Quality Improvement Discussion Paper
Improvement initiative in a healthcare facility is a process, which has a considerable influence on the internal and external environment of a certain establishment. Every particular healthcare system has an influence on the contemporary development of the nationwide and global healthcare industry as well as the development of these microsystems influence every particular team of professionals. The improvements are standardized by international organizations and the contemporary related scientific work, which can be accessed by healthcare professionals in the course of evidence-based practice. Every improvement requires a systematic approach, which is carried out with use of specifically designed frameworks.
Discussion of Microsystem
Microsystem represents the internal environment of a healthcare facility, which is integrated into the system of a higher level, which represents macrosystem. As argued by Hall and Roussel, microsystems appear in every kind of healthcare facilities, such as primary care clinics, neonatal intense care clinics, renal dialysis units, diabetes care clinics and other similar care providing establishments (2014). According to Lifvergren, clinical microsystem represents a comparatively small group of people, who work in closely integrated environment regularly with the purpose to provide care to “discrete subpopulations of patients” (2012). Thus, the healthcare macrosystem comprises diversified microsystems, which are integrated by general regulations common for all the facilities as well as specific practices which are features of particular facilities. According to Hall and Roussel, certain quality improvement measures are incorporated in the operations of a certain facility though the development of a specific microsystem, which dictates the adopted practices and daily routines by means of specific organizational culture, which is an integral part of every microsystem (2014). The complex structure of microsystem presupposes positive and negative practices observed in the formation of a certain microsystem. Some microsystems can be characterized as effective, others require considerable improvement.
There eight features of effective microsystem, which are as follows: existing integrated of informational system, measurable operations, interdependence of diverse teams in the structure, alignment with and supportiveness of the macrosystem, unchangeable core purpose of the organizational buildup, connection to the local and global community, constant investment in improvement programs and, finally, alignment of the roles of employees with specific trainings they undergo (Hall and Roussel, 2014).It is possible to assess microsystems with application of 5Ps method, which comprises analysis of the internal environment according to such criteria as Purpose, Patients, Professionals, Processes, and Patterns (Smith, 2012). The microsystem dealing with heart failure patients readmissions at hospital settings can be characterized by the primary purpose of reducing the cases of readmissions by developing sophisticated reporting system, regular analysis of the operations and identification of the most heart failure vulnerable patients (Desai and Stevenson, 2012). Patients of this microsystem are characterized by such demographic features as median age of 79 years (Hernandez et al., 2010). The patterns of heart failure patients readmissions are represented by the rate of 21.3% during the first 30 days (Hernandez et al., 2010). The heart failure readmissions team comprises such professionals as …