Why healthcare organizations must embrace the 'Quadruple Aim'

Image removed.The movement to add a fourth component to the healthcare industry's ideal of the Triple Aim appears to be gaining steam.

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In its current form, the Triple Aim--better care, better health and lower costs--fails to acknowledge workers' critical role in transforming healthcare, Rishi Sikka, of Advocate Health Care, Julianne Morath, of the Hospital Quality Institute, and Lucian Leape, of the Harvard School of Public Health, write in an opinion piece in the BMJ Quality & Safety journal. Thus, they call for a Quadruple Aim that emphasizes the original three goals plus the goal of improving caregivers' experiences, echoing a similar piece published late last year in the Annals of Family Medicine.

Never has such an effort been more important, as reams of research indicate that many healthcare workers not only fail to find joy and meaning in their work, but also are at risk of serious physical and psychological harm on the job, the piece argues. Indeed, worker injuries are sky-high in the healthcare industry, workplace violence is on the rise, and peer bullying and burnout take their toll on many clinicians.

"The precondition for restoring joy and meaning is to ensure that the workforce has physical and psychological freedom from harm, neglect and disrespect," the authors write. "For a health system aspiring to the Triple Aim, fulfilling this precondition must be a non-negotiable, enduring property of the system."

To achieve this, the authors write that healthcare organizations must improve metrics in two broad areas: workforce engagement and workforce safety. To assess worker engagement and burnout, they say, organizations must conduct annual surveys and compare the results to benchmarks within and outside of the healthcare industry.

To ensure safer workplaces, they suggest organizations keep track of work-related injuries, including those that result in lost time, disability or death. Often this effort is primarily up to providers, as government entities like the Occupational Safety and Health Administration have in the past been able to do little to protect healthcare workers, FierceHealthcare has reported.

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Organizations may also want to encourage their clinicians--especially nurses--to practice self-care, which can help combat worker infighting and other stressors in the workplace, Susan Groenwald, Ph.D., R.N., president of the Chamberlain College of Nursing, recently told FierceHealthcare.

To learn more:
- read the opinion piece

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