Quality by Design

Quality by Design: A Clinical Microsystems Approach

“Quality by Design: A Clinical Microsystems Approach” offers a new and unique approach to an old problem: how to redesign health services processes to improve quality, add value, reduce variation, and improve morale, in such a way that frontline caregivers lead the process of change, rather than obey it. The book is a practical reflection of research and applied training conducted at Dartmouth Medical School under the leadership of Paul Batalden, Eugene Nelson, and Marjorie Godfrey.





Practice Based Learning and Improvement: A Clinical Improvement Action Guide. 2nd Edition

In microsystem thinking, the quality and value of care produced by a large health system can be no better than the services generated by the small systems of which it is composed. This new edition of a best-selling book explains how to integrate clinical microsystems and practice-based learning into your own organization.







From Front Office to Front Line: Essential Issues for Health Care Leaders, experts provide guidance on how to address today’s critical issues

From Front Office to Front Line: Essential Issues for Health Care Leaders released October, 2005 by the Joint Commission Resources features the chapter, Leading the Macrosystem and Mesosystem for Peak Microsystem Performance . This essential reading written by Paul Batalden, Eugene Nelson, Paul Gardent and Marjorie Godfrey discusses how health care leaders can achieve and sustain measurable quality and safety results at all levels of the organization. They present a useful summary of leadership frameworks and offer a practical outline of how to lead at the macrosystem level.

Friends Publications






Running Group Visits in Your Practice, Edward B. Noffsinger

Dr. Noffsinger is the foremost expert on and inventor of group visit models. This book/DVD package is the only comprehensive reference and implementation guide on the market with regard to group visit models. The group visit model is not only of interest to physicians: group vists may shape political and health care policy decisions in the near future.









Getting to Maybe
“A practical, inspirational, revolutionary guide to social innovation” from our friend and colleague, Brenda Zimmerman. Brenda continues to explore complexity science and expand our thinking and actions in complex systems.

The Best Practice





The Best Practice: How The New Quality Movement is Transforming Medicine, Charles Kenney
Americans have always thought their healthcare system was the best in the world. But starting in the late 1990s, shocking reports emerged that showed this was far from the truth. Treatment-related deaths or “complications” were found to be the fifth leading cause of death for Americans, and hundreds of thousands of patients were being harmed by botched medical procedures.

Spurred by the quality crisis, a group of visionary physicians led by Donald Berwick and Paul Batalden embarked on a study of industrial “quality improvement” techniques, daring to apply them to the practice of medicine despite resistance from the medical community. The Best Practice tells the story of this burgeoning movement, and of how the medical landscape is being radically transformed—for the better.







The Small Book About Large System Change
This book tells the story about the creating of large system change. The specific context and subject matter deals with primary heath care in England, but the principles of such change and the lessons and insights learnt are generic. They have relevance and offer great potential for other sectors and contexts.






Organizing For Quality
This challenging and highly practical book draws on the findings from an international study designed to help practitioners and researchers understand the factors and processes that enable healthcare organisations in the United States and Europe to achieve—and sustain—high quality services for their users.

The in-depth case-studies from seven leading hospitals give an international, evidence-based outlook that focuses on both the organisational and cultural processes of quality improvement.

Implication for research and practice are considered, and a checklist of possible challenges has been drawn up to help identify any ‘gaps’ in initiatives.

Healthcare policy makers and shapers including hospital chief executives and NHS directors will find this book enlightening, as will healthcare quality improvement and service development researchers and professionals. Clinicians with an interest in quality improvement will also find much of interest.


Improving Primary Care






Improving Primary Care: Strategies and Tools for a Better Practice
A friend of our clinical microsystem community, Tom Bodenheimer and his colleague Kevin Grumbach “offers frank appraisals and concrete recommendations for primary care practitioners on how to meet the huge, stress-inducing, challenges that they face on a daily basis. The authors offer innovative approaches and suggestions to dealing with primary care issues ranging from the latest electronic technologies to non-traditional options for the patient-physician encounter.”