This document discusses systems and microsystems in healthcare. It defines a microsystem as a small group that provides care to a specific patient population. Microsystems aim to provide care, meet patient needs, and maintain operations. The quality of macro health systems depends on the quality of its microsystems. Microsystems can vary in how clinical staff work together, how information flows, and the quality of care provided. When microsystems function well, patients experience high-quality, efficient care.

1. SYSTEMS AND
MICROSYSTEMS
Astrid Grgurich & Jess Morritt

2. Systems and Microsystems
 1. Systems and microsystems: what are they
and the theories behind them
 2. Microsystems in context of tool application
 3. Outcomes and quality care, including a case
study

3. Systems Theory

4. What is a Microsystem
 A small group of people who work together on
a regular basis to provide services to
individuals within a discrete subpopulations.
 Aims, processes, information and technology
and outcomes.
1. Do the work.
2. Meet member needs.
3. Maintain itself as a functioning unit.
(Foster, Johnson, Nelson &
Batalden,2007)

5. Characteristics of Clinical
Microsystems
(Foster, Johnson,
Nelson & Batalden,
2007)

6. Chain of Effect in Improving Health
Care Quality
(Nelson, et al., 2007).

7. Structure of the Health System
 1. Bigger systems (macrosystems) are made
of smaller systems
 2. These smaller systems (microsystems)
produce quality, safety, and cost outcomes at
the from line of care
 3. Ultimately the outcomes of the
macrosystems can be no better than the
microsystems of which it is composed
(Nelson, et al., 2007).

8. Clinical Microsystem
(Microsystem
Academy, 2011).

9. Patient Experience of the
Microsystem
 Patients in need of care may find:
 Clinical staff working together (or against one another)
 Smooth-running front-line health care units (or units in
tangles)
 Information readily available, flowing easily, and in a
timely fashion (or not)
 Health care units that are often embedded in helpful
larger organisations (or cruel bureaucracies)
 Health care units that are seamlessly linked together
(or totally disjointed)
 High-quality, sensitive, efficient care (or care that is
harmful or even lethal, wasteful, and expensive)
(Nelson, et al., 2007).

10. References
 Cherry, B., & Jacob, S. (2011). Contemporary nursing: Issues,
trends and management (5th ed.). St. Louis, MI: Elsevier Mosby.
 Foster, T., Johnson, J., Nelson, E., & Batalden, P. (2007). Using a
Malcolm Baldrige framework to understand high performing clinical
microsystems. Quality Safety Health Care, 16, 334-341.
 Microsystem Academy. (2011). Clinical microsystems. Retrieved
from http://clinicalmicrosystem.org/
 Nelson, E., Batalden, P., & Godfrey, M. (Eds.). (2007). Quality by
design: A clinical systems approach. San Francisco, CA: Jossey-
Bass.
 Nelson, E., Batalden, P., Huber, T., Mohr, J., Godfrey, M., Headrick,
L., & Wasson, J. (2009). Microsystems in health care: Part 1.
Learning from high-performing front- line clinical units.Journal on
quality improvement, 28(9), 472-493.