![]() ![]() There are an increasing number of forces that create demands on providers’ performance and cognitive load. Thus, healthcare systems are facing 2 daunting yet seemingly opposed challenges: striving to achieve the goals proposed in the Quadruple Aim while increasing productivity. Most private insurers mimic this productivity-based reimbursement strategy. Reimbursement for care provided in the United States is based on productivity, i.e., work relative value units (wRVU), despite a shift towards value-based care by the Centers for Medicare and Medicaid Services. These foci are crucial for healthcare quality, yet healthcare systems must also consider other factors. These performance dimensions can be applied to far-reaching, crucial healthcare challenges, such as reducing the massive rates of burnout present in healthcare workers and combating rising healthcare costs. The framework encompasses reducing costs, improving population health and patient experience, with a new fourth domain: healthcare team well-being. In 2014, the Quadruple Aim-adapted from the widely-accepted Triple Aim -was suggested as a framework to optimize healthcare system performance. A larger-scale study over a longer time period is needed to confirm findings and examine feasibility and cost-effectiveness. These preliminary results support the feasibility of introducing substantial process changes that show promising improvement in both the Quadruple Aims and productivity. The intervention group offered 48% more patient slots than the average reference team. Compared to the reference team, the intervention team performed better in all Quadruple Aims and productivity measures. Clinic output data were retrieved for 467 visits. ![]() In total, 46 team surveys and 156 patient surveys were collected. Study outcomes were measured via provider/staff and patient surveys and administrative data. ![]() The five remaining providers and their teams comprised the reference group, who continued patient care as usual. ![]() One provider and their team implemented an efficiency-focused intervention that modified work roles and processes focused on utilizing all team members’ skills as allowable by applicable licensure restrictions. Participants were 25 employees and their patients in a primary care clinic. This quasi-experimental pilot study tested a 2 week intervention aimed to address the Quadruple Aims while improving productivity. Per Capita Cost: Creating value by focusing on quality, eliminating waste, and reducing unwarranted variation considering the total cost of care over time, not just the cost of an individual health care activity.Healthcare is battling a conflict between the Quadruple Aims-reducing costs improving population health, patient experience, and team well-being-and productivity.Experience of Care: Providing a care experience that is patient and family centered, compassionate, convenient, equitable, safe and always of the highest quality.Population Health: Improving the health of a population by encouraging healthy behaviors and reducing the likelihood of illness through focused prevention and the development of increased resilience.The ultimate goal for the Military Health System (MHS), the MHS Quadruple Aim, represents the MHS leadership’s commitment to delivering value to all they serve and is aligned with the MHS strategic goals and value proposition to include: Readiness: Ensuring that the total military force is medically ready to deploy and that the medical force is ready to deliver health care anytime, anywhere in support of the full range of military operations, including humanitarian missions. ![]()
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