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On the whole, my organization functions well and exhibits many characteristics of a successful microsystem as defined by Nelson et al. (2002). The score I’ve given my organization is 18 points, and this result is above average. There are some aspects of the clinical microsystem that could be improved by addressing certain shortcomings and gaps, but most others should be maintained at the current performance level.
Leadership in my organization is strong, which plays a significant role in providing safe and efficient care (Godfrey, Nelson, Wasson, Mohr, & Batalden, 2003). For instance, our managers establish and explain performance goals and track their completion consistently. We also benefit from high levels of organizational support, which is manifested primarily in rewards and recognition schemes. The management also provides information relevant to improving care outcomes, such as assessments and feedback. However, the staff focus in my organization is not as strong as it could be. While the managers know each employee well, some nurses experience workload issues that impact care quality. Addressing the workload by improving staffing and workflow would benefit both care providers and patients (Mohr et al., 2003). Although continuing education is available to everyone, many nurses do not have enough training in interprofessional collaboration and teamwork, which influences our care outcomes. Hence, the results in education and training and interdependence are lower than they could be.
With regards to patient focus, my organization scored high because managers are always willing to improve services and listen to patients. For example, last year, we received some complaints about waiting times, and the manager responded by hiring two new nurses to enhance the workflow. Nevertheless, the community and market focus is rather low since we do not always have enough knowledge about community resources available to every group of patients. Sometimes nurses and physicians have to research relevant community resources on their own, which takes time from their patient appointments. It would be beneficial to improve community outreach by increasing the number of programs available and forming closer ties with specialized care providers (Huber et al., 2003).
The performance of the microsystem is generally high, and there are processes in place to measure outcomes consistently, report any gaps to managers and staff, and implement improvement processes. We also use evidence-based practices whenever possible in order to enhance patient outcomes. For instance, when there was an issue with an increase in adverse drug reactions reported by patients, the managers introduced a new evidence-based survey to collect more information about patients and the medications they take before ordering a prescription.
Lastly, information technology works relatively well, mainly when it concerns the integration of information with patients. We have a functional patient portal where patients can access all relevant information, but we also provide other resources, including brochures, websites, and face-to-face patient education. Patients are always asked if the information was clear to them or if they need any further explanations. However, the integration of information with providers and staff is sometimes lacking. For example, prescription information may be missing from the EHR, and I have to reach out to the pharmacy to find out if the patient took a particular medication. Also, the clinical decision support system used in my organization is not always useful and might create distractions due to irrelevant alerts. The management is currently working with IT professionals to improve information technology use.
References
Godfrey, M. M., Nelson, E. C., Wasson, J. H., Mohr, J. J., & Batalden, P. B. (2003). Microsystems in health care: Part 3. Planning patient-centered services. The Joint Commission Journal on Quality and Safety, 29(4), 159-170.
Huber, T. P., Godfrey, M. M., Nelson, E. C., Mohr, J. J., Campbell, C., & Batalden, P. B. (2003). Microsystems in health care: Part 8. Developing people and improving work life: What front-line staff told us. The Joint Commission Journal on Quality and Safety, 29(10), 512-522.
Mohr, J. J., Barach, P., Cravero, J. P., Blike, G. T., Godfrey, M. M., Batalden, P. B., & Nelson, E. C. (2003). Microsystems in health care: Part 6. Designing patient safety into the microsystem. The Joint Commission Journal on Quality and Safety, 29(8), 401-408.
Nelson, E. C., Batalden, P. B., Huber, T. P., Mohr, J. J., Godfrey, M. M., Headrick, L. A., & Wasson, J. H. (2002). Microsystems in health care: Part 1. Learning from high-performing front-line clinical units. The Joint Commission Journal on Quality Improvement, 28(9), 472-493.
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