The Introduction of Clinical Microsystems into an Emergency Department.
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The provision of high quality care is the responsibility of all healthcare staff, but in today’s climate of ever decreasing budgets and resources it is even more important. The Emergency Medicine programme (EMP) has been charged by the Health Service Executive (HSE) to revolutionise the way emergency departments (ED) provide care in an effort to reduce the patient experience times in the ED. The overarching aim of the EMP is the provision of safe quality care , and one of the methodologies for achieving this aim is the use of systems management tools, the Emergency Medicine Programme recommends the use of Clinical Microsystems (microsystems). This change project centres on the implementation and use of microsystems within an emergency department and describes the processes involved in its implementation into practice. The HSE change model based on an organisational approach was used as a framework to guide the change into practice. The Stufflebeam (CIPP) evaluation model was used to assess the success of both the implementation of microsystems into practice and evaluate the resultant improvements in patient care. A number of quality improvement projects were undertaken and these have been assessed and evaluated by the group. Both the improvement team and the wider departmental staff are in agreement that clinical microsystems has improved patient care and allowed ownership of quality improvement initiatives by staff in the department as evidenced by the literature. The evaluation of the project has provided for the continued use of clinical microsystems in the department.