Clinical Microsystem

Answer

Clinical Microsystem

Part I: Organization Microsystem Assessment

Introduction

A major clinical practice improvement strategy involves the use of microsystems. Anderson, Khatri, and Blankson (2015) defines clinical microsystems as a team of healthcare professionals working together to enhance the quality and safety of care. This paper evaluates X Community Healthcare Center clinical microsystem. The microsystem consists of 15 healthcare professionals who include; 2 Primary Care Physician (PCP), 3 Medical Assistants (MA), 5 Registered Nurses (RN), 1 Nutritionist, 3 Enrolled Nurses (EN), 1 technical assistant. The 15 professionals meet once every week to assess their achievements, challenges and develop improvement strategies. The microsystem’s mission is to deliver primary health care services that are of high quality, safety, and accessible to all community members. Its vision is to eliminate all healthcare challenges within society. Core values include; quality, safety, teamwork, equality, collaboration, accountability, accessibility, professionalism, and respect. Key informants and data source are the healthcare records and interaction with the team members.

Leadership

                The microsystem is led by one PCP who is specialized in family practice and is assisted by RN. The role of the PCP is to ensure that all the objectives of the team are met while the RN is responsible for organizing meetings, setting agendas, and communicating key points to the other members. The effectiveness of the microsystem is reflected in the weekly meetings, discussions on social media group platform, and collaboration among the team. Transformational leadership model is applied which mainly involves motivation of the team members and collaboration (Boamah, Laschinger, Wong, & Clarke, 2018). Overall support entails human, technical, and financial resources. The microsystems regularly examine its needs, present them to the healthcare management and are provided with sufficient support with regards to workforce and equipment.

Staff

The microsystem has 15 members as aforementioned. The team employs the 5P framework of purpose, patients, providers, patterns, and process. Presently, the microsystem is undergoing training on various aspects including communication and interpersonal skills, teamwork, and medical errors. The training aligns with the microsystem vision, mission, and core values to promote quality and safety. The education also involves the patient-centred model where all healthcare practices are aligned with the patient’s requirements and needs (Kogan, Wilber, & Mosqueda, 2016). In addition, the microsystem has ongoing education on the application to information and communication technology at the workplace which is aimed at promoting efficiency in care. Another key aspect in the microsystem is promoting the employee satisfaction. The main strategies employed in this regard are establishing a supportive environment and ensuring that all their needs are met including work-life balance. Monitoring of employee satisfaction mainly involves continuous interaction with them to establish their needs such as training, work-related stress, and other challenges. Based on the obtained information, effective improvement strategies are implemented.

Patients

The patient is at the center of the microsystem’s mission and vision. While aiming at providing quality and safe care, the microsystem’s main objective is to provide person-centred care. Patient satisfaction is, therefore, monitored through their comments regarding the services. These comments can be provided through the health center social media platform or suggestion box. Further, the patient is required to fill in a small section regarding the provided services and areas of improvement. On the other hand, the microsystem aims at providing culturally competent services which are central in promoting patient quality and safety. Moreover, it is the patient’s desire to receive error-free services which are also a key goal of the microsystem.

Performance

                A microsystem is directed by its specific mission, vision, and goals. This outlines the performance of the microsystem which should be evaluated regularly. The microsystem has an effective performance monitoring system. This entails assessing the patient’s complaints and grievances, medical errors, employee and patient satisfaction, and major improvements in the service delivery. During the weekly meetings, the team examines the achievement of the previous set agenda and matches the achievement of the present goals with the four key variables mentioned above. In case there are any errors, complaints or grievances, the healthcare team collaboratively work to develop mitigation strategies. The alignment of the healthcare services with the mission and vision of the organization is centered on providing quality and safe care. The main barriers in delivering effective care are limited technical support and an increase in the number of patients while the healthcare providers’ number remain the same. To overcome this barrier, the federal and local governments are working collaboratively to address these issues by equipping the facility and expanding it to accommodate more patients. In addition, there are efforts to increase the number of staffs to meet the high number of patients.

Information and Communication Technology

                One of the key challenges in the microsystem is the limited use of advanced information and communication technology (ICT). However, the center has implemented electronic health recording model which collects, process, and stores patient information (Nguyen et al., 2016). Recently, the center changed from using the paper-based model to adopt the EHR which was essential in enhancing service delivery. All departments are linked to ensure uniformity in information accessibility and recording. Notably, all health care providers are currently being educated on the use of these systems, which are aimed at reducing errors and fostering efficient information flow. However, there are still several aspects that have to be considered in advancing the ICT systems such as the use of PDA and outsourcing the storage and processing systems.

