About Us

The Microsystem Academy at The Dartmouth Institute for Health Policy and Clinical Practice is a leader in Clinical Microsystem development, research, teaching, and coaching since this work began in the early 1980s. Through the integration of professional experience, empirical and cutting-edge research methodologies and information, the Microsystem Academy’s education programs offer exciting and rigorous action learning curricula in the art and science of healthcare quality improvement.

Vision, Mission, & Values


The Dartmouth Institute Microsystem Academy, a globally recognized leader and friend to organizations and individuals at all levels of healthcare delivery systems, seeks to provide vital education and coaching tools and resources to support exceptional healthcare and the continual improvement of care.


Through strategic relationships with interdisciplinary health care providers, patients and their families, we engage in research, education, and coaching to develop systems of care based on a clinical microsystems approach and team coaching methodology; share the knowledge, processes, and tools to support the development of organizational improvement capability; conduct action research that explores microsystems, mesosystems and macrosystem organization, leadership development, and team coaching resulting in high performing systems; act on evaluative information to continually improve our methods and the programs and services we offer.


The Dartmouth Institute Microsystem Academy is strongly committed to advancing the field of continual improvement at all levels of healthcare delivery systems, starting with frontline inter professionals including patients and families; collaborating with health systems to co-design and improve population health across the globe; honoring the unique contexts, environments, and needs of clients and strategic partners; disseminating new knowledge widely so that others may easily benefit and adapt to relevant settings.

What is a Microsystem?

A small group

A clinical microsystem is a small group of people who work together on a regular basis to provide care to discrete subpopulations of patients.

An adaptive system

A clinical microsystem is a complex adaptive system, and as such it must do the primary work associated with core aims, meet the needs of its members, and maintain itself over time as a clinical unit (Value by Design, pp. 3–4).


An evolving system

A clinical microsystem evolves over time and is often embedded in larger organizations.

Performance outcomes

A clinical microsystem has clinical and business aims, linked processes, and a shared information environment, and it produces performance outcomes.

It is transformative

Value creation at the overall health system level depends not only on the improvement and innovation that takes place within microsystems, but in the integration between and across the many frontline functional units that make up the system. Two or more microsystems create a mesosystem, which reflects the journey of the patient and family. In fact, transformation of these essential building blocks that combine to form the care continuum is critical to realizing the value proposition of a seamless, patient-centered, high quality, safe, and efficient health system.

Organizations that have intentionally developed pervasive improvement capability in their microsystems have a strategic advantage when it comes to accelerating and sustaining system-level improvement. These organizations have an efficient and effective means of getting everyone involved to accomplish their strategic plan campaign.

Our Expertise

Improvement Capability

As the basic building block of any health care delivery system, the microsystem is the unit where policy is put into practice, good value, and safe care are produced, and workplace motivators exist. The overall care provided by the entire organization can be no better that the sum of its frontline microsystems. Our work at The Dartmouth Institute Microsystem Academy is to engage with interdisciplinary health care professionals, organizations, and health systems to share our knowledge, methodologies, and tools to support the continual improvement of care at all levels.

Finding time to improve care can be difficult. The only way to improve and maintain quality, safety, and value is by blending analysis, change, measurement, and redesign into regular patterns and daily habits of frontline clinicians and staff. The Dartmouth Institute Microsystem Academy, the original developer of clinical microsystem theory, has a proven track record of working with dozens of healthcare organizations since the 1980s. We provide vital education, evaluation, and coaching tools and resources to help organizations achieve successful transformation to high performing organizations.

Team Coaching

Empirical evidence has shown that interdisciplinary groups who have coaching support are more likely to be successful in their improvement efforts. “The Team Coaching Model” developed by Marjorie Godfrey, PhD, is grounded in multiple disciplines, theories, and original research focused on cultivating improvement capability at the front line of health care. The Team Coaching Model is based on direct experiences of coaching interdisciplinary health care professionals worldwide to transform cultures and behaviors to be able to provide care and simultaneously improve care for populations of patients.

The discipline of coaching aims to increase improvement and group dynamic capabilities. Coaching is not about “telling” groups what to do, but to engage in dialogue using humble inquiry and helping (Schein) to develop supportive relationships, explore new possibilities, innovate and assess desired improvements. Coaching includes 1) understanding group and system dynamics, 2) exploring one’s self through critical reflection, 3) applying clinical microsystem theory, and 4) enhancing effective communication, conflict management, and negotiation skills.

Thousands of individuals from over a dozen countries have participated in our distinctive coaching programs, which offer participants an opportunity to develop effective coaching skills in real time as they take on longitudinal coaching responsibilities of an interdisciplinary frontline team at their home sites.