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Team-based Learning in Microsystems: An Organizational Model for Success
Paul Barach and Julie K. Johnson

Healthcare institutions are challenged to provide an environment for safe patient care within increasingly complex organizational and regulatory environments while striving to maintain financial viability. Furthermore, as complex, disorganized, and opaque systems, healthcare organizations may lead to patient discomfort and harm as well as much waste. The clinical microsystem can help organizations learn based on the smallest, fully functioning organizational element. Team-based organizational learning offers a useful and effective model to enhance and affect the culture of large organizations. The clinical microsystem provides a conceptual and practical framework for approaching organizational learning and delivery of care that allows organizational leaders to embed quality and safety into a microsystem’s developmental journey. Leaders can set the stage for making safety a priority for the organization while allowing individual microsystems to create innovative strategies for improvement. Microsystem theory can help in the evaluation and planning of organizational change. This model has implications for planning sustainable growth and stability. The microsytems’ team-based approach supports organizational analysis and enhances a culture of interdependency, accountability, shared learning and resources–thus enhancing organizational memory and practice.

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