Microsystems in health care: Part 4. Planning patient-centered care.
BACKGROUND
Clinical microsystems are the essential building blocks of all health systems. At the heart of an effective microsystem is a productive interaction between an informed, activated patient and a prepared, proactive practice staff. Support, which increases the patient's ability for self-management, is an essential result of a productive interaction. This series on high-performing clinical microsystems is based on interviews and site visits to 20 clinical microsystems in the United States. This fourth article in the series describes how high-performing microsystems design and plan patient-centered care. PLANNING PATIENT-CENTERED CARE: Well-planned, patient-centered care results in improved practice efficiency and better patient outcomes. However, planning this care is not an easy task. Excellent planned care requires that the microsystem have services that match what really matters to a patient and family and protected time to reflect and plan. Patient self-management support, clinical decision support, delivery system design, and clinical information systems must be planned to be effective, timely, and efficient for each individual patient and for all patients.


CONCLUSIONS
Excellent planned services and planned care are attainable today in microsystems that understand what really matters to a patient and family and have the capacity to provide services to meet the patient's needs.
Dartmouth Medical School, Hanover, New Hampshire, USA.
John H
JH
Wasson
Marjorie M
MM
Godfrey
Eugene C
EC
Nelson
Julie J
JJ
Mohr
Paul B
PB
Batalden
D000555:Ambulatory Care Information Systems; D003661:Decision Support Techniques; D017598:Efficiency, Organizational; D019317:Evidence-Based Medicine; D006801:Humans; D007407:Interviews as Topic; D019982:Organizational Case Studies; D010348:Patient Care Team; D010353:Patient Education as Topic / Q000458:organization & administration; D010358:Patient Participation; D018802:Patient-Centered Care / Q000379:methods / Q000458:organization & administration* / Q000592:standards; D010934:Planning Techniques; D011216:Practice Management, Medical; D017064:Process Assessment, Health Care / Q000458:organization & administration*; D011369:Professional-Patient Relations; D012648:Self Care; D013597:Systems Analysis; D014481:United States