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Quality by Design: A Clinical Microsystems Approach - Second Edition

The new second edition features the microsystem model expansion into the meso and macrosystem structures, processes, roles, and outcomes.  Exploring coproduction of care for populations of patients, identifying new innovative health care professional education and examining key vertical and horizontal measurement to provide critical dashboards to monitor, sustain and continue improvement at the front line and pathways of care. Leadership wisdom and expertise is offered by Dr. Paul Batalden and Professor Emeritus Edgar H. Schein.  New case studies in each of the chapters bring the fundamental micro-meso and macrosystem concepts to life. Each chapter includes learning objectives, activities, exercises, and discussion topics.

Expected release is June 2018.

Quality by Design: A Clinical Microsystems Approach

"Quality by Design: A Clinical Microsystems Approach" offers a new and unique approach to an old problem: how to redesign health services processes to improve quality, add value, reduce variation, and improve morale, in such a way that frontline caregivers lead the process of change, rather than obey it. The book is a practical reflection of research and applied training conducted at Dartmouth Medical School under the leadership of Paul Batalden, Eugene Nelson, and Marjorie Godfrey.

Value by Design: Developing Clinical Microsystems to Achieve Organizational Excellence

“Value by Design: Developing Clinical Microsystems to Achieve Organizational Excellence” is a practical guide for real-world improvement in clinical microsystems. Clinical microsystem theory, as implemented by the Institute for Healthcare Improvement and health care organizations nationally and internationally, is the foundation of high-performing front line health care teams who achieve exceptional quality and value. These authors combine theory and principles to create a strategic framework and field-tested tools to assess and improve systems of care. Their approach links patients, families, health care professionals and strategic organizational goals at all levels of the organization: micro, meso and macrosystem levels to achieve the ultimate quality and value a health care system is capable of offering.

Case Studies In Patient Safety: Foundations for Core Competencies

This unique compendium of case studies on patient safety – told from the perspective of the patient and family – illustrates 24 stories of preventable health care errors that led to irreparable patient harm. The reader is guided through a structured analysis of the events, eliciting lessons learned and strategies for preventing similar events in the future. Learning objectives for each case facilitate the reader’s development of a set of core competencies related to improving safety and quality of health care. Students of the health professions including medicine, nursing, pharmacy, health administration, public health, as well as practicing professionals such as patient safety officers, chief quality officers, risk managers, and health service researchers will gain valuable insight into the real-world of medical errors and a better understanding of how they can be prevented through practical, actionable methods.

Sustainably Improving Health Care: Creatively Linking Care Outcomes, System Performance and Professional Development

"Sustainably Improving Health Care: Creatively Linking Care Outcomes, System Performance and Professional Development (Culture, Context and Quality in Health Sciences Research, Education, Leadership and Patient Care)" promotes the importance of integrating improved care outcomes, system performance, and professional development so that the future of health care advancement is creative and sustainable.

It addresses the challenge of creating and nurturing a culture of continuous improvement that is able to sustain and generate creative professional work for the improvement of health care. Using real-world examples, the book succinctly reveals how the model can be practically applied from a variety of different perspectives.

Lessons Learned in Changing Healthcare…and How We Learned From Them

The pressure for changing healthcare is evident everywhere. Newly available data on excessive variation in quality, safety and cost are present in academic publications, disease registries, national scientific organizational reports, government-mandated reports and the published articles of numerous commissions and task groups. Personal experiences of disappointed patients, families and communities add a sense of urgency to the need for change. All around us, people are at work leading change in healthcare. All of these leaders have a journey of experience from which they have learned (and are learning!) lessons. The lessons have developed in response to the wide variety of publicly available information, perceived challenges and conflicts, co-workers desire for meaning and joy in work and personal recognition of better alternatives to the present situation all part of the lived experience of leaders.

Practice Based Learning and Improvement: A Clinical Improvement Action Guide. 2nd Edition

In microsystem thinking, the quality and value of care produced by a large health system can be no better than the services generated by the small systems of which it is composed. This new edition of a best-selling book explains how to integrate clinical microsystems and practice-based learning into your own organization.

From Front Office to Front Line: Essential Issues for Health Care Leaders, Leading the Macrosystem and Mesosystem for Microsystem Peak Perfo

From Front Office to Front Line: Essential Issues for Health Care Leaders released October, 2005 by the Joint Commission Resources features the chapter, Leading the Macrosystem and Mesosystem for Peak Microsystem Performance . This essential reading written by Paul Batalden, Eugene Nelson, Paul Gardent and Marjorie Godfrey discusses how health care leaders can achieve and sustain measurable quality and safety results at all levels of the organization. They present a useful summary of leadership frameworks and offer a practical outline of how to lead at the macrosystem level.

