Effective clinical teams are considered essential to the production of high-value systems of care particularly within primary care. The clinical microsystems framework is one approach to training primary care teams how to engage in quality improvement activities. From 2008 to 2014, a Microsystems approach was implemented with 58 primary care teams at a large Midwestern academic health care center that was aligning its primary care disciplines and embarking upon an ambitious primary care delivery system redesign. The UW PATH collaborative evaluated the implementation of the Microsystems approach using mixed methods and found that a microsystems approach is valuable for building team relationships and quality improvement skills but is challenged in a larger, diverse academic primary care context. Microsystem investment alone may faciliatte change but is not sufficient to respond to the challenges of a rapidly changing health care environment.
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