Quality by Design: A Clinical Microsystems Approach offers a new and unique approach to an old problem: how to redesign health services processes to improve quality, add value, reduce variation, and improve morale, in such a way that frontline caregivers lead the process of change, rather than obey it. The book is a practical reflection of research and applied training conducted at Dartmouth Medical School under the leadership of Paul Batalden, Eugene Nelson, and Marjorie Godfrey, the directors, respectively, of Dartmouth Medical School departments of: Quality Improvement, Health Improvement, Leadership Development, and Clinical Practice Improvement.