Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Nov-Dec;12(6):573-6.
doi: 10.1370/afm.1713.

From triple to quadruple aim: care of the patient requires care of the provider

Affiliations

From triple to quadruple aim: care of the patient requires care of the provider

Thomas Bodenheimer et al. Ann Fam Med. 2014 Nov-Dec.

Abstract

The Triple Aim-enhancing patient experience, improving population health, and reducing costs-is widely accepted as a compass to optimize health system performance. Yet physicians and other members of the health care workforce report widespread burnout and dissatisfaction. Burnout is associated with lower patient satisfaction, reduced health outcomes, and it may increase costs. Burnout thus imperils the Triple Aim. This article recommends that the Triple Aim be expanded to a Quadruple Aim, adding the goal of improving the work life of health care providers, including clinicians and staff.

Keywords: health care workforce; patient-centered care; primary health care.

PubMed Disclaimer

References

    1. Berwick DM, Nolan TW, Whittington J. The Triple Aim: care, health, and cost. Health Aff (Millwood). 2008;27(3):759–769. - PubMed
    1. Sinsky CA, Willard-Grace R, Schutzbank AM, Sinsky TA, Margolius D, Bodenheimer T. In search of joy in practice: a report of 23 high-functioning primary care practices. Ann Fam Med. 2013;11(3): 272–278. - PMC - PubMed
    1. Detsky AS. What patients really want from health care. JAMA. 2011; 306(22):2500–2501. - PubMed
    1. Berwick DM. What ‘patient-centered’ should mean: confessions of an extremist. Health Aff (Millwood). 2009;28(4):w555–w565. - PubMed
    1. Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172(18):1377–1385. - PubMed