Marjorie M. Godfrey, PhD, MS, BSN, FAAN, Founding Executive Director, the Institute for Excellence in Health and Social Systems, Research Professor, Department of Nursing, University of New Hampshire. Affiliate Professor Jönköping University, Jönköping Sweden. Previously Founding Co-Director Dartmouth Institute Microsystem Academy, Geisel School of Medicine, Dartmouth College. Tina C. Foster, MD, MPH, MSc, Professor of Obstetrics and Gynecology, Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Professor of The Dartmouth Institute, Geisel School of Medicine at Dartmouth. Previously Co-Director Dartmouth Institute Microsystem Academy, Geisel School of Medicine, Dartmouth College. Julie K. Johnson, MSPH, PhD, Professor Department of Surgery and Center for Healthcare Studies Northwestern University Eugene C. Nelson, DSc, MPH, Professor of Community and Family Medicine, Geisel School of Medicine at Dartmouth, and The Dartmouth Institute for Health Policy and Clinical Practice. Director of Population Health and Measurement, The Dartmouth Institute. Paul B. Batalden, MD, Professor Emeritus, The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College.

• Tables, Figures, and Exhibits xiiiForeword xxiPreface xxvAcknowledgments xxixThe Editors xxxiiiThe Contributors xxxixIntroduction xli1 Clinical Microsystems – Success Characteristics of High-Performing Microsystems 1Julie K. Johnson, Marjorie M. Godfrey, Boel Andersson- Gäre, Susanne Kvarnström, Tina C. Foster2 Developing High-Performing Microsystems 37Marjorie M. Godfrey, Tina C. Foster, Steve Harrison, Martin J. Wildman, Julie K. Johnson3 Leading Improvement of Healthcare Service Systems: Microsystems, Mesosystems, and Macrosystems 71Paul B. Batalden, Edgar H. Schein, Don Caruso, Marjorie M. Godfrey, Tina C. Foster, Julie K. Johnson4 Developing Professionals and Improving Work Life 111Marjorie M. Godfrey, Tina C. Foster, Gay L. Landstrom, Joan Clifford, Julie K. Johnson5 Transforming a Primary Care Clinic to an NCQA- Certified Patient- Centered Medical Home 145Marjorie M. Godfrey, Tina C. Foster, Randy Messier, Julie K. Johnson6 Partnership within the Clinical Microsystem’s Framework: Coproducing Good Outcomes with Patients and Families 189Maren Batalden, Julie K. Johnson, Cristin Lind, Helena Hvitfeldt, Paul B. Batalden, Tina C. Foster, Marjorie M. Godfrey7 Improving Patient Safety and Reliability 217Julie K. Johnson, Paul R. Barach, Gautham K. Suresh, Tanya Lord, Marjorie M. Godfrey, Tina C. Foster8 Creating an Actionable Healthcare Information Environment to Inform Intelligent Action 251Brant J. Oliver, Eugene C. Nelson, John N. Mecchella, AnnMarie R. Hess, Marjorie M. Godfrey, Tina C. Foster, Julie K. Johnson9 Interprofessional Education and the Clinical Microsystem 299Tina C. Foster, Paul N. Uhlig, Brant J. Oliver, Gay L. Landstrom, Julie K. Johnson, Marjorie M. Godfrey10 The New Frontier of System Improvement – Mesosystems 333Marjorie M. Godfrey, Tom Downes, Steve Harrison, Julie K. Johnson, Tina C. FosterAfterword 367Appendix: Accelerating Improvement in Clinical Mesosystems 375Glossary 477Name Index 495Subject Index 501

Marjorie M. Godfrey, PhD, MS, BSN, FAAN, Founding Executive Director, the Institute for Excellence in Health and Social Systems, Research Professor, Department of Nursing, University of New Hampshire. Affiliate Professor Jönköping University, Jönköping Sweden. Previously Founding Co-Director Dartmouth Institute Microsystem Academy, Geisel School of Medicine, Dartmouth College. Tina C. Foster, MD, MPH, MSc, Professor of Obstetrics and Gynecology, Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Professor of The Dartmouth Institute, Geisel School of Medicine at Dartmouth. Previously Co-Director Dartmouth Institute Microsystem Academy, Geisel School of Medicine, Dartmouth College. Julie K. Johnson, MSPH, PhD, Professor Department of Surgery and Center for Healthcare Studies Northwestern University Eugene C. Nelson, DSc, MPH, Professor of Community and Family Medicine, Geisel School of Medicine at Dartmouth, and The Dartmouth Institute for Health Policy and Clinical Practice. Director of Population Health and Measurement, The Dartmouth Institute. Paul B. Batalden, MD, Professor Emeritus, The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College.