Conclusion

                Conclusively, X healthcare center consists of a 15-workforce microsystem whose main objectives is to promote accessibility of quality and safe care. The key strengths include person-centered care model and integration of safety and quality in care. The two main challenges include increased number of patients and limited application of technology which are part of improvement strategies.

PART II

X organization is a community health center with a capacity to serve 150 patients daily. The facility also has a 52-bed ward that accommodates all types of illnesses and emergencies including accidents and fire. It has 27 staff which comprises the 15-member microsystem, while the rest is the management and support staff. The main organization mission is to provide accessible, quality, and safe care to diverse patients. Core values are accountability, equality, respect, availability, and collaboration (Patterson et al., 2016). Over the years, the organization has grown from the previous 10-bed facility to the current state which is based on the increased community size. Currently, the organization aims at increasing the level of technology to promote efficiency in services provision. 

Problem

One of the main challenges in the organization is limited level of technology. Presently, the main ICT in the organization is the EHR which was implemented last year. The organization uses an outdated information storage system which impedes its efficiency (Stanimirovic, 2015). Often, patients and staff have launched complaints regarding how slow the machines and services are. Healthcare providers are also still using the paper approach in taking the patient’s details during rounding. Further, there are only two technicians who have training needs on the use and maintenance of advanced ICT technologies. Although the organization has laid strategies to advance its ICT, it is still a challenging aspect which needs urgent intervention to reduce medical errors and inefficiencies.

Literature

Presently, ICT is a major trend. According to Anwar, Sulaiman and Dominic (2014), the integration and application of ICT is reflected across all domains with the main role being to promote the lives of patients. Stanimirovic and Vintar (2015) argue that failure to implement advanced ICT systems has resulted in rigid organizational structures which impede efficiency. This is reflected in uncoordinated business approaches and compromise to the quality of services. Both in the urban and rural health care settings, the importance of ICT is manifested in providing better care and reducing the mortality and morbidity rate. As espoused by Bhati (2015), the current world is characterized by the application of advanced technology. In India for instance, Bhati (2015) note that some of the main services applying advanced technology include Pregnancy Child Tracking and Health Services Management Systems (PCTS) which have been key in reducing maternal death. Alongside the implementation of advanced technology, enhancing the employee technical competence is a critical aspect which involves implementing education programs. As noted by Lindberg, Nilsson, Zotterman, Soderberg, and Skar (2013), enhancing the health care technical competence is imperative in improving communication and service delivery. Notably, the application of advanced ICT is also in education, and as noted by Del Carmen Ortega-Navas (2017), this is critical in on job training and other approaches such as online and workshops.

Objectives

There are three key objectives in promoting ICT at X organization. These include upgrading the hospital information technology systems, outsourcing ICT storage and processing, and enhancing the technical team competence in operating the advanced technology. The first objective involves installing improved technologies and systems such as computers. In addition is the adoption of personal digital assistant (PDA) to completely transition from paper-based approach to the use of ICT. The second objective is outsourcing the information collection and storage systems. In small and medium enterprises, hosting the information storage systems presents as a major financial challenge. Therefore, outsourcing the hosting services is essential in improving efficiency and reducing other challenges such as cybercrimes (Jiang et al., 2015). In the third objective, it involves educating all employees from the technical team to the nurses and physicians on the use of these systems.

Action Plan

The action plan will involve three months. The first month will entail purchasing and installing advanced technological systems. The procurement will involve tendering process to a cheap but trusted vendor. During this month, the best hosting services provider will be selected. A key aspect to consider will be the economic value, which will comprise the cost and benefit analysis. In the second month, it will mainly involve training and education on the use and application of the advanced ICT. This will target all the employees from physicians to the technical team. To avoid resistance to change, it is essential to include the employees in the planning and implementation process (Ali, Zhou, Miller, & Ieromonachou, 2016). The last month will involve commissioning and testing the advanced systems. This will provide an overview of the ICT performance and some of the improvement areas.

Evaluation

The evaluation process will comprise the last month of the implementation strategy. The evaluation will be based on the three objectives mentioned above. The system should be flawless and perform all the required activities. In addition, all workers accessing the ICT systems should use them with ease. The technical team should also demonstrate comprehensive knowledge regarding the use and maintenance of the systems. A cost-benefit analysis will also be conducted for the system to ascertain its merits. The patients will also be part of the evaluation where their perception regarding the systems will be considered in future improvements.

In summary, implementation of ICT systems is an essential trend in the current health care system which is aimed at promoting the quality and safety of healthcare service delivery. For X organization which is a community health care center, a key gap is limited application of technology systems. Therefore, the above plan entails implementation of advanced ICT system and educating all the employees on their use.