• Led by Sheffield Teaching Hospitals NHS Foundation Trust, in partnership with The Dartmouth Institute Microsystem Academy, Sheffield Health and Social Care NHS Foundation Trust, and Sheffield Children’s NHS Foundation Trust.
  • Based within Sheffield Teaching Hospitals and the Children’s Hospital.
  • Uses clinical microsystems methodology to help build improvement capacity into everyday frontline work.
  • Frontline staff are trained as improvement coaches and work with teams to help them improve the quality and value of care they deliver.

As health care needs continue to increase, the systems need to adapt to changing conditions and focus on providing value in care. A key question for many organisations is how to build quality improvement work into everyday frontline work – so that it is seen as ‘the way we do things around here’, rather than additional or optional aspects of work.

The clinical microsystems methodology was developed in the USA by The Dartmouth Institute, and has been used globally to develop sustainable health care improvements in quality of care and efficiency. Clinical microsystems are the building blocks of organisations such as hospitals and can be characterised as the small units where care happens with a group of patients, for example wards, outpatient clinics and diagnostic departments.

The Sheffield Microsystem Coaching Academy (MCA) is an innovative initiative where frontline staff train as improvement coaches and work with teams to help them improve the quality and value of care they deliver. They do this through understanding their systems and processes, and redesigning care through testing small changes.

The MCA course is five months long and coaches are expected to actively work with a microsystem team as they train. Four cohorts of the MCA have been run, with 84 coaches being trained and over 107 microsystem teams having been coached. Of those coaches trained, 62% are still actively coaching.

Many teams have been able to demonstrate measurable improvements, including reductions in waiting times in outpatient settings, and increased theatre productivity and efficiency.

Contact details

For further information about the project, please email Nick Miller, MCA Manager and MCA Faculty member.

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