Maximizing Healthcare Performance: The Evolution from Triple to Quadruple Aim - Research Paper

Introduction

Healthcare organizations are increasingly seeking to optimize healthcare performance. Traditionally, a three-pronged approach known as Triple Aim was pursued to optimize the performance of healthcare systems. Under this approach, efforts were focused on improvement of population health, enhancement of patient experience, as well as lowering of the healthcare costs. Recently, the approach has evolved into Quadruple Aim. Focus on the improvement of the work life of the healthcare providers has been added on top of the three goals pursued in the Triple Aim. Each of the four measures is impacted by the various decisions made at the organizational level. To inform and justify these decisions, organizations are turning to another approach known as evidence-based practice (EBP). This paper seeks to discuss the connection between the Quadruple Aim and EBP.

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EBP

EBP refers to a problem-solving approach adopted in clinical practice incorporating the best evidence gotten from well-designed studies, clinical expertise, as well as patient preferences and values used in making various decisions regarding patient's care (Walt, 2018). EBP principles have been revised over the years and has also extended to other disciplines. At the core of EBP is the need to make decisions that promote health (Melnyk, Fineout-Overholt, Stillwell, and Williamson, 2010). This is achieved through the integration of the best available evidence, expertise of the clinicians, and various characteristics of those affected (Crabtree, Brennan, Davis, and Coyle, 2016). The integration of these factors is done in a way that is compatible with the organizational and environmental context.

The Quadruple Aim

The Triple Aim, the precursor of the Quadruple Aim, was aimed at optimizing the health system performance and ultimately improving patient outcome. This approach was largely aimed at the enhancement of patient experience as well as improvement of the general health of the population while cutting on costs at the same time (Kane, Bodenheimer, and Sinsky, 2019). However, working on the three aims came with various setbacks. Burnout and dissatisfaction among the health care workforce, was among the major setbacks. Burnout is generally associated with increased medical errors, reduced patient outcomes, and lower patient satisfaction. It may also lead to increase in the cost of healthcare. Therefore, the success of the Triple Aim was jeopardized by burnout (Havens, Gittell, and Vasey, 2018). To remedy this, another goal that sought to improve the work life of the health care providers was added onto the Triple Aim to constitute the Quadruple Aim (Sikka, Morath, and Leape, 2015). The measures of the Quadruple Aim include the health of the population, patient experience, cost of care, as well as the level of care given to the provider (Rathert, Williams, and Linhart, 2018).

The Connection Between EBP and the Quadruple Aim

From the above discussion, it is clear that both EBP and the Quadruple Aim are pursued to enhance the performance of health systems. It is also clear that to make reliable decisions regarding the elements of the Quadruple Aim, EBP is indispensable (Melnyk, 2017). Health organizations, therefore, must acknowledge and respect the connection between the two. Through the utilization of EBP, heath care providers can consult the best research evidence and use it to improve the patient's outcome. By doing so, one of the goal of Quadruple Aim is achieved. Studies have also shown that implementation of EBP leads to reduction in the cost of healthcare. When used by various health bodies such as Center for Disease Control and Prevention (CDC), EBP can help in the prevention of disease and the general promotion of public health (Steele et al., 2015). Evidence from studies can also help come up with strategies of improving the healthcare workforce and hence achieve the fourth goal of the Quadruple Aim (Boller, 2017).

Conclusion

This discussion has shown that there exists a strong connection between EBP and the Quadruple Aim. EBP helps in making decisions that in turn, help achieve the four goals of Quadruple Aim. Therefore, health organizations should incorporate EBP in the strategies formulated to achieve the Quadruple Aim.

References

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