The purpose of this assignment is to provide students with an opportunity to develop their assessment of a
clinical microsystem and associated work environment to improve outcomes based on evidence and best
practices. In a future practicum/internship you will be leading a unit-based team to improve outcomes. These
outcomes might be clinical, operational, educational, interpersonal, technological or financial and they will
align with the organizational goals and mission. The microsystem assessment is foundational as a starting
point for clinical nurse leaders to understand the complexity, culture, team work and data driven outcomes of
a given unit and to determine what problem needs to be prioritized for improvement. The outcome chosen to
focus on in the Intensive Care Unit (ICU) Microsystem is Central Line Blood Stream Infection (CLABSI). This is
the focus of improvement for the ICU.
PART 1
To start the assignment, use the microsystem workbook as your guide and reference. Complete a
Microsystem Unit Profile (see page 6 in the inpatient workbook as an example of a SUMMARY UNIT
PROFILE). If you do not have a specific microsystem work setting and corresponding workbook, then use the
Supporting Microsystem Workbook below and adapt it to the components of your team, setting, or select a
microsystem within a regional hospital or other organizational entity that is conducive to a system level
improvement project. Ask your instructor for guidance if needed to help focus the potential improvement /
practice change project. THE UNIT IS ICU AND THE HOSPITAL IS KAISER PERMANENTE SAN LEANDRO
CALIFORNIA
Clinical Microsystem – Assessing, Diagnosing and Treating Your Inpatient Unit (DOC)
Supporting-Microsystem-workbook-1.doc
THE DARTMOUTH INPATIENT WORKBOOK WILL BE UPLOADED AS AN ATTACHMENT.
Go to the website below and select the Greenbook/workbook that is most appropriate for your clinical
microsystem/unit based team. The Greenbooks are in MS Word so you can download, edit and use them to
complete the assignment. This can be a time-consuming assignment, so plan ahead and schedule
informational interviews to obtain information and data that might not be readily available. Read the workbook
and sample worksheets and interview staff members, unit leaders, managers or other interdisciplinary team
members to obtain an accurate assessment and analysis of your microsystem.
Dartmouth Microsystem Academy: Dartmouth – Generic Microsystem Workbooks (Links to an external site.)
THE DARTMOUTH INPATIENT WORKBOOK WILL BE UPLOADED AS AN ATTACHMENT.
PART 2
Write a scholarly paper that briefly describes your unit characteristics, such as the organizational setting,
Purpose, Patient population characteristics and Professional/staff skill mix, Processes and Patterns that
showcase excellent care and/or opportunities for improvement. Focus your paper to succinctly capture
information about the 5 Ps framework for your assessment and include “metrics that matter” (data) which you
discover by analyzing processes and patterns that represent a gap analysis and impact your unit
effectiveness, efficiency, quality, safety.
Microsystem Assessment
Introduction
Briefly describe how a systems approach can improve health care outcomes.
Background
Briefly describe the unit characteristics, 5 P’s and any other relevant data or key information to provide a synopsis of your microsystem (i.e. patient population, staff skill mix, educational levels, length of stay, other relevant data, work environment, team dynamics, communication styles, culture etc.) Use the microsystem guidebook, communication assessment, and microsystem financial assessment or other worksheets as guides to help you with the assessment.
Focus on the 5 Ps and “metrics that matter” as a framework for your assessment.
Trends and Patterns
What trends and patterns, broken processes were apparent as you completed your assessment? What relevant data were you able to review? Provide your rationale for specifying your trends and base your rationale on unit specific data. What is a key area of concern or topic (supported by qualitative and/or quantitative data) that is of interest to you related to a priority for improvement?
Proposed Solutions
What do you see as inefficient use of resources or opportunities to improve patient care outcomes? What solution do you propose to reduce the impact of waste or to improve quality or safety or unit culture? Make a case for your proposed solution and provide a rationale based on unit data and researching the evidence for improving practice.
Role of the Clinical Nurse Leader
To improve a selected problem/topic area, which of the 9 clinical nurse leader roles will be dominant as you lead a key change process at the point of care?
Conclusion
One or two paragraphs with succinct summary and recommendations for topic selection during practicum/internship.
References
Appendix (1) required – Clinical Microsystem Unit Profile
Additional Appendices (1)
Your paper is to be written in APA format using academic writing skills (3rd person, formal, objective tone), with appropriate headings, citations. Organize the paper with an introduction, each of the 4 headings listed above with the relevant information, and end the essay with a conclusion followed by recent references (within 5 years) and at least 1 Appendix – the completed Unit Profile. The essay is to include well-drawn points based on your own analysis of source material. Include a rationale for each of your points in fully developed paragraphs. Please read the grading rubric before beginning this assignment to make yourself familiar with the grading criteria. The essay is to be no longer than 5 pages, excluding the title page, references, and appendices. The microsystem assessment UNIT Profile is a required Appendix.
Rubric
Criteria Ratings Pts
This criterion is linked to a Learning Outcome-Addresses Posed Questions 6 pts
Full Marks
4 pts
This criterion is linked to a Learning Outcome-Analysis and Content 6 pts
Full Marks
4 pts
This criterion is linked to a Learning Outcome-Organization 6 pts
Full Marks
4 pts
This criterion is linked to a Learning Outcome-References and Support 6 pts
Full Marks
4 pts
This criterion is linked to a Learning Outcome-Clarity and Writing Mechanics 6 pts
Full Marks
4 pts
Total Points: 30