisSujoy Dasgupta
 
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...Shubhanshu Gaurav
 
BENIGN BREAST DISEASE
BENIGN BREAST DISEASE BENIGN BREAST DISEASE
BENIGN BREAST DISEASE Mamatha Lakka
 
Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024EwoutSteyerberg1
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.pptRamDBawankar1
 
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdfSGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdfHongBiThi1
 
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio..."Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio...Sujoy Dasgupta
 
Physiology of Smooth Muscles -Mechanics of contraction and relaxation
Physiology of Smooth Muscles -Mechanics of contraction and relaxationPhysiology of Smooth Muscles -Mechanics of contraction and relaxation
Physiology of Smooth Muscles -Mechanics of contraction and relaxationMedicoseAcademics
 
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdfSGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdfHongBiThi1
 
Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Peter Embi
 
Basic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptxBasic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptxkomalt2001
 
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfCONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfDolisha Warbi
 
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdfSGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdfHongBiThi1
 

Último (20)

pA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologypA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacology
 
AORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectionAORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissection
 
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptxANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
 
Male Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondMale Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and Beyond
 
Adenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisAdenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosis
 
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
 
American College of physicians ACP high value care recommendations in rheumat...
American College of physicians ACP high value care recommendations in rheumat...American College of physicians ACP high value care recommendations in rheumat...
American College of physicians ACP high value care recommendations in rheumat...
 
BENIGN BREAST DISEASE
BENIGN BREAST DISEASE BENIGN BREAST DISEASE
BENIGN BREAST DISEASE
 
Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
 
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdfSGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
 
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio..."Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
 
Physiology of Smooth Muscles -Mechanics of contraction and relaxation
Physiology of Smooth Muscles -Mechanics of contraction and relaxationPhysiology of Smooth Muscles -Mechanics of contraction and relaxation
Physiology of Smooth Muscles -Mechanics of contraction and relaxation
 
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdfSGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
 
GOUT UPDATE AHMED YEHIA 2024, case based approach with application of the lat...
GOUT UPDATE AHMED YEHIA 2024, case based approach with application of the lat...GOUT UPDATE AHMED YEHIA 2024, case based approach with application of the lat...
GOUT UPDATE AHMED YEHIA 2024, case based approach with application of the lat...
 
Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024
 
Basic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptxBasic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptx
 
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
 
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfCONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
 
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdfSGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
 

Microsystem analysis webinar_feb_21_2013[1]

  • 1. Know your Clinical Setting: Microsystem Analysis Carol Callaway-Lane, DNP, ANCP-BC
  • 2. Define a clinical microsystem  Identify the role of a clinical microsystem within the context of a larger healthcare macrosystem  Distinguish methods of evaluating a clinical microsystem using the 5 P‟s; and  State the importance of evaluating the clinical setting before proceeding with quality improvement changes.
  • 3.  UnderstandProcesses and Organizations of Patient Care to Improve Patient Care Outcomes
  • 4. Providers need to be able to: ◦ Assess the needs of a population of patients ◦ Give the right care to the right patients at the right time for the right cost. ◦ Understand the health care system ◦ Improve the health of a population
  • 5. Simple Model of Improvement model for Aims complex What are we trying to accomplish? issues…. Measures How will we know if a change is an But what improvement? happens Process Analysis before you What changes can we make that will result define your in improvement? specific Act Plan aim?? (Stop or Spread) Improvement PDSA Cycle You must Study Do evaluate Results Improvement your clinical setting.
  • 6. Improvement Idea Assembly a Team Evaluate the Clinical Setting Determine Baseline Measurement Model for Improvement
  • 7. Micro-systems are the building blocks that come together to form the macro-organization or the macrosystem 7
  • 8. Market / Geopolitical Veteran system (Fed Self-care Govt) system VA Macrosystem (Facility/VISN) Individual care-giver & Veteran system VA VA Mesosystem Microsystem
  • 9. The combination of a small team of people who work together on a regular basis—or as needed—to provide care and the individuals who receive that care (who can also be recognized as members of a discrete subpopulation of patients.)  Dartmouth Clinical Microsystem
  • 10. A clinical microsystem has clinical and business aims, linked processes, a shared information environment and produces services  Care which can be measured as performance outcomes. These systems evolve over time and are (often) embedded in larger systems organizations.  Dartmouth Clinical Microsystem
  • 11. Core team of health professionals  Defined population of people they care for  Information & information technology  Support staff, equipment, environment  Processes, activities specific to accomplishing the aim
  • 12. g new options for future improvements.
  • 13. Purpose: What you do  Patients: Who you care for  Personnel: who provides the care  Processes: SOP‟s  Patterns: safety, functional status,
  • 14. What is the primary goal of your clinical area or „microsystem‟  Mission statement or definition of the area  What is the unique contribution that it makes within the overall macrosystem?
  • 15. Who is receiving the care?  What are the characteristics of the patients when they enter your microsystem? ◦ Who are they? ◦ How old are they? ◦ What are the top diagnoses? ◦ What is their state of health? ◦ How did they enter your microsystem? ◦ What are their “health care needs”
  • 16. Who are the people who are a part of your microsystem?  What is their skill level?  What do they think about their work?  What are the characteristics of their work time?
  • 17. What types of processes does the environment do?  Think of routines or standard operating procedures they you do.
  • 18. Care Delivery Process: Microsystem © Center for the Evaluative Clinical Sciences, Trustees of Dartmouth College
  • 19. Functional Health Status Clinical Satisfaction Outcome Costs
  • 20. Patterns measure the performance of the microsystem. Patterns of: ◦ leadership, cultural, traditional workflow  They gauge the value of care. ◦ What types of safety mechanisms are in place ◦ Are there meetings to discuss outcomes of care on a regular basis? ◦ Are there faculty/staff meetings to discuss the successes/struggles of the environment?
  • 21. 1. Providers + beneficiaries 2. People + Information Technology 3. People, Work in a setting 4. Purpose
  • 22. You cannot effectively change a system that you do not fully understand  Avoid unintended consequences  Engagement of members of the microsystem or environment  Evaluating your microsystem is the first step to quality improvement

Notas del editor

  1. At the end of this webinar, each participant will be able to: