Healthcare Delivery Systems

Improvement Project

Sarah Naves, Alaina Hill, Megan Custis, Lisa Siewert, and Jen Garred
November 16th, 2016

Overview of Patient Care Delivery System

Leadership
oStrengths-based
Culture and Support
oInterdisciplinary teamwork approach
Patient/Staff Focus
oPatient-centered care, valued staff
Interdependence
oPositive collaboration
Information and Healthcare Technology
o Readily available but time-consuming
Healthcare Improvement
oProcess improvement: Visitor identification
Staff Performance
o Efficient and cost-effective

Microsystem Model:
Leadership

St. Marys Emergency Department exhibits a

strengths-based nursing leadership style. Nurse
leaders focus on the development of workers
strengths as opposed to identifying problems.

Nurse leaders create a positive environment by:

o Recognizing uniqueness of staff while working
as a whole
o Focusing on goodness of fit
o Promoting learning
(Marquis & Huston, 2015)

Microsystem Model:
Organizational Culture and Support
The

Emergency Department at St. Marys uses

an interdisciplinary teamwork approach among
RNs and Providers.
The organization supports the microsystem
through:
o Providing resources and information
o Providing recognition
o Providing training and continuing education
(Institute for Healthcare Improvement, 2015)
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Microsystem Model:
Patient Focus & Staff Focus
Patient Focus: Patient centered care is achieved through
honoring the patients values, preferences and needs.
oThe ultimate goal is optimal health and quality of life
for patients.
Staff Focus: The staff of the ED feels that they are
valuable members of the team and understand their
roles.
o Physically safety
o Psychosocial well being
o Meaning and purpose with their work.
(Institute for Healthcare Improvement, 2015)

Microsystem Model:
Interdependence of Care Team

Characteristics include:
oSupportive
oFriendly
oCollaboration
oOpen communication

Care team includes:

o RNs, techs, LPNs, paramedics, doctors,
respiratory therapists, IV team, radiology,
security
(Institute for Healthcare Improvement, 2015)
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Microsystem Model:
Use of Information and Healthcare Technology

Information and technology connect the care

team to each other and the patients and viceversa

Integration of information with:

o Patients: given standard information, but
improvements in the works
o Staff and Providers: have necessary information
readily available

o Technology: accessed and enhancing to work, but

time consuming
(Institute for Healthcare Improvement, 2015)

Microsystem Model:
Process for Healthcare Delivery Improvement

Healthcare delivery improvement tasks included

with daily tasks and care. Active in quality and
healthcare delivery improvement, often
centering around patient flow through this
microsystem.
Strengths
o ample staff support and discipline for changes
o financial support and time available to staff to
support improvements
o positive and supportive atmosphere for
learning
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Microsystem Model:
Staff Performance Patterns

Staff focus on: patient centered care (meeting

patient needs), smooth service flow and
streamlining patient care, time effective care,
cost balance and reduction, minimizing patient
time in ED (discharge, or transfer and
admittance), frequent data collection and audits
Routine data collection of
o Patient outcomes
o Performance and processes
o Avoidable costs/Cost reduction
(Institute of Healthcare Improvement, 2015)

Specific Aspect Targeted for Improvement

Process Improvement
The need for improvement in relation to this
aspect of the microsystem is based on the
observations of the student nurse working in the
ED
Ample resources are available to facilitate
process improvement

(Institute of Healthcare Improvement, 2015)

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Specific Aspect Targeted for Improvement

(cont.)
Goal: to create a positive impact on the delivery
of patient-centered care
The Joint Commission 2016 National Patient
Safety Goals
oImprove the Accuracy of Patient Identification
World Health Organization
oPatient Safety Solutions

(The Joint Commission, 2016; World Health Organization,

2007)

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Leading the Plan for Healthcare Delivery

Improvement

Plan for Completion of Improvement Project

oAssessment of Unit Strengths and Limitations
oUpdating Hospital Policy and Procedure
Manuals
oEducating Staff
oStaff Follow-Up
Staff Presentation
oNurse Educator/Senior Nurse Manager/Unit
Nurse Manager/Charge Nurse
Orientation for New Staff
Morning Meetings
Continuing Education

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References
Institute for Healthcare Improvement. (2015). Clinical
Microsystem Assessment Tool. Retrieved from
http://www.ihi.org/resources/pages/tools/clinicalmicrosy
stemassessmenttool.aspx
Nancarrow, S. A., Booth, A., Ariss, S., Smith, T., Enderby,
P., & Roots, A. (2013). Ten principles of good
interdisciplinary team work. Human Resources for
Health, 11, 19. http://doi.org/10.1186/1478-4491-11-19
Marquis, B. L., & Huston, C. J. (2015). Twenty-first-century
thinking about leadership and management. In B. L.
Marquis & C. J. Huston (Eds.), Leadership roles and
management functions in nursing: Theory and
application (8th ed.) (pp. 53-68). Philadelphia, PA:
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Lippincott Williams & Wilkins.

The Joint Commission. (November, 2016). Hospital: 2016

National Patient Safety Goals. Retrieved from
https://www.jointcommission.org/hap_2016_npsgs/
World Health Organization. (May, 2007). Patient
Identification. Retrieved from
http://www.who.int/patientsafety/solutions/patientsafety/
PS-Solution2.pdf

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