Friends' Books

Helping: How to Offer, Give and Receive Help

Helping is a fundamental human activity, but it can also be a frustrating one. All too often our sincere offers of help are resented, resisted, or refused—and we often react the same way when people try to help us. In this seminal book on the topic—named one of the top five leadership books of 2009 by strategy+business magazine—Edgar Schein analyzes the social and psychological dynamics common to all types of helping relationships, explains why help is often not helpful, and shows what any would-be helpers must do to ensure that their assistance is both welcomed and genuinely useful. Using examples from many types of relationships—doctors and patients, consultants and clients, husbands and wives—Schein offers specific techniques and illuminating examples that help us determine what type of help to offer and how best to offer it in any situation. These techniques not only apply to all kinds of one-on-one helping in personal and professional relationships, teaching, social work, and medicine but also can be usefully applied to teamwork and to organizational leadership.

Humble Inquiry: The Gentle Art of Asking Instead of Telling

Communication is essential in a healthy organization. But all too often when we interact with people—especially those who report to us—we simply tell them what we think they need to know. This shuts them down. To generate bold new ideas, to avoid disastrous mistakes, to develop agility and flexibility, we need to practice Humble Inquiry.

Ed Schein defines Humble Inquiry as “the fine art of drawing someone out, of asking questions to which you do not know the answer, of building a relationship based on curiosity and interest in the other person.” In this seminal work, Schein contrasts Humble Inquiry with other kinds of inquiry, shows the benefits Humble Inquiry provides in many different settings, and offers advice on overcoming the cultural, organizational, and psychological barriers that keep us from practicing it.

Humble Consulting: How to Provide Real Help Faster

Organizations face challenges today that are too messy and complicated for consultants to simply play doctor: run a few tests, offer a neat diagnosis of the “problem,” and recommend a solution. Edgar Schein argues that consultants have to jettison the old idea of professional distance and work with their clients in a more personal way, emphasizing authentic openness, curiosity, and humility. Schein draws deeply on his own decades of experience, offering over two dozen case studies that illuminate each stage of this humble consulting process. Just as he did with Process Consultation nearly fifty years ago, Schein has once again revolutionized the field, enabling consultants to be more genuinely helpful and vastly more effective.

Organizational Culture and Leadership, Fourth Edition

Regarded as one of the most influential management books of all time, this fourth edition of Leadership and Organizational Culture transforms the abstract concept of culture into a tool that can be used to better shape the dynamics of organization and change. This updated edition focuses on today's business realities. Edgar Schein draws on a wide range of contemporary research to redefine culture and demonstrate the crucial role leaders play in successfully applying the principles of culture to achieve their organizational goals.

Difficult Conversations: How to Discuss What Matters Most

We attempt or avoid difficult conversations every day-whether dealing with an underperforming employee, disagreeing with a spouse, or negotiating with a client. From the Harvard Negotiation Project, the organization that brought you Getting to Yes, Difficult Conversations provides a step-by-step approach to having those tough conversations with less stress and more success. you'll learn how to:

  • Decipher the underlying structure of every difficult conversation 
  • Start a conversation without defensiveness 
  • Listen for the meaning of what is not said 
  • Stay balanced in the face of attacks and accusations
  • Move from emotion to productive problem solving
Thanks for the Feedback

Douglas Stone and Sheila Heen have spent the past fifteen years working with corporations, nonprofits, governments, and families to determine what helps us learn and what gets in our way. In Thanks for the Feedback, they explain why receiving feedback is so crucial yet so challenging, offering a simple framework and powerful tools to help us take on life’s blizzard of offhand comments, annual evaluations, and unsolicited input with curiosity and grace. They blend the latest insights from neuroscience and psychology with practical, hard-headed advice. Thanks for the Feedback is destined to become a classic in the fields of leadership, organizational behavior, and education.

Getting Together: Building a Relationship that Gets to Yes

Expanding on the principles, insights and wisdom that made GETTING TO YES a worldwide bestseller, Roger Fisher and Scott Brown offer a straightforward approach to creating relationships that can deal with difficulties as they arise. GETTING TOGETHER takes you step-by-step through initiating, negotiating, and sustaining enduring relationships ― in business, in government, between friends and in the family. The Steps: Rationality ― Balance emotion with reason. Understanding ― Learn how others see things. Communication ― Always consult before deciding…and listen. Reliability ― Be wholly trustworthy, but not wholly trusting. Persuasion, not coercion ― Negotiate side by side. Acceptance ― Deal seriously, with those with whom you differ.

