Every Number Has A Story
Marjorie M. Godfrey
System Levels
Example
Frontline
Patient
Units
Microsystem
Nursing
Divisions
Mesosystem
Nursing
Services
Macrosystem
Source: Henriks, Bojestig, Jonkoping CC Sweden
Meta/Macro/Meso/Microsystem
Metasystem- County Council (Registries)
Improvement Actions
Registry Strategy
Back and forth
improvement planning
Macrosystem- Organizations
Measurement & Accountability
Align Strategy
MesosystemPathways for subpopulations
Align Measurement &
Accountability
Microsystem- Front Line
“Catch Ball” or “Be on the same team with the same goal”
Improvement Actions
Registry Strategy
Metasystem- County Council (Registries)
Macrosystem- Organizations
MesosystemPathways for subpopulations
Global Aim
The ‘big picture’
Global
Aim
3
Specific Aim
The ‘component
parts’
2
1
SDSA
3
Change Idea
2
Conceptual
Definition
‘The Measure’
1
PDSA
Operational
Definition
‘Specify &
Quantify’
A P
S D
A P
S D
A P
S D
Measures
Change Ideas
Specific Aim
Measurement
Plan
‘The How’
Measurement & Accountability
Meta/Macro/Meso/Microsystem
Global Aim
Theme
Assessment
Microsystem- Front Line
How Can Mr. Potato Head Bring Fun To Measurement?
What we will do…
• Successive PDSA cycles
• Simulate rapid cycle improvement
at the microsystem level
• Improve within separate microsystems
•Benchmark performance and utilize
collaborative structures to accelerate
improvement.
• Aggregate to higher system levels in real time