Region Jnkpings ln The Microsystem Festival

The Microsystem Festival 2018
- Program, Detailed Information


Pre-Festival Day - February 27

A day consisting of several selectable streams:


Exploring coaching session on micromastery - Part 1: Making Sense

Time: 9.30  – 12.30
Place: Qulturum, House B4, Ryhov County Hospital, Jönköping


9.30 Registration

10.00 – 12.30

Target group:
Persons working with or are curious about coaching for improvement in the system of health and social care. This is not about coaching individual patients, but about coaching organizational changes that leads to improvements for and with patients/clients.

To explore and develop specific coaching actions aiming to build purpose, meaning and sense of coherence in every coach session.

To explore co-creation as a help to build purpose and meaning in your team
Presenter: Katarina Sjöström

To explore how to coach for resilience and wellbeing in your improvement team
Presenter: Dee Gray (Grays, UK)


Hackathon – creating new ideas and practical actions to deliver large scale change

Join colleagues from across the world in our first microsystem festival Hackathon, 13.00–17.00!

Jönköping is the venue of the largest hackathon in the world, the Dreamhack. We want to take the spirit of the Dreamhack and apply it to one of the biggest challenges we face as healthcare improvers: making change happen on a large scale.
Hackathons are a powerful and creative way to collaborate and experiment with other people with similar interests to solve big problems. The mission of our microsystem festival hackathon is to tackle the challenge of scaling up improvements that work well at a microsystem level so that many more people can benefit from them. We want to move from micro-mastery to macro-mastery!
During a four hour hackathon, we will:

  • Explore the challenges of scaling up improvements from microsystem to macro-system
  • Learn how a hackathon works
  • Identify some real life issues to work on
  • Form teams to tackle the challenges, using an evidence-based design methodology
  • Make presentations to an expert panel
  • Learn greatly in a fun, active way, with other healthcare improvers from across the world


Study visits/Co-learning

(approx. time frame: 09.30–16.30)

Welcome to the co-creative learning at the pre-festival session where we will share with you the good examples in our healthcare system that came up as a result of many years with improvement work. Shared values, competence and skills, trust, innovation, working processes, accuracy, integration and person-centeredness; all those together are quality which has been a driving force for the County's work for many years and they are still the basis for our ambition to create a resilient system for health and care and social welfare for the citizens at Jönköping County.

In the morning, you will meet the Chief Executive of Region Jönköping County Agneta Jansmyr, Chief Medical Officer Mats Bojestig and Chief Executive of learning and Innovation Göran Henriks. They will share with you some facts and their vision on leadership and improvement of health and care services in Jönköping County.

In the afternoon, you will go for site visits and see examples of improvement work where the innovative thinking, teamwork and person-centeredness were key elements to create new working processes and methods.


The Microsystem Festival - February 28

9.00-9.45 Registration and Coffee

9.45-10.15 Opening of the 15th Clinical Microsystem Festival

10.15-11.10 Keynote I: Micromastery
                   Presenter: Göran Henriks
                   (Qulturum, Region Jönköping County, Sweden)

11.10-12.00 My microsystem

12.00-13.15 Lunch

Block A 13.15-16.45 (Afternoon Refreshments 14.30-15.00)


  • The Mastery of Co-production

Collaboration can be done in many different ways, but for health and social care to work sustainable in the future, teamwork is essential. It is therefore necessary that all parties contribute as much as they can. In this workshop we will show different examples of how to approach co-production. The most important thing is to see the possibilities and then to use both education and personal experience. It is also essential that everyone in the team is equally important to the group.

Presenters: Patrik Blomqvist and Annmargreth Kvarnefors (Region Jönköping County, Sweden) and Lars Winborg (HSO, Sweden)


  • Resilience and wellbeing-masterclass for leaders

A highly interactive class on how Antonovsky's work informs the programmes at Grays, and how they have utilised his and others work to create their own evidence based model. Gray was established by Dr Dee Gray in 2003 and it utilises learning and research technologies to enhance and improve individual and organisational wellbeing, learning and performance. The participants will be invited to apply the model at micro and meso levels during the class and to discuss how they could practically take the model forward in their own work.


