Optimizing Healthcare Performance- The Three Pillars of the Triple Aim

Optimizing Healthcare Performance- The Three Pillars of the Triple Aim

Evidence-based practice (EBP) and the Quadruple Aim focus on achieving better patient care and outcomes. The Quadruple Aim focuses on reducing healthcare costs, improving population health, improving patient experience, and improving team well-being, and is achieved through enhanced efficiency in healthcare (Arnetz et al., 2020). On the other hand, EBP is the integration of clinical knowledge, patient preferences, and the best available research evidence to guide healthcare and clinical decisions. EBP contributes to the achievement of healthcare efficiency, improved patient safety, and better patient outcomes (Leming-Lee & Watters, 2019). Thus, the connection between EBP and the Quadruple Aim can be explored based on how EBP contributes to the achievement of the Quadruple Aim.

EBP in Reducing Healthcare Costs

The reduction of healthcare costs is one of the major aims of the Quadruple Aim. The focus of this aim is to ensure the costs of healthcare services remain affordable to the general population with the goal of ensuring equitable access. The implementation of EBP in healthcare settings has the potential to significantly reduce the costs of care. EBP promotes the utilization of the most cost-effective and targeted intervention for a condition or a situation. The decision to select the intervention of choice is based on the comparative analysis of evidence on possible and available interventions. This avoids the use of unnecessary or ineffective treatments that contribute to higher care costs. A major contributing factor to healthcare costs is the wastage of available scarce resources (Shrank et al., 2019). EBP helps reduce wastage and, therefore, the costs of healthcare by freeing up resources from non-value-added and inefficient production practices (Sikka et al., 2015).

EBP in Improving Population Health

Improving population is another major area of focus in the Quadruple Aims. Population health focuses on health outcomes, the distribution of such outcomes, and the patterns of health and determinants of health among a group of individuals (Silberberg et al., 2019). EBP is a result of systematic searching for, analysis, and implementation of the best evidence of intervention with a focus on improving healthcare outcomes at the individual and community level (Crabtree et al., 2016). Therefore, through EBP, health systems design and implement interventions, including curative and preventative interventions, that improve the overall health outcomes of the population.

EBP in Improving Patient Experience

Patient experience is one of the major outcomes of quality care. The Quadruple Aim seeks to deliver care that goes beyond the physical outcomes of care to satisfaction and comfort. Integrating EBP within usual patient care means implementing interventions that focus on the physical, mental, social, economic, and cultural aspects and needs of the patients. It also supports a culture of quality care and patient safety, which contribute to improved patient-physician relationships and patient satisfaction (Karaca & Durna, 2019).

EBP in Improving Healthcare Team Well-being

Healthcare providers’ wellness and satisfaction with their work roles determine their ability to deliver quality and safe patient care as well as achieve the other aspects of the Quadruple Aim. Healthcare workers are at risk of and experience psychological and physical harm due to factors within their work environment (Kim et al., 2016). Too much workload can lead to an unbalanced work-life balance. Poor work-life balance is a risk for poor health, poor delivery of care services, burnout, and absence from work. EBP supports the improvement of healthcare workers’ wellbeing by creating a work environment that creates a balance between work and personal life by ensuring the efficiency of the process of care delivery. It also helps implement strategies that eliminate or reduce the major stressors that affect the care providers’ job satisfaction and well-being, thus helping achieve the Quadruple Aim.

 References

Arnetz, B. B., Goetz, C. M., Arnetz, J. E., Sudan, S., Vanschagen, J., Piersma, K., & Reyelts, F. (2020). Enhancing healthcare efficiency to achieve the Quadruple Aim: an exploratory study. BMC Research Notes, 13(1). https://doi.org/10.1186/S13104-020-05199-8

Crabtree, E., Brennan, E., Davis, A., & Coyle, A. (2016). Improving Patient Care Through Nursing Engagement in Evidence-Based Practice. Worldviews on Evidence-Based Nursing, 13(2). https://doi.org/10.1111/wvn.12126

Karaca, A., & Durna, Z. (2019). Patient satisfaction with the quality of nursing care. Nursing Open, 6(2), 535–545. https://doi.org/10.1002/NOP2.237

Kim, S. C., Stichler, J. F., Ecoff, L., Brown, C. E., Gallo, A. M., & Davidson, J. E. (2016). Predictors of Evidence-Based Practice Implementation, Job Satisfaction, and Group Cohesion Among Regional Fellowship Program Participants. Worldviews on Evidence-Based Nursing, 13(5). https://doi.org/10.1111/wvn.12171

Leming-Lee, T. S., & Watters, R. (2019). Translation of Evidence-Based Practice: Quality Improvement and Patient Safety. Nursing Clinics, 54(1), 1–20. https://doi.org/10.1016/J.CNUR.2018.10.006

Shrank, W. H., Rogstad, T. L., & Parekh, N. (2019). Waste in the US Health Care System: Estimated Costs and Potential for Savings. JAMA, 322(15), 1501–1509. https://doi.org/10.1001/JAMA.2019.13978

Sikka, R., Morath, J. M., & Leape, L. (2015). The quadruple aim: Care, health, cost, and meaning in work. In BMJ Quality and Safety (Vol. 24, Issue 10). https://doi.org/10.1136/bmjqs-2015-004160

Silberberg, M., Martinez-Bianchi, V., & Lyn, M. J. (2019). What Is Population Health? Primary Care, 46(4), 475–484. https://doi.org/10.1016/J.POP.2019.07.001

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Healthcare organizations continually seek to optimize healthcare performance. For years, this approach was a three-pronged one known as the Triple Aim, with efforts focused on improved population health, enhanced patient experience, and lower healthcare costs.

More recently, this approach has evolved to a Quadruple Aim by including a focus on improving the work life of healthcare providers. Each of these measures is impacted by decisions made at the organizational level, and organizations have increasingly turned to EBP to inform and justify these decisions.

Optimizing Healthcare Performance- The Three Pillars of the Triple Aim

To Prepare:

Read the articles by Sikka, Morath, & Leape (2015); Crabtree, Brennan, Davis, & Coyle (2016); and Kim et al. (2016) provided in the Resources.
Reflect on how EBP might impact (or not impact) the Quadruple Aim in healthcare.
Consider the impact that EBP may have on factors impacting these quadruple aim elements, such as preventable medical errors or healthcare delivery.
To Complete:

Write a brief analysis (no longer than 2 pages) of the connection between EBP and the Quadruple Aim.

Your analysis should address how EBP might (or might not) help reach the Quadruple Aim, including each of the four measures:

Patient experience
Population health
Costs
Work-life of healthcare providers