Concepts include removal of extraneous cognitive load, using clinician neural resource (brain power) optimally for highest order decision making in patient care. The goal of HFE is to fit the healthcare system to the human instead of the human to the healthcare system. Developing the fourth aim of improving the experience of providing care, had high acceptability and aligned with other health system goals of optimization of safety, quality, and performance by applying a human factors/ergonomic (HFE) framework that considers human capabilities and human limitations. This report will describe the process of transition from The Triple Aim to The Quadruple Aim administrative framework of healthcare delivery at the University of Rochester Medical Center. Patient safety, quality of care and clinician well-being are inextricably linked. The biological, psychological and social consequences of burnout from excessive acute and chronic occupational stress are more of a threat to healthcare than commonly acknowledged. High acute occupational stress and chronic occupational stress can cause direct and indirect effects on safety and quality of care.
Research is pointing to consequent negative effects on quality, safety, joy, meaning and sustainability of healthcare practice. The framework encompasses reducing costs, improving population health and patient experience, with a new fourth domain: healthcare team well-being 2. It is at the forefront of Canadian reform debates aimed to improve a complex and often-fragmented health care system. As a result, the experience and human factors of providing care are often overlooked at high level decision-making unless incorporated into the healthcare delivery framework, proposed as the fourth aim of The Quadruple Aim framework. In 2014, the Quadruple Aimadapted from the widely-accepted Triple Aim was suggested as a framework to optimize healthcare system performance. The Quadruple Aim advocates for: improving patient experience, reducing cost, advancing population health and improving the provider experience. Many industries which support healthcare and healthcare administrators do not have firsthand knowledge of the complexities in delivering care. A common administrative framework of healthcare involves focus upon costs, quality and patient satisfaction (The Triple Aim). Annals of Family Medicine, 12, 573-576.Īddressing Human Factors in Burnout and the Delivery of Healthcare: Quality & Safety Imperative of the Quadruple Aimīurnout, Human factors, Ergonomics, Safety, Clinician Wellbeing, Quadruple Aim, Integrative ModelĪBSTRACT: Human factors in the delivery of service are considered in many occupations of high impact on others such as airline industry and nuclear power industry, but not sufficiently in healthcare delivery. (2014) From Triple to Quadruple Aim: Care of the Patient Requires Care of the Provider.
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