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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
Editor's Notes
- #3: At the end of this webinar, each participant will be able to: