Healthcare's New Quadruple Aim - 3 Key Components

Three Key Components of the Quadruple Aim

By Dike Drummond MD, CEO TheHappyMD.com

Medicine's new Quadruple Aim is the realization that building a quality healthcare delivery system is a lot like building a house.

  • If you have a good foundation, you can build a solid structure. 
  • If your foundation is unstable, weak or inadequate - your house will be in a constant state of falling apart. You cobble things back together, just in time for the walls to start crumbling again. 
  • If the "house" you want to build is a high quality, cost effective healthcare system with high patient satisfaction ... this is the old Triple Aim ... the only legitimate foundation is the health and wellbeing of the workers in the system.

The Quadruple Aim IS the foundation of quality healthcare.

Every single contact with patients, test ordered, procedure performed and drug prescribed ...  is predicated on the assumption that your people are happy and healthy and enjoying their work.

Your ability to fulfill the promises of the Triple Aim is based on the assumption that your employees are at their best. Unfortunately we know that is measureably NOT TRUE. 

If your workers are burned out - quality and satisfaction go out the window and your system lurches from one crisis to the next. 

With recent studies suggesting that 50% of doctors are burned out on any given office day, the logical question is HOW?

HOW do you install the Quadruple Aim in your organization? 

Where do you get started and HOW do you create health and wellbeing in your providers and staff?

In our work with over 60 corporate clients, we have noticed a distinct pattern of three interlocking components that appear to enable the Quadruple Aim.Unfortunately the simultaneous presence of all three in any given healthcare delivery organization is rare - less than 10% of organizations that employ physicians in our experience.

Three Key Components of the Quadruple Aim

Mission -- Systems & System Design -- Culture

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1) Mission

Do the people - the providers and staff - appear in the Mission Statement?

Go find your organizations Mission Statement now. As you read it, do you see anything in the words that prioritizes the health and wellbeing of the workers in the system? Is there anything about building a quality workplace experience and caring for the people?

Without this clearly laid out in the Mission Statement, the old Triple Aim will trample your people's wellbeing. Cost, quality and the patient experience will always trump any concerns about additional stresses on the providers and staff. 

2) Systems & System Design

Do the people doing the work have a legitimate say in the design and implementation of the systems of care? 

Is there any function within your organization that is ...

  • Asking you about what you find most stressful at work
  • Running projects to improve the system and lower your stress levels
  • Welcoming your feedback and implementing your ideas to build a better workplace

Without this stress feedback loop and the willingness to change the systems of care to support the health and wellbeing of the providers of care ... any changes at work simply add more to your task list and relentlessly increase stress levels over time.

3) Culture

Is your organization's culture one that values the worker's wellbeing? Does anyone care about the experience of working in your organization? How might you figure that out?

The most research-proven method would be to us the good old Gallup 12 questions. How many of the people working on your wing or ward would answer "Yes" to the whole list?

Here are the Gallup 12 questions:

  • Do you know what is expected of you at work?
  • Do you have the materials and equipment to do your work right?
  • At work, do you have the opportunity to do what you do best every day?
  • In the last seven days, have you received recognition or praise for doing good work?
  • Does your supervisor, or someone at work, seem to care about you as a person?
  • Is there someone at work who encourages your development?
  • At work, do your opinions seem to count?
  • Does the mission/purpose of your company make you feel your job is important?
  • Are your associates (fellow employees) committed to doing quality work?
  • Do you have a best friend at work?
  • In the last six months, has someone at work talked to you about your progress?
  • In the last year, have you had opportunities to learn and grow?

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In our experience, organizations that embrace the three components of the Quadruple Aim outlined above, have much higher engagement, camaraderie and less burnout.

AND installing these three components results in rapid culture change and prevention of burnout.

  • Put your people in your Mission Statement. Take a stand for their health and wellbeing.
  • Build a Stress Feedback Loop into your Process Improvement activities. As your people what is stressing them out ... and get on it.
  • Focus on building a Culture of Trust, Teamwork and Engagement by following the simple principles embodied by the Gallup 12 questions. They are a research proven and time honored set of guidelines that will never go out of style as long as healthcare is delivered by humans. 

PLEASE LEAVE A COMMENT:

What do you see as the foundational components of the Quadruple Aim and what is working in your organization?

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Dike Drummond MD is CEO and Founder of TheHappyMD.com. His coaching, training and consulting organization is focused on the prevention of physician burnout and creation of true Quadruple Aim leaders and organizations. He is the author of “Stop Physician Burnout” with over 25,000 copies in print and delivered live burnout prevention training to over 10,000 physicians in 2016 alone.

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