Presenter: Dee Gray (Grays, UK)


  • Rethinking outpatients - The mastery of flipped thinking

Outside of primary care one of the highest volume activities in most health systems is consultation with specialists and the investigation and treatment associated with this.  In spite of its importance the activities are not well understood and the experience for patients is often poor.  Many of the processes and ways of organising care have not changed much for decades.  This session will explore some of the innovative ways the approach to outpatient care is being rethought including, virtual clinics, instant access, multidisciplinary, telemedicine and methods to remove the need for a consultation at all.  We will do this through case studies, examples from Region Jönköping County and from the participants.  We will also spend time interactively working out some of the many new design rules and approaches that can be used to rethink outpatient care and specialist consultation. 

Presenter: Nigel Edwards (Nuffield Trust, UK) 


  • Connectivism: Building mastery in connecting

If you are curious in the concept of connectivism, please join us in an exploration of the secrets behind the need of connectors and understanding of connectivism.
Connectivism can be described as the integration of principles explored by chaos, network, and complexity and self-organization theories. Connectivism starts when we see that:
Learning and knowledge rests in diversity of opinions  and that learning is a process of connecting nodes or competence sources. The starting point of connectivism is the individual and the relationships within networking. This opportunity of  knowledge development (personal to network to organization) allows learners to remain current in their field through the connections they have formed.

Presenters: Helen Bevan (National Health Service, UK), Göran Henriks (Region Jönköping County, Sweden) Christian von Plessen (Regional Health Research, University of Southern Denmark) 


  • Micromastery and Micro-mesosystem Improvement - Coaching - Part 2: Learn Small, Learn Fast

Based on the book "Micromastery: Learn Small, Learn Fast"  (2017) by Robert Twigger this session will be highly interactive and filled with learning and skill development that is fun and memorable.  When we take the time to cultivate small and quantifiable areas of expertise, we change everything. We become faster and more fearless learners, spot more creative opportunities, improve our brain health and boost our happiness. We see knowledge itself completely differently.  So start small. Start specific. But start - come join us on the path to mastery.

Presenters: Julie Johnson (Northwestern University, USA) and Marjorie Godfrey (The Dartmouth Institute, USA and Jönköping Academy, Sweden)


  • The mastery of workplace learning

Presenters: To be announced

17.00–17.50 Keynote IICrisis, Leadership and Humanity

With the Ebola outbreak 2014-2015 as the backbone of the presentation Stefan tells a story about what happens in an organisation in a major disaster. He talks about how a few courageous people where trying to get on the possibly last plane going in to Liberia, knowing that there might not be a plane home. The team had to find order in chaos, facing your fear of dying, while literally seeing other people die around you. How do you cope, how can you be personal with your patient, how can you be a good colleague and how can you be a good manager?

Presenter: Stefan Liljegren

18.00–20.00 Evening buffet with entertainment

The Microsystem Festival – March 1

9.00–9.15 Opening of day two

Block B 9.15–10.15 Parallel seminars


  • A new approach to improving patient flow: make it simple, make it fun

Through introducing a combination of a daily focus on different aspects of improving patient flow with a new approach to delivering change, Yeovil Hospital has transformed its approach to care. Our daily themes focus on areas of operational challenge. For example, on 'Morning Monday' we focus on discharging patients before midday as we recognise we need to discharge patients earlier in the day to reduce ED crowding. 30 Bed Friday focuses on freeing up 30 beds to get through the weekend without running out of capacity. These daily themes are complemented by a new model of change that moved from project groups to a more informal, fun and engaging approach that saw managers and Directors out on wards talking to staff about what we need to do. This approach has led to significant savings (over £3m), best in class performance, and better care for our patients. It is also a more attractive place to work for our staff leading to lower vacancies and better morale.

Presenter: Simon Sethi (National Health Service, UK)

  • The Flow Coaching Academy program – replication by social franchise

We are developing a network of Flow Coaching Academy franchises across the UK to learn together. We have gained confidence from early positive outcomes that the curriculum and course structure to train Flow Coaches is effective. The current challenge is learning to overcome the barriers of replicating this at scale and sustainable improvement coaching capability across the NHS. Our presentation will include our learning of the power of co-coaching, the content and structure of the training program and an expertise on scaling and replication from the International Centre for Social Franchising.

