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Clinical Microsystems

All health systems are composed of a few basic parts—Front-Line Clinical Microsystems, Overarching Macrosystems, and Patient Subpopulations needing care. Microsystems thinking makes several organizational assumptions:

  • Bigger systems (macrosystems) are made of smaller systems.
  • These smaller systems (microsystems) produce quality, safety, and cost outcomes at the front line of care.
  • Ultimately the outcomes of the macrosystem can be no better than the microsystems of which it is composed.
In addition, the microsystem is the logical locus for linkage between vision and delivery and therefore can and should act as the “agent for change” within a macrosystem. If strategically driven and if the performance of each individual microsystem is optimized, the microsystems within a macrosystem is optimized, the microsystems within a macrosystem can facilitate systematic transformation at all levels of the system.