ABSTRACT: Health care is a service industry. A fundamental attribute of many successful service industries is the "small replicable unit (SRU)." There are three essential elements of an SRU:

1. the smallest core unit of activity,
2. micromeasures designed to help manage the core activities, and
3. combinations of the activities and measures to match local customer needs.

We describe a model for geriatric care based on "SRU thinking." We demonstrate how this approach places measurement of patient values, clinical improvement strategies, and research objectives into day-to-day health care delivery.

To generate fast results, we make available the Dartmouth COOP Clinical Improvement System (DCCIS) on the internet. For this, you add five questions to the basic survey and see the results after a month or two. You examine the results for subgoups of patients who have different problems, etc.