Getting Started with Microsystems

Getting Started with Microsystems

Aim: Provide helpful articles, tools, and process to get started with clinical microsystems.

Once you have decided to move forward with clinical microsystem thinking and tools, you may wish to review these articles. These articles will help build a vision in your mind and help other’s in your organization see the possibilities of Clinical Microsystem Improvement, where everyone “Takes provides exceptional care and services while continuously improving.”

The Toyota articles highlight the special aspects of Toyota to help us design the Toyota of health care.

The IHI Execution of Strategic Improvement provides guidance and structure to designing thoughtful strategic plans and infrastructure to your organization transformational journey. The Baldrige and Microsystem paper draws parallels between the two systems and highlights the complimentary aspects of each.

Buy-In Vs. Ownership (hyperlink)
No Satisfaction (hyperlink)
Learning To Lead At Toyota (hyperlink)
Execution of Strategic Improvement Initiatives  (hyperlink)
Decoding the DNA of the Toyota Production System (hyperlink)
Using a Malcolm Baldrige framework to understand high performing clinical microsystems (hyperlink)
How Toyota Can Save Your Life…at the hospital (hyperlink)
What is “quality improvement” and how can it transform healthcare? (Batalden/Davidoff) (hyperlink)

Microsystems At A Glance developed BY Microsystem Members FOR Microsystem Members

A primer for microsystems
The aim of “Microsystems At A Glance” is to introduce and attract new colleagues to the developmental journey of Microsystems toward transformation by providing an overview and quick introduction to the body of knowledge, various tools and processes. This makes it easier for you to join in how we are improving care and the workplace. The transformation will result in your being able to “provide exceptional care AND continuously improve your care delivery system.”

  • The PDF Version allows you to print a “booklet” version when you print the document front and back as designed, you can then assemble the pages, and fold in half.
  • The Word version allows you to print full pages.

Effective Meeting Skills (hyperlink to video)

Getting started with clinical microsystems includes convening an interdisciplinary lead improvement team to lead the transformation and improvement in the selected microsystem. The interdisciplinary team should represent all roles in the unit including housekeepers, unit secretaries, nurses, respiratory therapists, social workers, MDs, students, etc. If you review chapter 12 in “Quality By Design,” you will become familiar with the Effective Meeting Skills (page 243).

A helpful tool to assist you with practicing effective meeting skills is the Meeting Role and Process Cards. The cards follow this section and were first created and used by the Cystic Fibrosis Center at the Children’s Hospital of the King’s Daughter in Norfolk, Virginia.

The PDFs are the FRONT of the cards and the BACK of the cards. If you download the PDFs, you can have the cards printed front and back.

The meeting cards help to remind individuals of the roles they assume to ensure an effective meeting. The roles include: 
Time Keeper, and

Also, included are tips on the meeting processes of brainstorming and multi-voting.

Many lead improvement teams have discovered the cards are very helpful when trying out the meeting process and roles for the first few times. Some tips from them include:

  1. The leader of the meeting should be the leader for a month or a set period of time to ensure follow through and continuity on a phase of improvement. Remember, this does not mean the leader of the unit assumes this role.
  2. The recorder should use flipcharts to highlight decisions and next steps. The flipcharts can be displayed on the unit after the meeting.
  3. The recorder can type notes directly on a computer during the meeting to become more efficient to then distribute the notes. Ideally, the computer being connected to a LCD projector during the meeting ensures everyone follows along and becomes an “electronic” flipchart.
  4. The timekeeper should give half-way and 1 minutes notices.
  5. The facilitator role card is helpful to understand the role of the facilitator for the meeting.