Microsystems in health care: Part 3. Planning patient-centered services.
BACKGROUND
Strategic focus on the clinical microsystems--the small, functional, frontline units that provide most health care to most people--is essential to designing the most efficient, population-based services. The starting place for designing or redesigning of clinical microsystems is to evaluate the four P's: the patient subpopulations that are served by the microsystem, the people who work together in the microsystem, the processes the microsystem uses to provide services, and the patterns that characterize the microsystem's functioning.
DIAGNOSING AND TREATING A CLINICAL MICROSYSTEM: Methods and tools have been developed for microsystem leaders and staff to use to evaluate the four P's--to assess their microsystem and design tests of change for improvement and innovation.
Based on its assessment--or diagnosis--a microsystem can help itself improve the things that need to be done better. Planning services is designed to decrease unnecessary variation, facilitate informed decision making, promote efficiency by continuously removing waste and rework, create processes and systems that support staff, and design smooth, effective, and safe patient care services that lead to measurably improved patient outcomes.


CONCLUSIONS
The design of services leads to critical analysis of the resources needed for the right person to deliver the right care, in the right way, at the right time.
Godfrey
Marjorie M
MM
Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
Nelson
Eugene C
EC
Wasson
John H
JH
Mohr
Julie J
JJ
Batalden
Paul B
PB
D017598:Efficiency, Organizational; D006301:Health Services Needs and Demand; D006801:Humans; D007857:Leadership; D008281:Maine; D017146:Models, Organizational; D009817:Office Management; D019982:Organizational Case Studies; D010347:Patient Care Planning / Q000458:organization & administration*; D018802:Patient-Centered Care / Q000458:organization & administration*; D010934:Planning Techniques; D011320:Primary Health Care / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D017064:Process Assessment, Health Care; D017749:Total Quality Management; D014600:Utilization Review