Value by Design: Developing Clinical Microsystems to Achieve Organizational Excellence

The Clinical Improvement Guide takes the clinical microsystem approach, introduced in the authors best-selling book Quality by Design, and expands it into a comprehensive approach to clinical improvement, assessment, and measurement of processes, outcomes and performance for all the settings in which health services are delivered. This book is based on courses that the authors have taught for more than ten years in the Center for Health Care Improvement Leadership at The Dartmouth Institute for Health Policy and Clinical Practice, one of the leading institutions for health care and medical quality research.   Part 1 covers foundations of quality, safety, cost improvement, assessment of system performance, measurement of quality and value, and application of the clinical microsystems approach.   Part 2 is a clinical microsystem action guide, explaining how to apply microsystem concepts and methods in different care settings -- primary care practices, specialty medical practices, emergency departments, inpatient care units, and so forth. Each area is linked with applicable methods and techniques, specific instructions, and tools and techniques needed to assess and improve a clinical microsystem.   Part 3 covers specific statistical tools for quality and process improvement, such as star diagrams and lean methods. This valuable section will be essential to any user of the book who is not well versed in general process improvement methodologies.   The book will include two extended case examples running throughout the book that will show how one can go from the background chapters featured in Part 1 to their application in Part 2.     Each chapter in Part 1 will have a summary of take home points and study questions for discussion in small groups. Part 2 will have examples of completed working assignments. The appendix will include two complete clinical microsystem final reports to demonstrate how application of the physiology model can lead to a comprehensive, specific, and useful report that details a particular clinical microsytems strengths along with targeted, high leverage opportunities for improvement.