Presenters: Martha Paren (International Centre for Social Franchising), Tom Downes (National Health Service, UK) and Carlene Rowson (National Health Service, UK)


  • The Microsystem that has saved real lives and gives hope for future. "The Power of One That Inspires Everyone"

The information in our days is too much and too difficult to understand. Sometimes it is impossible to choose what is right and what is wrong. And the question "To be or not to be" is actual especially in conservative medical practice. In developing countries such as Armenia the medical rules are regulated by many organizations - Ministry, Government, Associations and Opinion Leaders. Sometimes the rules are also coming from "outside countries". All these caused a lot of misunderstandings for doctors of everyday practice and of course for patients.
During Microsystem festival in Jönköping in 2016 I understood the "POWER of ONE" concept. And this gives me opportunity to bring the new method of treatment to my clinic. Our achievements gave us strength to spread this information with other clinics and make policy makers to listen to us! By this
victory our university clinic staff believed in "one person's power" and tries to inspire this faith to other people not only in medicine.

Presenter: Arman Harutyunyan (Yerevan State Medical University, Armenia)

  • Adopting design thinking approach to inpatient postnatal care in a busy National Health Service hospital in United Kingdom to improve user experience and quality of care

This is the first time we have adopted a design thinking approach to improve experiences during in-hospital postnatal care. We have begun to understand what the lived experience is on the postnatal ward for the mums and those who deliver care. It has also highlighted that to improve experiences we will require a multi-pronged approach, which extends beyond higher financial investment in the service. Through engagement and support of the users and the wider hospital team (clinical, administrative and managerial) we have started to develop quality improvement projects in areas that are also likely to have a positive impact on length of stay in hospital and complaints received by the

Presenter: Sunita Sharma (National Health Service, UK)


  • Micro mastery show of the gems from Gouda

Patient as partner is based on Clinical Microsystem Thinking. Since 2013, the Green Heart Hospital has been working on this concept, with the front workers being closely involved in quality enhancements, implementing bottom up improvements along with the patient. This project goes hand in hand with the quality and safety system, emphasising the benefit to the patient. Each team in the hospital has 1 or more coaches who discuss issues during whiteboard sessions and make plans for improvements. Patient as partner is based on patient input. The patient's feedback is actively requested. From this the improvement begins. The healthcare provider can also signal a problem from the perspective of the patient, with the aim of improvement for the patient's benefit.
After this session, participants will be able to:
1: Implement a movement similar to patient as partner
2: Keep their staff inspired and excited
3: Apply the examples learnt here in their own setting

Presenters: Lia Donkers and Astrid van der Bas (Transmural Network, Netherlands)

  • This session is followed by an interactive session about patient as partner and how this can be implemented throughout the world

Moderator: Glenn Roberts, King's College, London


  • Cross country collaboration as a key for micromastery with Esther ( = patient/client)

The Esther Network is made of clinicians, patients, and families who work to improve complex care. Started in Region Jönköping county, Sweden. “Esther” is a symbolic person, with complex care needs who requires the coordination and integration between hospital, primary care, home care, and community care. There are similar networks in Singapore and UK.The accumulation of small, everyday things,have a big impact on the patients' experience and wellbeing. We learned that there is more that unites Singapore, Sweden and UK than that divides us. That the ESTHER model with the basic questions:
1. What is best for Esther
2. Who need to cooperate in order to do that? gives good results and better quality care for less cost in all three countries. The portfolio of useful improvements is shared between the three countries. The ESTHER improvement coaches are linked via Facebook which gives both a broad range of support during improvement work and borrow instead of starting from scratch.

