![]() ![]() Manchanda and some others suggest we consider expanding the IHI Triple Aim to the “Quadruple Aim” to include critically important job satisfaction. Otherwise, they’re at risk for burnout and anything but joy in work. Manchanda also argues that if frontline providers are asked to address upstream factors like poor housing or job insecurity, they need to have the resources and the knowledge and the active partnerships to draw from. WIHI is pleased to present a Special Edition Podcast, featuring Rishi Manchanda of HealthBegins, discussing why it’s important for health care to “move upstream” to address the social determinants contributing to many patients’ poor health today. Rishi Manchanda, MD, MPH, Chief Medical Officer, The Wonderful Company President & Founder, HealthBegins.Leaders and providers of health care should consider adding a fourth dimension-improving the work life of those who deliver care-to the ensure better care, better health, and lower costs. Positive engagement of the health care workforce is of paramount importance in achieving the primary goal of the Triple Aim-improving population health. The Triple Aim is paving the way forward for our health care system. ![]() To avoid shifting burnout from physicians to practice staff, ensure that staff who assume new responsibilities are well-trained and understand that they are contributing to the health of their patients and that unnecessary work is reengineered out of the practice.This has been shown to increase efficiency and save 30 minutes of physician time per day. Co-locate teams so that physicians work in the same space as their team members.Standardize and synchronize workflows for prescription refills, an approach which can save physicians five hours per week while providing better care.Expand roles allowing nurses and medical assistants to assume responsibility for preventive care and chronic care health coaching under physician-written standing orders.Use pre-visit planning and pre-appointment laboratory testing to reduce time wasted on the review and follow-up of laboratory results.Team documentation has been associated with greater physician and staff satisfaction, improved revenues, and the capacity of the team to manage a larger panel of patients while going home earlier. Implement team documentation: nurses, medical assistants, or other staff present during the patient visit, enter some or all documentation into the EHR, and assist with order entry, prescription processing, and charge capture.How can health care organizations work toward the fourth aim, improving the work life of clinicians and staff? The following list suggests some practical steps from the Annals of Family Medicine: Caregiver burnout among nurses and other team members may contribute to the overuse of resources and increased costs of care. The IHI and other groups have recommended expanding Triple Aim to a Quadruple Aim, adding the goal of improving the work life of health care providers, including clinicians and staff.īurnout among the health care workforce can threaten the success of Triple Aim by lowering patient satisfaction and increasing the possibility of errors. Thus, employee burnout can jeopardize the success of Triple Aim. Burnout is associated with lower patient satisfaction, reduced health outcomes, and it may increase costs. Members of the health care workforce have reported widespread burnout and dissatisfaction. Working on these three elements does not come without setbacks. The Triple Aim-enhancing patient experience, improving population health, and reducing costs-is widely accepted as a compass to optimize health system performance. ![]()
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