The clinical microsystems approach: Does it really work? A systematic review of organizational theories of health care practices.

Journal of the American Pharmacists Association : JAPhA
André CôtéClémence Dallaire

Abstract

Faced with increased expectations regarding the quality and safety of health care delivery systems, a number of stakeholders are increasingly looking for more efficient ways to deliver care. This study was conducted to provide a critical appraisal and synthesize the best available evidence on the impact of implementing clinical microsystems (CMS) on the quality of care and safety of the health care delivery. A comprehensive and systematic search of 6 electronic databases, from 1998 to 2018, was conducted to identify empirical literature published in both English and French, evaluating the impact of implementing CMS in health care settings. We included all study designs that evaluate the impact of implementing CMS in health care settings. Independent reviewers screened abstracts, read full texts, extracted data from the included studies, and appraised the methodological quality. Of the 1907 records retrieved, 35 studies met the inclusion criteria. The settings included general practice clinics (n = 18), specialized care units (n = 14), and emergency and ambulatory units (n = 3). The implementation of CMS helped to develop the patient-centered approach, promote interdisciplinarity and quality improvement skills, increase the flui...Continue Reading

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