Presenters: Anna Carlbom (Graham Care, UK), Nicoline Vackerberg (Region Jönköping County, Sweden) and Esther Lim (SingHealth, Singapore)

  • The Design and Learning Centre for Clinical and Social Innovation is "Making out-of-hospital care safer for both citizens and the professionals" by using micromastery type techniques as demonstrated by the implementation of the ESTHER culture of care

The implementation of the ESTHER culture of care has shown the benefit of micro mastery by gaining ownership and trust by both citizens and the professionals. Our Design and Learning Centre for Clinical and Social Innovation has been able to learn from Sweden and implement their model locally without the need for further piloting.
This has been possible by identifying 4 levels of continuous quality improvement starting with the citizen (ESTHER), the professional (creating over 220 ESTHER Ambassadors), the team (training 48 ESTHER coaches) and the system (empowering ESTHER Cafes owned by communities). We are looking to further develop the brand by creating an ESTHER kitemark and an ESTHER app. Our ESTHER program development uses the same methodology as other projects under production in the DLC by using innovation workshops to codesign and engage with citizens and professionals to enable the adoption of new products / ways of working that are better, safer and cheaper!

Presenters: Robert Stewart (Design and Learning Centre for Clinical and Social Innovation, UK) and Anna Carlbom (The Graham Care Group, UK)


  • Shared decision making with children with brain injuries and their families: A quality improvement project

The aim of this project is to improve the involvement, participation and satisfaction of children and families in decisions about their care at The Children's Trust. This project uses quality improvement methodology and tools developed by the Collaboration for Leadership in Applied Health and Care, Northwest London (CLAHRC NWL) to improve the clinical microsystem at The Children's Trust. The project will use a range of activities to meet its aim including process mapping, action effect diagrams and PDSA cycles. Families and service users will be actively involved at every stage of the process. Data will be gathered on various aspects of the service as well as measuring the quality and frequency of decisions, and emerging results will be presented at the festival. The  project lead will also reflect on her journey in quality improvement and discuss how she has negotiated some of the challenges that are inherent when seeking to improve a clinical microsystem.

Presenter: Tai Frater (Brunel University London, UK) 

  • The brain tumour team - from idea to reality

Each year, about 1300 people in Sweden are diagnosed with some type of brain tumour. There is a great need for an overall function for patient and relative to contact regardless wherever in the care chain they are. Therefore, in 2017, the brain tumour team was started at the Neurosurgical Clinic in Linköping in order to follow the care process and be the spider in the network when needed, for patients and close relatives. To achieve this, the team has a common email address and phone, as well as regular meetings in order to evaluate and improve teamwork. We have seen a marked increase in inflows by e-mails as well as phone calls from patient and relatives and also an increased demand for team services from other clinics. Ongoing: The study Follow-up and evaluation of patients with malignant glioma, continued dissemination about the team work and develop the team function and knowledge. The team is part of a cluster work aimed at getting a patient centered care.

Presenters: Ann-Charlotte Bremer, Anne-Lie Lindevall, Charlotte Åström och Jard Svensson (Neurosurgical clinic at the University Hospital in Linköping, Sweden)


  • What are patients really waiting for? How to make the invisible visible in an acute NHS hospital

Achieving Reliable Care puts the patient and their needs at the heart of delivering quality care. It is an intervention, used by ward teams, to bring all aspects of the patient's plan in one place, improving the coordination of care across the multidisciplinary team.
ARC provides a consistent approach to the delivery of all patient care, reducing variability and demonstrating that patients get what they need when they need it.  When they don't, delays are highlighted earlier, contributing to a culture where delays are no longer accepted as the norm.
ARC makes the invisible, visible as each and every delay is captured. The myths about where inefficiencies lie are exposed as ARC builds a visual picture which aids sensitivity to operations at micro, meso and macro levels. Organisations know exactly what their patients are waiting for. Ultimately, ARC helps patients to spend less time waiting in hospital and see a reduction in their length of stay. (c956)

Presenters: Cindy Storer and Liz Watson (National Health Service, UK)

  • Cooperation in the best interests of the child

An improvement work has been carried out at the MRI section, X-ray department, Division of Medical Services at Ryhov Hospital in Jonkoping, Sweden. Staff involved has been nurses and physicians from various clinics working with children scheduled for MRI examination under anaesthesia. The aim of the improvement work was to limit discomfort for the children under care by increasing cooperation between clinics involved in the patient care. By using a more person-centered approach  various needs of the patient were taken care of at the same time, for example bloodtests, ofthalmology-, dental- and ENT examinations while the children already were anaestethized for MRI examination. From the child's perspective, it means less hospital visits and less anesthesia occasions. It is also an economical gain for both the family and the hospital. Finally the examination results are accessible faster for the remittent as well as the parents.

