Improving a Microsystem

Microsystems already exist.  Microsystem improvement involves engaging the microsystem team members (the multi-disciplinary members of staff that work in that microsystem) in a structured process to improve the quality of care for patients and the staff who work there.

The diagram to the below shows the three key elements involved in this approach. Click here for more information.

  1. Team coaching - Quality improvement is not easy, and having a coach to help the team through the work is very helpful.  Evidence from research shows that having a coach to help and support improvement work greatly increases the chance of success.  The Sheffield Microsystem Coaching Academy (MCA) trains coaches to help microsystems work on improvement.
  2. Improvement Science - There are a number of tools and techniques that are essential for improvement work.  The MCA trains the coaches to use tools such as process mapping, time series measurement, and making small tests of change (Plan-Do-Study-Act cycles, or PDSA) to help the microsystem.  The microsystem then learn with the coach how to apply these tools to deliver measurable improvements using the structure of the Dartmouth Improvement Ramp shown below.  The coach builds with the team the capability to understand and use improvement science so that the process is sustained and everyone has two jobs when they come to work: to do their work and to improve it. 
  3. The Microsystem - This approach requires the active involvement of the microsystem team and regular weekly meetings are required to work on improvement.  Representatives from the stakeholders who play a part in that care are needed - doctor, nurse, therapist, clerical, ancillary, and manager, as well as any key supporting microsystems.  Patients are at the heart of microsystem improvement, and involving a patient in these microsystem improvement meetings is essential.

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