The Problem

Quality of patient care is a trans-disciplinary responsibility.  Quality of patient care in the USA is declining.  Complexity in health care delivery and the nursing shortage are commonly cited causes for this decline. Many health care systems have strived without results to resolve this problem through administration reorganization.  Health care systems are analogous to a large oak tree whose vitality and growth stems from the trunk of the tree-- the patient units comprise the trunk of the health care system.  The Institute of Medicine (IOM) emphasized the importance of assessing patient units or micro-systems as a vital step in providing quality of patient care.

The Plan

IOM performed a study to identify the major parameters of a micro-system.  The outcome of the study listed the following 14 parameters of a micro-system analysis:  investment improvement, alignment of roles and training, constancy of purpose, values, organizational support, interdependence of the health care team, connection to the community, micro-system outcome measures, use of technology, barriers, resource replication, evidence of micro-system, improvement, and leadership.  Each of the 14 parameters were rated as low, moderate, or high based on the supporting evidence for each parameter.  The study served as a blueprint for clinical leadership across the disciplines involved in health care delivery.

The Project

The clinical nurse leader is the newest master's role in nursing in the USA and has the charge of providing clinical leadership for the trans-diciplinary health care team.  This project presents the results and implications of four clinical nurse leaders who performed a micro-system analysis on the their units. 

Implications

The micro-system analysis will provide a model for other clinical leaders in health care to improve quality of patient care on the micro-system and, consequently, improve quality of patient care by all disciplines in the health care facility.