The Journey of a Microsystem Team

 Microsystem improvement work can be divided into the four key phases shown on the diagram below.

1. Assessment - It is important to understand the system before we try to improve it, so the 5P's are used to see the microsystem in a new light. 

We have provided a simple 'one page book' to help all new coaches understand how the 5P's can help them - you can download it here.

2. Diagnose - Based on this assessment what do we aim to improve?  What are our ideas for improvement?

3. Treatment - This step involves testing our improvement ideas using PDSA.  Here is a 'one page book' describing PDSA cycles. 

It is also essential to measure if the changes we make are improvements.  We have also created a 'one page book' covering the basics of using Run Charts in healthcare improvement work - you can download it here

We also have a short article on using Run Charts for Healthcare Improvement

4. Standardise - The last step is to consider how do we make sure our changes become habits - to ensure the redesigned process is the way we now do things around here.

An MCA coach will aim to take the team through this structure from start to finish whilst training with the academy, although all teams progress at different rates.

How long does it take?

People often ask how long improvement work takes. The simple answer is that as continuous testing of improvements becomes part of the culture, it should go on indefinitely. In terms of timescales from first forming the "Lead Improvement Group" to assessment of the system to testing changes and ultimately standardising improvements we have attempted to put together an apporximate timetable for landmarks in the process. This is not a fixed timetable as each microsystem has its own context but it should serve as a rough guide to moving forward with improvement work.

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