Understanding the complexity of redesigning care around the clinical microsystem

P. Barach*, J. K. Johnson

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

93 Scopus citations


The microsystem is an organizing design construct in which social systems cut across traditional discipline boundaries. Because of its interdisciplinary focus, the clinical microsystem provides a conceptual and practical framework for simplifying complex organizations that deliver care. It also provides an important opportunity for organizational learning. Process mapping and microworld simulation may be especially useful for redesigning care around the microsystem concept. Process mapping, in which the core processes of the microsystem are delineated and assessed from the perspective of how the individual interacts with the system, is an important element of the continuous learning cycle of the microsystem and the healthcare organization. Microworld simulations are interactive computer based models that can be used as an experimental platform to test basic questions about decision making misperceptions, cause-effect inferences, and learning within the clinical microsystem. Together these tools offer the user and organization the ability to understand the complexity of healthcare systems and to facilitate the redesign of optimal outcomes.

Original languageEnglish (US)
Pages (from-to)i10-i16
JournalQuality and Safety in Health Care
Issue numberSUPPL. 1
StatePublished - Dec 2006

ASJC Scopus subject areas

  • Health Policy


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