8/17/2023 0 Comments Quadruple aim bodenheimer![]() healthcare delivery system in response to the enactment of the Patient Protection and Affordable Care Act (ACA). In 2010, the framework of triple aim was interwoven into the fabric of the U.S. Leaders from the provider side, consumers, regulators, policymakers and academicians responded to the call to action of triple aim. The impetus for the drive toward healthcare improvement resulted from the displeasure and frustrations with poor health outcomes and the spiraling costs of healthcare. Healthcare organizations have adopted these aims to develop strategies for efficient, effective and sustainable delivery of healthcare services (Mery, Majumder, Brown, & Dobrow, 2017 Obucina et al., 2018). ![]() More than a decade ago, Triple Aim appeared in the literature through the work of three healthcare leaders whose focus on healthcare improvement centered around three areas: improved care, improved health of populations and reduced healthcare cost (Berwick, Nolan, & Whittington, 2008). Read more about the origins of The Quadruple Aim.By Nelson Tuazon, DNP, DBA, RN, NEA-BC, CENP, CPHQ, FNAP, FACHE, vice president and associate chief nursing officer, University Health System, and president, South Central Texas Organization of Nurse Executives ![]() And, I'll end by concurring with Michele's assessment that at NEQCA, we get it more than most! As one of many physician leaders in our network, rest assured that I get it. Unless and until we achieve the Fourth Aim, it will be difficult at best to make progress on the other three. We are holding ourselves to the higher (and harder) goal of defining specific and concrete interventions we can make that will have an equally concrete impact on the administrative burdens our providers face that are so toxic to our professional wellbeing. It is not enough to recognize and acknowledge the factors that contribute to physician burnout. ![]() While we’re pleased with these initial efforts, we know that we’re far from being able to declare victory just yet. More than 175 NEQCA clinicians and staff members registered for that session. In that session, Gail Gazelle, MD shared fifteen practical strategies to improve self-care and reduce burnout. At our recent NEQCA Annual Forum, we dedicated one of three breakout sessions to the important topic of physician resiliency.95% of survey respondents said the program helped them understand what can be done individually and as a team to combat physician burnout and improve the clinician experience. This summer, we hosted a NEQCA Connection program with Steve Beeson, Founder of The Clinician Experience Project, and the feedback we received on the program was terrific.In 2018, the group will consider templates to reduce the time burden of documentation and some form of ‘social networking’ to reduce the clinical isolation of solo practice. The longer-term goal is to create a sustainable model and a plan with clear deliverables and to focus on one or two initiatives each year. At the same time, they are looking at tactics to improve self-care in order to build resilience and protect against burnout. As a first step, the group is working to identify and implement organizational strategies for a healthier work environment to improve physician wellness. Over the past several months, Chief Medical Officer Jatin Dave has assembled a workgroup of NEQCA physicians to measure and improve physician wellbeing.The Fourth Aim is about improving the work life of those who deliver care, and we’ve made it – as I hope you realize – a major priority at NEQCA. Periodically, I'll write a short piece on one of the aims, and I decided to start this series with the one that often appears last on the list. I also believe it will continue to be a differentiator for our network, and our affiliated practices, as we work together on goals of better care, better health, lower cost and higher clinician satisfaction. While we didn't invent it, we've embraced the model, first introduced by Thomas Bodenheimer, MD and Christine Sinsky, MD in 2014, earlier and more fully than many other networks, and we've made it a central part of everything we do. President and Chief Executive Officer, New England Quality Care Allianceĭuring her last meeting as NEQCA Board Chair, Michele Crage, MD emphatically told her fellow Trustees, "Nobody gets the Quadruple Aim like NEQCA!" I think she's right. Achieving the Quadruple Aim Focus on Higher Clinician Satisfaction
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