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Table 2 Advanced and Integrated MicroSystems (AIMS) Interventions, Supporting Processes and Tools

From: Redesigning systems to improve teamwork and quality for hospitalized patients (RESET): study protocol evaluating the effect of mentored implementation to redesign clinical microsystems

Components

Descriptions

Supporting Processes and Tools

Unit-based Physician Teams

Localization of physicians to a minimal number of units on which they provide patient care

• Projecting expected patient volume

• Engaging stakeholders to redesign admission processes

• Monitoring progress and making adjustments

Unit Nurse-Physician Co-leadership

Collaborative model in which a nurse leader and physician leader are jointly responsible for quality improvement on their unit

• Co-leader selection and training

• Co-leader job descriptions and activities

• Establishing unit norms and values

• Co-leader integration into mesosystem activities

Enhanced Interprofessional Rounds

Interprofessional rounds, redesigned with input from frontline professionals to optimize collaboration and patient engagement

• Redesign work groups determine timing, format, duration, and location

• Discussions facilitated by unit co-leaders

• Roles / expectations of attendees defined

• Structured tools to support closed-loop communication

Unit-level Performance Reports

Performance reports designed to give unit leaders and frontline professionals relevant, interpretable, actionable data

• Monthly unit-level reports aligned with organizational priorities

• Daily reports to identify opportunities to improve care

• Just-in-time reports to identify opportunities to improve care

• Teamwork Climate survey reports

Patient Engagement Activities

Methods to continually inform and engage patients and families as partners in care

• Use of whiteboards to define goals and the daily care plan

• Patient experience rounds by unit co-leaders

• Conducting Interprofessional Rounds and nurse shift reports at bedside