Presenters: Gunilla Yngve and Ewa Geel (Region Jönköping County, Sweden)


  • A dialogue about 15 years of microsystem thinking - learning lessons

An interactive session about the Past, Current and Future of Microsystem Thinking.

Presenters: Marjorie Godfrey (The Dartmouth Institute, USA and Jönköping Academy, Sweden) and Christian von Plessen (Regional Health Research, University of Southern Denmark) 


10.15–10.45 Morning Refreshments

10.45–11.45 Keynote III: Patient Zero, One, One, Zero, One

This present moment used to be the unimaginable future" -Steward Brand. Today Fitbit has 90 Billion hours of heart rate data, 85 Trillion steps and 5 Billions nights of sleep. Apple has computers being worn by millions of people and recently had the FDA has cleared a new study for heart rate study with Apple and Standford. The statistics and facts about the digital health revolution no longer adequately tell the whole story of how humanity is being onboarded into a new world of digital health surveillance. Patient Zero, One, One, Zero, One is an intimate look of how the healthcare sector is responding the emergence of not only a new set of technologies but a new set of patients, the rise of the cyborg. From mental health to wearables our behaviors are driving everything from e-commerce to suicide prevention. What are the ethical, practical and real-world implications of life uploaded? 

PresenterChris Dancy

11.45–12.15 "My microsystem"

12.15–13.30 Lunch

Block C 13.30–14.30 Parallel seminars



  • "Big Room" live – the power of Flow Coaching to improve care across a mesosystem

This activity demonstrates the key concepts of Flow coaching and the power of patient co-design using the framework of a Toyota Big Room. It is designed to engage everybody from frontline junior staff and patients through to CEOs.

Presenters: Tom Downes (National Health Service, UK), Martha Paren (International Centre for Social Franchising) and Carlene Rowson (National Health Service, UK)


  • Organic development of wellness co-production in multiple sclerosis: The Multiple Sclerosis Foundation Wellness Outreach Program at a rural community hospital-based multiple sclerosis clinic in the northeastern United States

This wellness microsystem program represents key elements of a peer facilitated network as described in the Learning Health System model and is an example of co-production established before the formal introduction of the concept in the healthcare improvement field. The program is efficient and effective without requiring a high technology infrastructure. The program has built-in scalability based on the progression of program mentees to mentors, and over time mentor based leadership of the program has increased, requiring less coaching involvement by the clinician liaisons. The program has demonstrated initial stability and scalability over its first four years of operation without increasing costs. Stories prepared by mentors and mentees about their wellness journeys will be shared and recommendations for future formal research study of this program will be discussed.

Presenter: Brant Oliver (The Dartmouth Institute, USA)

  • Learning and coping - patient involvement to create education for empowerment and a better life with long term disease

The patient education method Learning and Coping, can be understood as a micro system that promotes learning, empowerment and better selfmanagement. By integrating different competences, professional and experience based, we can also ensure the quality and patient safety in patient education. An arena for exchanging of knowledge and experiences, between patients as well as between patients and professionals can be achieved. New insights and new knowledge enriches patients as well as professionals and can contribute to quality improvements in clinics that uses the method.

Presenters: Malena Lau och Åsa Davidsson (Västra Götalandsregionen, Sweden) 


  • The microsystem Institution of Lavigny or how to enhance the quality of rehabilitation (with a partner patient concept), from hope to reality

After 9 years of existence of interdisciplinary including the clinical pathway based on the ICF, it was necessary to evolve all these notions in order to optimize more the quality of the services offered to patients, in the face of evolutions of the health system and the demands of the population. The mind is that the rehabilitation process is in line with the patient's project and that the rehabilitation phase is part of a continuum between acute care and home. After setting up a whole concept to support the teams, our organization wants to be a micro-laboratory to test new organizational models. Thus, the integration of the concept of the patient partner of Montreal, will allow us to be even more focused on the patient. This will require us to review our organizational model somewhat to allow the patient more moments of exchange with the interdisciplinary team. Organized interdisciplinary work remains for the rehabilitation community an unavoidable reality.