Getting to Yes: Negotiating Agreement without Giving In

Getting to Yes offers a proven, step-by-step strategy for coming to mutually acceptable agreements in every sort of conflict. Thoroughly updated and revised, it offers readers a straight- forward, universally applicable method for negotiating personal and professional disputes without getting angry-or getting taken.

The Fifth Discipline Fieldbook: Strategies and Tools for Building a Learning Organization

Senge's best-selling The Fifth Discipline led Business Week to dub him the "new guru" of the corporate world; here he offers executives a step-by-step guide to building "learning organizations" of their own.

The TEAM Handbook, Third Edition

Oriel STAT A MATRIX's Team Handbook is the foremost resource on teamwork for both leaders and team members. Having sold over 1,300,000 copies of the first editions, the third edition offers new tools and strategies to help teams work well together. In February 2009, this book was featured in The 100 Best Business Books of All Time by Jack Covert and Todd Sattersten.

The Health Care Data Guide: Learning from Data for Improvement

The Health Care Data Guide is designed to help students and professionals build a skill set specific to using data for improvement of health care processes and systems. Even experienced data users will find valuable resources among the tools and cases that enrich The Health Care Data Guide. Practical and step-by-step, this book spotlights statistical process control (SPC) and develops a philosophy, a strategy, and a set of methods for ongoing improvement to yield better outcomes.

Provost and Murray reveal how to put SPC into practice for a wide range of applications including evaluating current process performance, searching for ideas for and determining evidence of improvement, and tracking and documenting sustainability of improvement. A comprehensive overview of graphical methods in SPC includes Shewhart charts, run charts, frequency plots, Pareto analysis, and scatter diagrams. Other topics include stratification and rational sub-grouping of data and methods to help predict performance of processes.

Illustrative examples and case studies encourage users to evaluate their knowledge and skills interactively and provide opportunity to develop additional skills and confidence in displaying and interpreting data.

10% Happier: How I Tamed the Voice in my Head

After having a nationally televised panic attack, Dan Harris knew he had to make some changes. A lifelong nonbeliever, he found himself on a bizarre adventure involving a disgraced pastor, a mysterious self-help guru, and a gaggle of brain scientists. Eventually, Harris realized that the source of his problems was the very thing he always thought was his greatest asset: the incessant, insatiable voice in his head, which had propelled him through the ranks of a hypercompetitive business, but had also led him to make the profoundly stupid decisions that provoked his on-air freak-out.

Eventually Harris stumbled upon an effective way to rein in that voice, something he always assumed to be either impossible or useless: meditation, a tool that research suggests can do everything from lower your blood pressure to essentially rewire your brain. 10% Happier takes readers on a ride from the outer reaches of neuroscience to the inner sanctum of network news to the bizarre fringes of America’s spiritual scene, and leaves them with a takeaway that could actually change their lives.

Accelerating Health Care Transformation with Lean and Innovation: The Virginia Mason Experience

Virginia Mason Medical Center (VMMC) was one of the first health care organizations to implement Lean and its methodologies. Other organizations have followed VMMC’s lead, but this world class organization still leads in the utilization of innovative Lean tools.

Accelerating Health Care Transformation with Lean and Innovation: The Virginia Mason Experience describes how VMMC has systematically integrated innovative structures, methods, and cultural practices into its implementation of Lean. Describing how your organization can create a strategy and build a culture of innovation and learning, it supplies concrete examples that show―not just conceptually, but through VMMC's actual experiences―how Lean and innovation can work hand-in-hand to incrementally improve and radically transform your value streams.

Explaining how to use the voices and experiences of patients and their families to drive improvement and innovation in new directions, the book supplies a clear understanding of how Lean can help you achieve your goals in today’s increasingly demanding marketplace.

Running Group Visits in Your Practice

Dr. Noffsinger is the foremost expert on and inventor of group visit models. This book/DVD package is the only comprehensive reference and implementation guide on the market with regard to group visit models. The group visit model is not only of interest to physicians: group vists may shape political and health care policy decisions in the near future.

Leadership Jazz: The Essential Elements of a Great Leader, Second Edition

Since it was first published to wide acclaim in 1992, the bestselling Leadership Jazz has firmly placed itself among the great business classics. Former President Bill Clinton called it “astonishing,” and the late Peter Drucker advised, “Read this slowly. This book is wisdom in action.”

