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For the most part efforts to improve quality and value have overlooked the functional front-line units -- where patients and providers meet -- as a high leverage area. This article focuses on these front line units, called clinical microsystems, and describes current research on key characteristics, quality outcomes, and cost-efficiencies of high-performing clinical units. Twenty microsystems, representing different parts of the health care continuum, were selected for study. The research design was observational, using qualitative methods such as personal interviews and direct observations supplemented by reviews of financial information and medical charts.

Executive Summary for Health Care Leaders
Microsystems in Health Care:
The Essential Building Blocks of High Performing Systems

Research Project Supported by the Robert Wood Johnson Foundation
RWJ Grant Number 036103
November 30, 2001