Microsystem Performance Improvement Plan

Microsystem Performance Improvement Plan

Instructions are below. I have attached the Microsystem Assessment paper you wrote that my instructor graded and has her comments. She did not like the paper and she will be looking at this paper extra carefully to make sure I implement changes and that it is written better. Please read her comments in the attached document. If you need any information from me please let me know ASAP. I really need to make a good grade on this paper because I did not make a good grade on the Microsystem Assessment. Please follow the instructions and rubric carefully. Thank you

General Info about the Unit and the VA:

We have a union in our organization. The charge nurse that is rotated weekly is responsible for any problems that arise on the unit, they do participate in patient care, and determine assignments for the day such as CBG control testing at the end of the shift, ordering supplies for post-surgery patients such as juices and graham crackers, cups, spoons, coffee etc. Make the assignment for nurses working in the prescreening clinic. Surgeries we do in ASC  – Cataracts, Total Hip Arthoplasty (will be admitted), Breast reductions, Carpal Tunnel, Prostatectomy, Lithotripsy, TURBT W/ Mitomycin, FESS, Throacic – Lobectomy (will be admitted), amputation, Penile implants, shoulder arthroscopy, Hysterectomy, etc..

Interventional Radiology is the main issue, they bring the patients in at 0730 and the patient isn’t seen until after 1pm. It causes the ASC nurses to have to go into overtime when the patient is brought back around 5pm and we get off at 6:30pm. Some patients require 4 hours of bed rest (lying flat). The patient is aggravated and the staff are upset as well. It doesn’t matter to IR because they get to go home once they bring the patient to us after the procedure to recover. It is due to them not having urgency and the process…orders not in the computer when the patient arrives so we have to call and get the physician to put in orders whenever they arrive. Patient didn’t receive a preop call for IR and the patient ate breakfast and instead of rescheduling they wait longer to cover 6 to 8 hours to perform the procedure. Appointment times not put in the system and the patient arrives out of nowhere and is supposed to have surgery in IR.

Fall Semester: Microsystem Performance Improvement Plan (due this term)

The student will utilize the course textbooks, the Dartmouth College Assessment Tools (Trustees of Dartmouth College, Godfrey, Nelson, Batalden & Institute for Healthcare Improvement, 2001 – Google), prior course textbooks (i.e. Quality and Safety), and resources from the Institute for Healthcare Improvement to develop a performance improvement project for the selected microsystem. (VERY IMPORTANT)

Written Paper

In a written narrative form, describe (maximum 7 pages) your proposed performance improvement plan. It is very important to narrow your plan so that it can be implemented AND evaluated by the end of spring semester (Practicum II).


  1. Introduction
  2. Organization’s strategic plan and strategic priorities
    1. Describe the current strategic initiatives of the organization and how this improvement plan fits into these initiatives.
  3. Identification and brief description of the improvement model/theory that will be used to guide the improvement plan (i.e. PDSA, LEAN/Sigma 6, etc.)
  4. Plan for improvement (information that will be needed for Institutional Review Board)
    1. Project Title
    2. Purpose of the Project
    3. Project Question(s)—can use PICO format
    4. Background of the Project (Literature review)–why is this issue a problem (significance)? Scope of the problem? National guidelines to improve the problem? Include 2-3 sentences that describe how this issue is a problem (from the microsystem assessment).
    5. Methodology
      1. Setting
      2. Identification of team members and role on the team (include at least 1 interprofessional colleague)
  • Subjects (who, how many, etc.)
  1. Step-by-step plan (Who will do what? When? How? For example, administer a survey?)
    1. Include national recommendations for improvement strategies (your strategy to improve the problem must be evidence-based)
  2. Outcome measures
    1. What data, or metrics, will you gather so that you will know if the change has made a difference, i.e. survey, knowledge test, increased patient satisfaction scores?
    2. Are you using identified data or non-identified data (i.e. grouped versus individual data?)
  3. Financial considerations
    1. What is the projected ‘cost’ of the plan? (i.e. human and material)
    2. How will this cost be covered?
  4. Conclusion
    1. Anticipated benefit to the microsystem and patient safety (return on investment)
    2. Translation of the treatment plan to the mesosystem and/or macrosystem (how easily could your proposed project be implemented at the division and/or organizational levels?)

APA format is required and solid academic writing is expected. Include all references—Reference page is not part of the word limit. Review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectation for successful completion of the assignment.

(Ambulatory Surgery Unit – Downtown Charlie Norwood Medical Center)

Required Textbooks for Class: You must use these references in the paper along with outside sources.

Nelson, E. C., Batalden, P. B., & Godfrey, M. M. (Eds.). (2007). Quality by design: A clinical microsystem approach (1st ed.). San Francisco, CA: Jossey-Bass.

Reference Textbook: Textbook from NURS6114 Introduction to Health Systems Leadership course (Roussel, Management and Leadership for Nurse Leaders )

Quality By Design: A Clinical Microsystems Approach – ISBN 0787978981 (1st Edition)

Institute for Healthcare Improvement – Google