Now updated for first time in well over a decade, this powerful book reveals why today, more than ever, leadership is more an art than a science. Today’s best leaders, De Pree says, are attuned to the needs and ideas of their followers, and even step aside at times to be followers themselves. Filled with insightful stories from De Pree’s experience as the chairman of Herman Miller and from people he’s met along the way, Leadership Jazz reveals how to:

• Hold people accountable and give them space to reach their potential
• See the needs of employees and those of the company as the same
• Inspire change and innovation
• Work effectively with creative people

Complete with an extensive new introduction from De Pree on why his philosophy is more relevant now than ever before, Leadership Jazz gives you an entirely new way to look at the difficult job of leader.

Bringing User Experience to Healthcare Improvement: The Concepts, Methods and Practices of Experience-Based Design

This work includes a foreword by lynne Maher. Head of Innovation Practice, NHS Institute for Innovation and Improvement, University Of Warwick, Coventry. "Experience Based Design" (EBD) is a new way of bringing about improvements in healthcare services by being user-focussed. Facilities, healthcare professionals, carers, family and friends are all involved in the patient experience and systems and policies need to adapt to take this into consideration. By exploring the underlying concepts, methods and practices of EBD, this exciting guide offers a unique approach to healthcare customer satisfaction. It offers recommendations for the future and many interesting points for discussion. It will be of great interest to health and social care management, particularly directors of service improvement in hospitals and directors of nursing, health and social care policy makers and shapers, and quality improvement and organisational development specialists in healthcare. Patient groups and national organisations, too will find the book inspirational. 'Experience based design-you cannot do without it. Read this book and it will change the way you think about providing health services for ever.' - Lynne Maher.

Organizing for Quality: The Improvement Journeys of Leading Hospitals in Europe and the United States

This challenging and highly practical book draws on the findings from an international study designed to help practitioners and researchers understand the factors and processes that enable healthcare organizations in the United States and Europe to achieve—and sustain—high quality services for their users. The in-depth case-studies from seven leading hospitals give an international, evidence-based outlook that focuses on both the organizational and cultural processes of quality improvement. Implication for research and practice are considered, and a checklist of possible challenges has been drawn up to help identify any 'gaps' in initiatives. Healthcare policy makers and shapers including hospital chief executives and NHS directors will find this book enlightening, as will healthcare quality improvement and service development researchers and professionals. Clinicians with an interest in quality improvement will also find much of interest.

The Best Practice: How The New Quality Movement is Transforming Medicine

Americans have always thought their healthcare system was the best in the world. But starting in the late 1990s, shocking reports emerged that showed this was far from the truth. Treatment-related deaths or "complications" were found to be the fifth leading cause of death for Americans, and hundreds of thousands of patients were being harmed by botched medical procedures.

Spurred by the quality crisis, a group of visionary physicians led by Donald Berwick and Paul Batalden embarked on a study of industrial "quality improvement" techniques, daring to apply them to the practice of medicine despite resistance from the medical community. The Best Practice tells the story of this burgeoning movement, and of how the medical landscape is being radically transformed—for the better.

Getting to Maybe: How the World is Changed

"A practical, inspirational, revolutionary guide to social innovation" from our friend and colleague, Brenda Zimmerman. Brenda continues to explore complexity science and expand our thinking and actions in complex systems.

Improving Primary Care: Strategies and Tools for a Better Practice

A friend of our clinical microsystem community, Tom Bodenheimer and his colleague Kevin Grumbach "offers frank appraisals and concrete recommendations for primary care practitioners on how to meet the huge, stress-inducing, challenges that they face on a daily basis. The authors offer innovative approaches and suggestions to dealing with primary care issues ranging from the latest electronic technologies to non-traditional options for the patient-physician encounter."

The Small Book about Large System Change

This book tells the story about the creating of large system change. The specific context and subject matter deals with primary health care in England, but the principles of such change and the lessons and insights learnt are generic. They have relevance and offer great potential for other sectors and contexts.

How the Way We Talk Can Change the Way We Work

Why is the gap so great between our hopes, our intentions, even our decisions-and what we are actually able to bring about? Even when we are able to make important changes-in our own lives or the groups we lead at work-why are the changes are so frequently short-lived and we are soon back to business as usual? What can we do to transform this troubling reality?

In this intensely practical book, Harvard psychologists Robert Kegan and Lisa Laskow Lahey take us on a carefully guided journey designed to help us answer these very questions. And not just generally, or in the abstract. They help each of us arrive at our own particular answers that can solve the puzzling gap between what we intend and what we are able to accomplish. How the Way We Talk Can Change the Way We Work provides you with the tools to create a powerful new build-it-yourself mental technology.