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
. 2020 Jul 31;13(1):362.
doi: 10.1186/s13104-020-05199-8.

Enhancing healthcare efficiency to achieve the Quadruple Aim: an exploratory study

Affiliations

Enhancing healthcare efficiency to achieve the Quadruple Aim: an exploratory study

Bengt B Arnetz et al. BMC Res Notes. .

Abstract

Objective: Healthcare is battling a conflict between the Quadruple Aims-reducing costs; improving population health, patient experience, and team well-being-and productivity. This quasi-experimental pilot study tested a 2 week intervention aimed to address the Quadruple Aims while improving productivity. Participants were 25 employees and their patients in a primary care clinic. 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. The five remaining providers and their teams comprised the reference group, who continued patient care as usual. Study outcomes were measured via provider/staff and patient surveys and administrative data.

Results: In total, 46 team surveys and 156 patient surveys were collected. Clinic output data were retrieved for 467 visits. Compared to the reference team, the intervention team performed better in all Quadruple Aims and productivity measures. The intervention group offered 48% more patient slots than the average reference team. These preliminary results support the feasibility of introducing substantial process changes that show promising improvement in both the Quadruple Aims and productivity. A larger-scale study over a longer time period is needed to confirm findings and examine feasibility and cost-effectiveness.

Keywords: Efficiency; Productivity; Quadruple Aim; Quality improvement; Team-based care.

PubMed Disclaimer

Conflict of interest statement

The QWC survey instrument is owned and marketed by the Swedish company Springlife AB. Bengt Arnetz is the co-founder and co-owner of this company. The company did not receive any compensation for the use of QWC questions in this study, nor was any data shared with the company. The remaining authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
Theoretical modeling linking all Quadruple Aims to organizational efficiency and productivity

Similar articles

Cited by

References

    1. Berwick DM, Nolan TW, Whittington J. The triple aim: care, health, and cost. Health Aff (Millwood) 2008;27(3):759–769. doi: 10.1377/hlthaff.27.3.759. - DOI - PubMed
    1. Bodenheimer T, Sinsky C. From triple to quadruple aim: care of the patient requires care of the provider. Ann Fam Med. 2014;12(6):573–576. doi: 10.1370/afm.1713. - DOI - PMC - PubMed
    1. Shanafelt TD, West CP, Sinsky C, et al. Changes in burnout and satisfaction with work-life integration in physicians and the general US working population between 2011 and 2017. Mayo Clin Proc. 2019;94(9):1681–1694. doi: 10.1016/j.mayocp.2018.10.023. - DOI - PubMed
    1. Papanicolas I, Woskie LR, Jha AK. Health care spending in the United States and other high-income countries. JAMA. 2018;319(10):1024–1039. doi: 10.1001/jama.2018.1150. - DOI - PubMed
    1. Centers for Medicare and Medicaid Services. MLN booklet: how to use the searchable Medicare Physician Fee Schedule (MPFS). 2020. https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN.... Accessed 22 July 2020.