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Quality By Design: A Clinical Microsystems Approach 1st Edition

4.8 out of 5 stars 15 customer reviews
ISBN-13: 978-0787978983
ISBN-10: 0787978981
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Editorial Reviews

From the Back Cover

Quality by Design offers a new and innovative approach to transforming our health care system to be safe, timely, effective, efficient, equitable, and patient-centered. The authors' microsystem concepts and proven approach achieve the best patient outcomes by developing reliable, efficient, and responsive systems that have the capability of meeting the individual needs of one patient, continually improving care for the next patient, and creating a great place to work for all staff.

Quality by Design reflects the research and applied training conducted at Dartmouth Medical School under the leadership of Eugene Nelson, Paul Batalden, and Marjorie Godfrey. The book includes the research results of high-performing clinical microsystems, illustrative case studies that highlight individual clinical programs, guiding principles that are easily applied, and tools, techniques, and methods that can be adapted by clinical practices and interdisciplinary clinical teams. The authors

  • describe how to develop microsystems that can attain peak performance through active engagement of interdisciplinary teams in learning and applying improvement science and measurement;
  • explore the essence of leadership for clinical Microsystems;
  • show what mid-level leaders can do to enable peak performance at the front lines of care;
  • outline the design and redesign of services and planning care to match patient needs with services offered;
  • examine the issue of safety;
  • describe the vital role of data in creating a rich and useful information environment;
  • provide a core curriculum that can build microsystems' capability, provide excellent care, promote a positive work environment, and contribute to the larger organization.

Quality by Design offers powerful theoretical frameworks and principles, valuable tools and techniques, and an action-learning program.

About the Author

Eugene C. Nelson, D.Sc., M.P.H., is director of quality administration for the Dartmouth-Hitchcock Medical Center and professor of community and family medicine at Dartmouth Medical School.

Paul B. Batalden, M.D. is the director of health care improvement leadership development, Center for the Evaluative Clinical Sciences, and professor of pediatrics and of community and family medicine at Dartmouth Medical School.

Marjorie M. Godfrey, M.S., R.N., is instructor for community and family medicine at and director of the Clinical Microsystem Resource Group at Dartmouth Medical School .

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Product Details

  • Paperback: 508 pages
  • Publisher: Jossey-Bass; 1 edition (March 16, 2007)
  • Language: English
  • ISBN-10: 0787978981
  • ISBN-13: 978-0787978983
  • Product Dimensions: 7 x 1.1 x 9.3 inches
  • Shipping Weight: 1.8 pounds (View shipping rates and policies)
  • Average Customer Review: 4.8 out of 5 stars  See all reviews (15 customer reviews)
  • Amazon Best Sellers Rank: #51,004 in Books (See Top 100 in Books)

Customer Reviews

Top Customer Reviews

By Shyan C. Sun on July 1, 2008
Format: Paperback
A Book Review
Quality by Design - A Clinical Microsystems Approach
Edited by Eugene C. Nelson, Paul B. Batalden and Marjorie M. Godfrey
First Edition, 459 pp., illustrated. Jossey-Bass 2007. ISBN: 978-0-7879-7898-3 (pbk)

Today most practicing clinicians know very little about quality improvement in health care and very few know how to do it the right way, partly because there are few publications serving as a "How-to Guide Book".

This Book "Quality By Design - A Clinical Microsystem Approach" published in 2007 by Jossey-Bass comes in handy for practicing physicians, academic or non academic. Now that the evidence of quality improvement work is a requirement for renewing the Specialty Board in Pediatrics, I believe that other specialties will follow suit soon.
The three authors are from the Center for the Evaluative Clinical Sciences at Dartmouth. They are the nation's leaders in developing and using measures of health care delivery system performance for the improvement of health care. They have written, published and taught extensively in the subject of quality improvement. Their series of 9 articles entitled "Microsystems in Health Care published in Joint Commission Journal on Quality and Safety" (2002-2003) was a landmark publication in health care literature.

What is different and unique in this book is its emphasis on quality improvement through the microsystem approach. To put it simply, the small system (microsystem like NICU) produced quality, safety and cost outcome at the front line of care. The outcome of a macrosystem (like hospital) can be no better than the outcomes of microsystems of which it is composed. Thus a microsytem is the most important building block of a health care system.
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Format: Paperback
This is a great book for those new to Clinical Microsystems AND those well-versed with the framework. QBD is an invaluable resource and offers operational definitions, practical examples and a guide to help teach those people unfamiliar with Clinical Microsystems. It is great to use as a quick reference or a full improvement guide book.
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This is an excellent guide for coaches working with clinical teams to train them on a process improvement model that most industries outside healthcare have used for decades. The tools described are simple to use, and the concepts are clearly stated for anyone not familiar with microsystem theory and background. The effect of using the described method is a palpable change in culture. The book contains an actual strategy for training interdisciplinary teams with the associated curriculum to empower interdisciplinary frontline teams to measure, monitor, and manage their own performance. Useful for coaches as well as team members.
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Truly the best written and most useful textbook I have used in any Nursing program. I initially rented this book and decided to purchase it because it is such an excellent reference. Presents a practical, step-by-step approach to improvement with real life examples.
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By Wild Bill on January 9, 2010
Format: Paperback Verified Purchase
If you have no significant experience in performance improvement, this is probably a good investment. I purchased on the recommendation at a meeting I attended. I've been in health system mgmt for about 15 yrs. Did pick up a couple ideas, but wasn't really worth the $50 paid for the used book.

Again, if you're new to mgmt, it's great. If you're experienced, you probably know this stuff already.

WB
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This is a great, helpful tool, written in textbook style. It is a bit of a "difficult" read, in that it is written in a very textbook-y, research-paper style. However, it is very informative, and will be extremely helpful to me in my work. After having read the whole thing, I would recommend that you read Part 2 first, then Part 1. Part 2 is more of a "how to" where Part 1 is much more theory.
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This is a terrific guide to quality improvement in health care systems. It contains specific advice on how to assess a clinical microsystem for improvement opportunities and how to go about addressing them. This is not a weighty academic tome to be perused and then set aside on a bookshelf-- it is full of practical ideas and tips you can use starting tomorrow. Quality improvement is a contact sport and Nelson, Batalden, and Godfrey draw on their decades of experience in the trenches to guide the reader to become a do-er. Their real world examples will leave you energized and excited to see what you can accomplish--starting tomorrow.
Patrick B Herson MD
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Excellent guide to those interested in designing healthcare systems
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