• Tables, Figures, and Exhibits xiiiForeword xxiPreface xxvAcknowledgments xxixThe Editors xxxiiiThe Contributors xxxixIntroduction xli1 Clinical Microsystems – Success Characteristics of High-Performing Microsystems 1Julie K. Johnson, Marjorie M. Godfrey, Boel Andersson- Gäre, Susanne Kvarnström, Tina C. Foster2 Developing High-Performing Microsystems 37Marjorie M. Godfrey, Tina C. Foster, Steve Harrison, Martin J. Wildman, Julie K. Johnson3 Leading Improvement of Healthcare Service Systems: Microsystems, Mesosystems, and Macrosystems 71Paul B. Batalden, Edgar H. Schein, Don Caruso, Marjorie M. Godfrey, Tina C. Foster, Julie K. Johnson4 Developing Professionals and Improving Work Life 111Marjorie M. Godfrey, Tina C. Foster, Gay L. Landstrom, Joan Clifford, Julie K. Johnson5 Transforming a Primary Care Clinic to an NCQA- Certified Patient- Centered Medical Home 145Marjorie M. Godfrey, Tina C. Foster, Randy Messier, Julie K. Johnson6 Partnership within the Clinical Microsystem’s Framework: Coproducing Good Outcomes with Patients and Families 189Maren Batalden, Julie K. Johnson, Cristin Lind, Helena Hvitfeldt, Paul B. Batalden, Tina C. Foster, Marjorie M. Godfrey7 Improving Patient Safety and Reliability 217Julie K. Johnson, Paul R. Barach, Gautham K. Suresh, Tanya Lord, Marjorie M. Godfrey, Tina C. Foster8 Creating an Actionable Healthcare Information Environment to Inform Intelligent Action 251Brant J. Oliver, Eugene C. Nelson, John N. Mecchella, AnnMarie R. Hess, Marjorie M. Godfrey, Tina C. Foster, Julie K. Johnson9 Interprofessional Education and the Clinical Microsystem 299Tina C. Foster, Paul N. Uhlig, Brant J. Oliver, Gay L. Landstrom, Julie K. Johnson, Marjorie M. Godfrey10 The New Frontier of System Improvement – Mesosystems 333Marjorie M. Godfrey, Tom Downes, Steve Harrison, Julie K. Johnson, Tina C. FosterAfterword 367Appendix: Accelerating Improvement in Clinical Mesosystems 375Glossary 477Name Index 495Subject Index 501

Marjorie M. Godfrey, PhD, MS, BSN, FAAN, Founding Executive Director, the Institute for Excellence in Health and Social Systems, Research Professor, Department of Nursing, University of New Hampshire. Affiliate Professor Jönköping University, Jönköping Sweden. Previously Founding Co-Director Dartmouth Institute Microsystem Academy, Geisel School of Medicine, Dartmouth College. Tina C. Foster, MD, MPH, MSc, Professor of Obstetrics and Gynecology, Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Professor of The Dartmouth Institute, Geisel School of Medicine at Dartmouth. Previously Co-Director Dartmouth Institute Microsystem Academy, Geisel School of Medicine, Dartmouth College. Julie K. Johnson, MSPH, PhD, Professor Department of Surgery and Center for Healthcare Studies Northwestern University Eugene C. Nelson, DSc, MPH, Professor of Community and Family Medicine, Geisel School of Medicine at Dartmouth, and The Dartmouth Institute for Health Policy and Clinical Practice. Director of Population Health and Measurement, The Dartmouth Institute. Paul B. Batalden, MD, Professor Emeritus, The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College.

• Tables, Figures, and Exhibits xiiiForeword xxiPreface xxvAcknowledgments xxixThe Editors xxxiiiThe Contributors xxxixIntroduction xli1 Clinical Microsystems – Success Characteristics of High-Performing Microsystems 1Julie K. Johnson, Marjorie M. Godfrey, Boel Andersson- Gäre, Susanne Kvarnström, Tina C. Foster2 Developing High-Performing Microsystems 37Marjorie M. Godfrey, Tina C. Foster, Steve Harrison, Martin J. Wildman, Julie K. Johnson3 Leading Improvement of Healthcare Service Systems: Microsystems, Mesosystems, and Macrosystems 71Paul B. Batalden, Edgar H. Schein, Don Caruso, Marjorie M. Godfrey, Tina C. Foster, Julie K. Johnson4 Developing Professionals and Improving Work Life 111Marjorie M. Godfrey, Tina C. Foster, Gay L. Landstrom, Joan Clifford, Julie K. Johnson5 Transforming a Primary Care Clinic to an NCQA- Certified Patient- Centered Medical Home 145Marjorie M. Godfrey, Tina C. Foster, Randy Messier, Julie K. Johnson6 Partnership within the Clinical Microsystem’s Framework: Coproducing Good Outcomes with Patients and Families 189Maren Batalden, Julie K. Johnson, Cristin Lind, Helena Hvitfeldt, Paul B. Batalden, Tina C. Foster, Marjorie M. Godfrey7 Improving Patient Safety and Reliability 217Julie K. Johnson, Paul R. Barach, Gautham K. Suresh, Tanya Lord, Marjorie M. Godfrey, Tina C. Foster8 Creating an Actionable Healthcare Information Environment to Inform Intelligent Action 251Brant J. Oliver, Eugene C. Nelson, John N. Mecchella, AnnMarie R. Hess, Marjorie M. Godfrey, Tina C. Foster, Julie K. Johnson9 Interprofessional Education and the Clinical Microsystem 299Tina C. Foster, Paul N. Uhlig, Brant J. Oliver, Gay L. Landstrom, Julie K. Johnson, Marjorie M. Godfrey10 The New Frontier of System Improvement – Mesosystems 333Marjorie M. Godfrey, Tom Downes, Steve Harrison, Julie K. Johnson, Tina C. FosterAfterword 367Appendix: Accelerating Improvement in Clinical Mesosystems 375Glossary 477Name Index 495Subject Index 501