Wasson JH, Anders SG, Moore LG, et al. Clinical microsystems, part 2: Learning from micro practices about providing patients the care they want and need. Joint Commission Journal on Quality and Patient Safety. 2008 Aug;34(8):445-452.

Small, independent practices — micro practices — are incorporating attributes of successful microsystems such as patient focus, process improvement, performance patterns, and information technology to provide patients with the care they want and need.

Nelson EC, Godfrey MM, Batalden PB, et al. Clinical microsystems, part 1: The building blocks of health systems. Joint Commission Journal on Quality and Patient Safety. 2008 Jul;34(7):367-378.

The body of knowledge on clinical microsystems can guide and support innovation and peak performance. Patients move into and out of an assortment of clinical microsystems such as a family practitioner's office, an emergency department, and an intensive care unit — their own unique "health system." This patient-centric view of a health system is the foundation of second-generation development for clinical microsystems.

Berwick DM. The science of improvement. Journal of the American Medical Association. 2008 Mar;299(10):1182-1184.

Individuals most involved in day-to-day improvement work in health care fear that if "evidence" is too narrowly defined and the approach to gathering evidence too severely constrained, progress may be the victim. The author discusses the question, "How can accumulating local reports of effectiveness of improvement interventions... be reconciled with contrary findings from formal trials with their own varying imperfections?"

Chalice R
Milwaukee, Wisconsin: ASQ Quality Press; 2007

This book details 46 steps, based on Toyota Lean Production methods, that health care providers can implement to reduce waste, lower cost, and improve quality. Practical examples demonstrate how to directly apply these successful methods to health care.

Berwick DM, Kaplan M. "What's the ethics of that?" A conversation with Thomas O. Pyle. Health Affairs. 2008 Jan/Feb;27(1):143-150.

Thomas O. Pyle served in the top echelons of the Harvard Community Health Plan (HCHP) for nineteen years. In that time, HCHP became the largest health maintenance organization in New England, and its reputation for innovation and entrepreneurship rose to the top ranks of the industry. This interview explores Pyle’s background, his interpretation of HCHP’s evolution and eventual transition to a much different organization, and his recommendations for the future.

Howard DH, Siminoff LA, McBride V, Lin M. Does quality improvement work? Evaluation of the Organ Donation Breakthrough Collaborative. Health Services Research. 2007 Dec;42(6 Pt 1):2160-2173.

The Organ Donation Breakthrough Collaborative is an ongoing nationwide quality improvement initiative to encourage adoption of "best practices" for identifying potential donors and obtaining consent for deceased organ donation. The authors conclude that the Breakthrough Collaborative led to an increase in donation rates at participating hospitals.

McCannon CJ, Berwick DM, Massoud MR. The science of large-scale change in global health. Journal of the American Medical Association. 2007 Oct;298(16):1937-1939.

Innovation in health care and, in particular, the rapid spread of effective changes such as new medicines and innovations in health care delivery are often slowly and unreliably adopted. Innovations remain hidden in pockets around the globe, flourishing locally in settings where local problem solvers create effective new approaches to problems without reliably reaching those in need elsewhere. This article describes the science behind spreading large-scale changes in a global health care setting.

Langley J, Beasley C. Health Information Technology for Improving Quality of Care in Primary Care Settings. Prepared by the Institute for Healthcare Improvement for the National Opinion Research Center under contract No. 290-04-0016. AHRQ Publication No. 07-0079-EF. Rockville, Maryland: Agency for Healthcare Research and Quality; July 2007.

This report examines the link between health information technology (IT) and quality improvement in a range of primary care settings. The report finds that most current health IT systems have a long way to go before they encompass the functionality that would support robust ongoing improvement of care. Health IT adoption must go hand-in-hand with the implementation of a robust care model and the routine use of solid improvement methods by clinicians and other staff.

Lloyd RC. "In God we trust; all others bring data." Frontiers of Health Service Management. 2007 Summer;23(4):33-38; discussion 43-45.

In this commentary on the lead articles about creating a meaningful and efficient performance measurement system in health care, the author discusses how the scientific method lies at the heart of all good research. The challenge is to have knowledge of the tools and methods, and to know which tool is right to use to solve a particular problem at hand.

Lynn J, Straube BM, Bell KM, Jencks SF, Kambic RT. Using population segmentation to provide better health care for all: The “Bridges to Health” model. The Milbank Quarterly. 2007 June;85(2):185-208.

The “Bridges to Health” model discussed in this article divides the population into eight groups, each with its own definitions of optimal health and its own priorities among services. Interpreting these population-focused priorities in the context of the Institute of Medicine’s six goals for quality (from the “Crossing the Quality Chasm” 2001 report) yields a framework that could shape planning for resources, care arrangements, and service delivery, thus ensuring that each person’s health needs can be met effectively and efficiently.

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