Quality by Design

A Clinical Microsystems Approach
1. Auflage 2007
ISBN: 978-0-7879-7898-3
Verlag: Wiley

Buch, Englisch, 512 Seiten, Format (B × H): 179 mm x 235 mm, Gewicht: 804 g

Quality by Design reflects the research and applied training conducted at Dartmouth Medical School under the leadership of Gene Nelson, Paul Batalden, and Marjorie Godfrey. The book includes the research results of high-performing clinical microsystems, illustrative case studies that highlight individual clinical programs, guiding principles that are easily applied, and tools, techniques, and methods that can be adapted by clinical practices and interdisciplinary clinical teams. The authors - describe how to develop microsystems that can attain peak performance through active engagement of interdisciplinary teams in learning and applying improvement science and measurement;
- explore the essence of leadership for clinical Microsystems;
- show what mid-level leaders can do to enable peak performance at the front lines of care;
- outline the design and redesign of services and planning care to match patient needs with services offered;
- examine the issue of safety;
- describe the vital role of data in creating a rich and useful information environment;
- provide a core curriculum that can build microsystems’ capability, provide excellent care, promote a positive work environment, and contribute to the larger organization.

Ancillary materials for use in classroom teaching, training, or coaching are available at https://clinicalmicrosystem.org/

Autoren/Hrsg.

Nelson, Eugene C

Batalden, Paul B

Godfrey, Marjorie M

Fachgebiete

• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizin, Gesundheitswesen Gesundheitssystem, Gesundheitswesen

Inhaltsverzeichnis

Tables, Figures, and Exhibits xiii

Foreword xix
Donald M. Berwick

Preface xxiii

Acknowledgments xxvii

Introduction xxxi

The Editors xxxix

The Contributors xliii

Part One: Cases And Principles 1

1 Success Characteristics of High-Performing Microsystems: Learning from the Best 3
Eugene C. Nelson, Paul B. Batalden, Thomas P. Huber, Julie K. Johnson, Marjorie M. Godfrey, Linda A. Headrick, John H. Wasson

True Structure of the System, Embedded Systems, and Need to Transform Frontline Systems

The Bladyka Case

Research Design

Results

Practical Implications

Conclusion

2 Developing High-Performing Microsystems 34
Eugene C. Nelson, Paul B. Batalden, William H. Edwards, Marjorie M. Godfrey, Julie K. Johnson

Case Study: A Decade of Progress for an Intensive Care Nursery

A Model of Development and a Curriculum to Catalyze Microsystem Growth

Conclusion

3 Leading Microsystems 51
Paul B. Batalden, Eugene C. Nelson, Julie K. Johnson, Marjorie M. Godfrey, Thomas P. Huber, Linda Kosnik, Kerri Ashling

Leader, Leadership, Leading

Recap of Methods

Three Fundamental Processes of Leading: What Clinical Microsystem Team Members Observe and Report

Discussion

Conclusion

4 Leading Macrosystems and Mesosystems for Microsystem Peak Performance 69
Paul B. Batalden, Eugene C. Nelson, Paul B. Gardent, Marjorie M. Godfrey

Case Study: A True Story, with Names Changed to Protect the Innocent

Leadership Frameworks: Some of the Best Approaches

Leading Large Health Systems to Peak Performance Using Microsystem Thinking

Conclusion

5 Developing Professionals and Improving Worklife 106
Thomas P. Huber, Marjorie M. Godfrey, Eugene C. Nelson, Julie K. Johnson, Christine Campbell, Paul B. Batalden

Case Study: Staff Development at Massachusetts General Hospital Downtown Associates

Conclusion

6 Planning Patient-Centered Services 124
Marjorie M. Godfrey, Eugene C. Nelson, John H. Wasson, Julie K. Johnson, Paul B. Batalden

Planning Patient-Centered Services and the 5 P’s

Case Study: Planning Services for Subpopulations of Patients to Best Provide Care for Individual Patients

A Developmental Journey: Beginning to Assess, Understand, and Improve a Clinical Microsystem

Analysis and Improvement of Processes

A Huddle in Plastic Surgery

Conclusion

7 Planning Patient-Centered Care 148
John H. Wasson, Marjorie M. Godfrey, Eugene C. Nelson, Julie K. Johnson, Paul B. Batalden

Planning Care Well: Exemplary Clinical Microsystems

Planning Care in Any Microsystem

A Low-Tech Example for Ambulatory Services: CARE Vital Signs

Conclusion

8 Improving Patient Safety 165
Julie K. Johnson, Paul Barach, Joseph P. Cravero, George T. Blike, Marjorie M. Godfrey, Paul B. Batalden, Eugene C. Nelson

Microsystem Patient Safety Scenario

Case Study: Dartmouth-Hitchcock PainFree Program

Conclusion

9 Creating a Rich Information Environment 178
Eugene C. Nelson, Paul B. Batalden, Karen Homa, Marjorie M. Godfrey, Christine Campbell, Linda A. Headrick, Thomas P. Huber, Julie K. Johnson, John H. Wasson

Case Study 1: Specialty Care: Dartmouth-Hitchcock Spine Center

Case Study 2: Overlook Hospital Emergency Department

Case Study 3: Intermountain Health Care Shock Trauma Intensive Care Unit

Tips and Principles to Foster a Rich Information Environment

Discussion

Conclusion

Part Two: Activating the Organization And the Dartmouth Microsystem Improvement Curriculum 197

10 Overview of path forward And Introduction to part two 199

Recap of Part One and Overview of Part Two

Using Real Case Studies and Practical Applications of Microsystem Thinkin

Über Autor(innen)

Eugene C. Nelson, D.Sc., M.P.H., is director of quality administration for the Dartmouth-Hitchcock Medical Center and professor of community and family medicine at Dartmouth Medical School.
Paul B. Batalden, M.D. is the director of health care improvement leadership development, Center for the Evaluative Clinical Sciences, and professor of pediatrics and of community and family medicine at Dartmouth Medical School.

Marjorie M. Godfrey, M.S., R.N., is instructor for community and family medicine at and director of the Clinical Microsystem Resource Group at Dartmouth Medical School.