Chronic Illness & Clinical Microsystems

IHP 505: Leadership in Clinical Microsystems Project Guidelines and Grading Guide



The final project for this course is the creation of an ideal clinical microsystem. During the coming weeks, you will be focused on various aspects of designing, implementing, and measuring the outcomes of a clinical microsystem to meet the needs of a patient living with a common chronic illness. During Module Ten, you will be responsible for presenting your ideal clinical microsystem to your peers in the course room. The process of designing and proposing methodologies for the implementation and evaluation of your clinical microsystem will require that you complete four project components throughout this course.

Final project grades will be awarded on the basis of your completed project that will be submitted during week eight of the semester, and the presentation of your project to 4–6 of your peers during week 9 (see grading rubric for details).



To successfully complete this project, you will be expected to apply what you have learned in this course and should include several of the following course objectives:

  1. Promotes positive and effective change and transformation within health care organizations
  2. Promotes innovation in strategic planning and health care administration strategies for optimal organizational performance
  3. Creates an environment grounded in ethical decision-making related to current health policy at the local, national, and international level
  4. Promotes a culture of lifelong learning across all levels of health care organizations
  5. Integrates the concepts of critical thinking, collaboration, and respect for diverse opinions into personal and organizational communication systems
  6. Incorporates effective evidence-based practices into efforts to improve administration and leadership within health care organizations


Main Elements

Course Project Paper (20 points)

Part One: Exploring Generative Relationships Through the Application of STAR for Chronic Care

In November 2003, the Centers for Medicare and Medicaid and The Joint Commission began to work to precisely and completely align these common measures for the care of patients with common chronic medical conditions so that they are identical. This resulted in the creation of one common set of measure specifications documentation known as the Specifications Manual for National Hospital Inpatient Quality Measures to be used by both organizations. The manual contains a common (i.e., identical) data dictionary, measure information forms, algorithms, etc. The goal is to minimize data collection efforts for these common measures and focus efforts on the use of data to improve the health care delivery process.

For this part of the course project, you will utilize the Joint Commission website to review the established core measures and select from this list a common chronic condition that will serve as the framework for this course project. This section of the project will be 4–6 pages of the final project paper, due at the end of Module Eight.

  1. Provide a brief, general summary of the chronic medical condition you have chosen, including the frequency of this condition, age at onset, major symptoms, and care needs.
  2. Identify the key relationships that must be engaged in providing care for patients living with this chronic condition. These relationships can be with individuals or institutions, and they can be internal or external to the primary care setting.
  3. Your paper must include a diagram that plots each of these relationships using the STAR model to depict an ideal clinical microsystem model of care for patients living with this chronic illness.
  4. You are expected to utilize scholarly research to support your writing. Your paper must contain 3–5 references related to the care needs of patients with the chronic condition that you have chosen as the focal point for this course project.


Part Two: Barriers to Achieving Generative Relationships

Based upon the application of the generative relationships that you developed using the STAR model reflect upon the potential barriers that related to the implementation and maintenance of these relationships and the consequences to patient care that may result. Propose strategies for overcoming these barriers.


This chapter of your course project should be 2–4 pages in length and contain a minimum of 3 scholarly references that describe challenges.

Part Three: Using Measurement to Improve Health Care Value

Utilize the Clinical Value Compass (CVC) (unit of analysis is the patient or population) to describe a balanced approach to measure and display health care in the microsystem that you have designed to meet the needs of patients with a chronic care condition. For this assignment, you must include a diagram of Side A and Side B of the Clinical Value Compass (Nelson et al., Chapter 4, pages 156–157) for your proposed clinical microsystem. In addition, you must complete a Balanced Scorecard which should provide measures to assess if the system is meeting the members’ needs while matching up with the strategic plan and larger organizational vision. The discussion portion of this assignment should include an explanation of the four points of success, including:


  1. Strategic learning and innovation. To achieve your vision, how will your microsystem sustain its ability to change and improve as fast as care needs require?
  2. Key processes. To satisfy health care consumers, what key processes must your microsystem perfect?
  3. Customers’ view of goodness. How should your microsystem appear to customers? Does the microsystem instill feelings of honesty, competence, and integrity?
  4. Financial Results. To succeed financially, how should your microsystem appear to shareholders and board members?


This chapter of your course project should be 4–6 pages in length and contain a minimum of 5 scholarly references that describe principles of measurement in clinical microsystems.


Part Four: Critiquing Data Collection Methodologies

Critique five research studies that focused on care of the patient population that you choose in microsystems. You will need to read five studies and provide a critique of the validity of the psychometric instrument that was used for data collection, the method that was used to deliver the instrument, and the measures that were taken to ensure accuracy, reliability, and freedom from bias. This paper should be 2–4 pages in length. Refer to this guide on how to prepare an annotated bibliography.


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