Personal Experience of a Microsystem
Theoretically, the larger system’s performance depends on its building blocks’ effectiveness. A microsystem is an interprofessional group of medical staff, administrators, and a patient subset collaborating to improve a front-line activity (O’Leary et al., 2019). I have previously worked as an LPN providing direct nursing care in a dermatology clinic, and our microsystem consisted of two physicians and LPNs, an RN and a clinic manager, and patients and their families. I developed close workplace relationships with everyone on my team during my employment in this facility. There was no staff turnover during the two years of my employment.
Five Success Characteristics of Leadership in the Clinical Microsystem
Strong Leadership
Five significant elements made this microsystem quite successful and healthy. First, there was strong leadership. In this physician-run practice, the clinic manager and physicians listened to us, respectfully interacted with staff, and made us feel valued. The clinic manager fostered a positive culture within the facility.
Focus on Employees
Second, an enhanced staff focus ensured that all interprofessional team members felt appreciated and empowered (Institute for Healthcare Improvement, n.d.). As nurses, we generated ideas for quality improvement projects that were well-supported. Additionally, the clinic manager aligned our roles within the practice based on our training competencies.
Education and Training
Thirdly, education and training were ongoing, largely provided by the RN and clinic manager. We were frequently trained on evidence-based practice guidelines, which contributed to enhancing patient outcomes.
Focus on Patient
Then, the patient focus within this microsystem was strong as the clinic manager adequately implemented procedures to ensure the smooth delivery of care and response to special patient requests. During my practice there, I felt that patient needs were met through caring, listening, and educating our clients.
Organizational Interdependence
Lastly, interdependence was well executed within this organization (Institute for Healthcare Improvement, n.d.). For example, each nursing staff member developed areas of interest or expertise, and we relied on each other to perform different tasks or responsibilities based on our strengths and interests.
However, organizational support was lacking within this microsystem (Institute for Healthcare Improvement, n.d.). As a small outreach specialty clinic, we received no organizational support from the larger system and were not provided recognition or reviews on performance. The larger organization did not look for ways to connect with us, and no hand-offs were provided.
Reflections on Leadership: Improvements and Continuities in the Microsystem
As a microsystem leader, I would improve the use of information and information technology because these are critical “participants” in coordinating work and avoiding workplace errors (Institute for Healthcare Improvement, n.d.). Further, as stated by Wasson et al. (2003), “At the heart of an effective microsystem is a productive interaction between an informed, activated patient and a prepared, proactive practice staff” (p. 227).
Therefore, I would keep this interaction strong and productive by maintaining an enhanced focus on staff and patients. According to Huber et al. (2003), it is essential to promote a culture where all employees matter: in this case, the microsystem can attain previously inexperienced performance levels. Our clinic had this healthy culture of involvement and value, so I would also keep it as a leader.
References
Huber, T. P., Godfrey, M. M., Nelson, E. C., Mohr, J. J., Campbell, C., & Batalden, P. B. (2003). Microsystems in health care: Part 8. Developing people and improving work life: What front-line staff told us. Joint Commission Journal on Quality and Safety, 29(10), 512–522. Web.
Institute for Healthcare Improvement. (n.d.). Clinical microsystem assessment tool. Web.
O’Leary, K. J., Johnson, J. K., Manojlovich, M., Goldstein, J. D., Lee, J., & Williams, M. V. (2019). Redesigning systems to improve teamwork and quality for hospitalized patients (RESET): Study protocol evaluating the effect of mentored implementation to redesign clinical microsystems. BMC Health Services Research, 19(293). Web.
Wasson, J. H., Godfrey, M. M., Nelson, E. C., Mohr, J. J., & Batalden, P. B. (2003). Microsystems in health care: Part 4. Planning patient-centered care. Joint Commission Journal on Quality and Safety, 29(5), 227–237. Web.