Expert Reviews

Clinical Microsystems: A Critical Framework for Crossing the Quality Chasm

Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan

Address correspondence to: Donald S. Likosky, PhD, Section Head, Section of Health Services Research and Quality, Department of Cardiac Surgery, University of Michigan Medical School, Ann Arbor, MI 48109. E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Received: 27 September 2013
Accepted: 4 February 2014

Abstract

Patients, payers, and the public have increased expectations concerning the quality, safety and costs of our health care delivery systems. Whether or not to redesign our complex delivery systems is no longer in question. In order to succeed in optimizing care and outcomes (clinical and financial) for our stakeholders, we must design and evaluate tests of change. This journey will require a fundamental shift in our traditional thinking about healthcare delivery systems, including how: (1) each of us relates (effectively or not) to one another, and (2) the value of our patient’s care is impacted accordingly. With this challenge in mind, this article will provide insight to the reader concerning clinical microsystems, small groups of professionals who work together on a regular basis to provide care to discrete populations of patients. The reader will learn how to leverage these microsystems to meet our stakeholders’ expectations, namely to optimize the quality, safety and costs of our health care delivery systems.