Presenters: Julien Moncharmont (Institution de Lavigny, Switzerland) and Pierrette Chenevard (Espace Compétences, Switzerland)

  • Virtual clinic review of Heart Failure patients improves coding accuracy

In this pilot cardiology quality improvement initiative, we observed a significant increase in actual number of LVSD patients as opposed to the pre intervention LVSD numbers. The pre intervention and post intervention numbers of LVSD patients represent a significant rise . Numerous medical therapies are developed to improve morbidity and mortality associated with Heart Failure with left ventricular systolic dysfunction. Identification and diagnosis, improved coding efficiency and optimum management of patients will have a significant impact on Heart failure outcomes in the primary and secondary care setting.

Presenters: Sadia Khan and Ammu Merin Mathew (West Middlesex University Hospital, UK)


  • Building a new Local Care Organisation (LCO) for Manchester from the community front line: a model for local micro-systems to shape strategy and big system change

Health and care organisations are growing to give strategic reach and reduce on-costs, and this may happen at  the expense of local responsiveness and relationships and be a diversion from the day job for clinical staff. A thoughtful and participative strategy process will respect locality, differentiate where appropriate, and accelerate integration as staff and local voices are heard and mobilized for positive change. A good process can produce core content for strategic documents which is recognised and owned by local teams, and which benefits from their local knowledge and expertise. Active participation may stimulate clinical teams to take immediate action in the spirit of new goals and the process brings real time engagement and support. Large group interventions play an important role in effective change management during organisational re-structuring and offer a route for the clinical micro-systems to shape the wider system in the interests of local service users.

Presenters: Sophia Christie (UKPrime, UK), Sohail Munshi and Katy Calvin Thomas

  • Culture Transformation Through Development of Microsystem Clinical Leadership

This presentation will provide a roadmap for assessment of microsystem and organizational culture, development of a plan for transformation and most importantly, how to effectively execute that transformation plan. Strategies will be shared for "staying the course", regardless of organizational barriers that might arise to derail the implementation of the transformation plan. Case studies of individual and group transformation, as well as outcomes achieved, will be shared to help the participant understand the impact of the strategies.

Presenter: Gay Landstrom (St. John Providence, USA) 


  • The Mastery of Your Daily Work – From structures to feelings

Capacity and production management, simply put, means to plan for the maximum output that a unit can produce in a given period with the available resources. However, in order to achieve best capacity planning, one must achieve a consensus about what the available resources are, if they are available and how to place them. Like many other organisations, the health and social care sector consists of very complex organisational structures and the perception of what is what usually differs from care unit to care unit, from hospital to hospital and as well as from person to person.

This seminar will explore how different inputs and views can affect capacity and production management and what happens in a group of staff when you get facts presented that don't always coincide with the view that existed earlier.

Moderators: Maria Malmström (Region Jönköping County, Sweden) and Pernilla Söderberg (Region Jönköping County, Sweden)



  • Setting up a Primary Care Quality Improvement Network

Setting up a Primary Care Quality Improvement Network - sharing learning both via generic QI training and sharing experience between teams of what has worked well, and what hasn't. Data support, expert Quality Improvement Professional input, and networking via face to face events and through cyber space are all part of what the network looks like. We would like to share with colleagues internationally:

– how we set up our network
– how we identify priorities
– how we keep Quality Improvers speaking to both each other,
   and their clinical colleagues
– what projects have been successful
– What we actually do on a day to day basis.

The challenges that primary care faces are pretty much the same everywhere and we would like to share what we are doing to address them via our Primary Care QI network.

Presenters: Lisa Carter, Jo Bennett and Elouise Johnstone (National Health Service, UK)

  • Seamless Surgery - Experience the elective surgical pathway at Sheffield Teaching Hospitals NHS Foundation Trust from the patient perspective and see how the Seamless Surgery team are improving the pathway

The Seamless Surgery Programme in Sheffield is all about creating a patient-focused elective experience through implementing best practice to ensure a smooth patient journey at all stages. At the session you will hear how we have taken an improvement approach that encourages front line teams to improve and redesign services whilst being aligned with Organisational objectives. Learning from improvement work within the organisation and across the NHS we established best practice principles for elective surgery enabling staff to work on parts of the process they can improve, to create better experiences for our patients. Hundreds of staff have got involved and worked on improvement projects that mean across the organisation we are changing the experience and outcome for thousands of our patients whilst helping create an efficient organisation. Throughout the Programme, a high impact engagement approach has been taken and this has been crucial in building widespread engagement in improving elective pathways and we look forward to sharing our learning, challenges and outcomes for this exciting programme of work, and talking about the next phase and future direction.

