ABSTRACT
This chapter illustrates an approach to improvement that recognizes the multitude of systems that are involved in the actual delivery of health care. Sustainable improvement in health care calls for a tripartite focus: better outcomes of care, better system performance, and better professional formation and development. The chapter deals with the small systems in which patients and providers meet: the clinical microsystem. It offers the microsystem framework as an approach to generating an understanding of system performance at multiple levels: micro-, meso-, and macrosystem. The chapter presents some case examples, by examining these case examples the readers can clearly see how the link between system performance and better patient outcomes can be leveraged by embedding measurement in efforts to improve care. Cooley Dickinson Hospital‘s investment in health professional development through educating managers and staff in the microsystems framework and training microsystems coaches dates to 2007.