Presenters: Paul Griffiths and Caroline Eadson (National Health Service, UK)


  • Open Space Dialogue, Questions raised during the Festival that need special attention

At the Microsystem Festival we would like to create space for news ideas, we are therefore providing a so called open space in the program. An hour without a predetermined agenda where we generate energy and commitment. If you are interested in exploring a topic related to microsystem thinking or micromastery at the open space, please Twitter what you wish to discuss using #qmicroopenspace or inform the staff at the registration.

Moderator: Anna Carlbom (The Graham Care Group, UK)


  • Newly added seminar! WHAT DO WE WANT?

In this presentation, I want to share my direct experience as a union leader in the improvement of health care. Here are the necessary building blocks to create the collective consciousness missing from most efforts at health care improvement in the U.S:

1. A Case for Change (social reality)
2. The Value Compass (“true north”)
3. Unit Based teams - microsystems (structure and methods)
4. A Trust Fund (resources)

In the U.S., in our increasingly diverse society, we have many built-in triggers that keep people apart. There are also built-in triggers that deepen a sense of grievance as incomes remain stagnant, net worth for many remains close to non-existent, and a combination of increasing automation, global competition for goods and services, and little to no existence of collective voice makes people feel completely vulnerable for the future of their children.
Grievance does not create a healthy and cohesive culture. Grievance breeds anger. We have had anger aplenty now for many decades with no success of solving the grievances.
The discussion across organizations ought to begin with a question, "What do WE want?" 
"Conscientization helps persons become conscious of and gain perspective on their perceptions of their social reality and of themselves, thereby mobilizing them to engage in a process of reflection and action to change the reality.” ("FREIRE, CONSCIENTIZATION, AND ADULT EDUCATION”, ARTHUR S. LLOYD, Adult Education, Vol. XXIII, No. 1, 1972, pp. 3-20).

Healthcare improvement is a "change of reality".

Is this a U.S. problem?  Is it a problem shared across Europe and elsewhere?  Perhaps it is instructive to talk about  "our American problem…our American exceptionalism" distinct from other societies' culture of social solidarity and the American culture of YOYO ("you are on your own").  I hope that there are similarities in experience across the boundaries of nations in our transformed global economy from which we can all learn.
Unions' responsibilities to their members have been tested in the extreme.  Their ability to adapt and innovate have been inhibited by the increasing economic insecurity of all workers in the U.S., including union members.
Conscientization was and is a central dynamic in the establishment and success of microsystems. 

Presenter: John August (Cornell University, USA)


14.30–15.00 Afternoon Refreshments

15.00–16.00 Keynote IV: Micromastery, ending of the Festival

 Improvement Science Day - March 2

The Clinical Microsystem Festival is followed by an Improvement Science Day, March 2, with a special focus on new research in the field. During the day we will get possibilities to share and explore research questions and methodologies.
The Improvement Science Day offers several lectures by internationally recognized researchers. The common denominators are the engagement in quality improvement of health and social care, the recognition of clinical microsystems and measures as engines for change. This will be illuminated from different perspectives by the lecturer.
The Improvement Science Day does also contain shorter oral presentations regarding the recent research in the field of clinical Microsystems and a poster walk.



Pre-Festival Day - Coaching 
& Scientific Day:
Nicoline Vackerberg

Pre-Festival Day - Study Visits
& Microsystem Festival Days:
Agata Rukat

Microsystem Festival Days:
Rebecka Berger

Project coordinators:

Anastasia Shklyar

Christina Åkesson

Project Advisors:

Pernilla Söderberg

Malin Skreding Hallgren

Patrik Blomqvist


Qulturum, House B4, County Hospital Ryhov, Jönköping

Frequently Asked Questions


Uppdaterad: 2018-01-10
Rebecka Berger, Qulturum, Verksamhetsnära funktion