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
- 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.
All article are found attached
2pages, APA format,
Please use rubrics
EVIDENCE-BASED PRACTICE AND THE QUADRUPLE AIM
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 are impacted by decisions made at the organizational level, and organizations have increasingly turned to EBP to inform and justify these decisions.
RESOURCES
Be sure to review the Learning Resources before completing this activity. Click the weekly resources link to access the resources.
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 of:
· Patient experience
· Population health
· Costs
· Work life of healthcare providers
BY DAY 7 OF WEEK 1
Submit your anaylsis.
SUBMISSION INFORMATION
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Rubric
NURS_6052_Module01_Week01_Assignment_Rubric
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NURS_6052_Module01_Week01_Assignment_Rubric |
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Criteria |
Ratings |
Pts |
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This criterion is linked to a Learning OutcomeWrite a brief analysis of the connection between evidence-based practice and the Quadruple Aim. Your analysis should address how evidence-based practice might (or might not) help reach the Quadruple Aim, including each of the four measures of:· Patient experience· Population health· Costs· Work life of healthcare providers |
85 to >76.0 ptsExcellentThe analysis clearly and accurately addresses in detail how evidence-based practice either supports or does not support the Quadruple Aim. … The analysis accurately and thoroughly explains in detail how the four measures of patient experience, population health, costs, and work-life of healthcare providers either supports or does not support the Quadruple Aim. … The analysis provides a complete, detailed, and specific synthesis of two outside resources reviewed on the four measures supporting or not supporting the Quadruple Aim. The response fully integrates at least two outside resources and two or three course-specific resources that fully support the analysis provided with credible and detailed examples. 76 to >67.0 ptsGoodThe analysis accurately addresses how evidence-based practice either supports or does not support the Quadruple Aim. … The analysis accurately explains how the four measures of patient experience, population health, and work life of healthcare providers either supports or does not support the Quadruple Aim. … The analysis provides an accurate synthesis of at least one outside resource reviewed on the four measures supporting or not supporting the Quadruple Aim. The response integrates at least 1 outside resource and two or three course-specific resources that may support the analysis provided and may include some detailed examples. 67 to >59.0 ptsFairThe analysis inaccurately or vaguely addresses how evidence-based practice either supports or does not support the Quadruple Aim. … The analysis inaccurately or vaguely explains how the four measures of patient experience, population health, and work life of healthcare providers either supports or does not support the Quadruple Aim. … The analysis provides an inaccurate or vague analysis of the four measures supporting or not supporting the Quadruple Aim with a vague or inaccurate analysis of outside resources. The response minimally integrates resources that may support the analysis provided and may include vague or inaccurate examples. 59 to >0 ptsPoorThe analysis inaccurately and vaguely addresses how evidence-based practice either supports or does not support the Quadruple Aim or is missing. … The analysis inaccurately and vaguely explains how the four measures of patient experience, population health, and work life of healthcare providers either supports or does not support the Quadruple Aim or is missing. … The analysis provides a vague and inaccurate analysis of the four measures supporting or not supporting the Quadruple Aim with a vague and inaccurate analysis of outside resources. The response fails to integrate any resources to support the analysis provided or is missing. |
85 pts |
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This criterion is linked to a Learning OutcomeWritten Expression and Formatting—Paragraph Development and Organization:Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria. |
5 to >4.0 ptsExcellentParagraphs and sentences follow writing standards for flow, continuity, and clarity. … A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria. 4 to >3.5 ptsGoodParagraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. … Purpose, introduction, and conclusion of the assignment is stated yet is brief and not descriptive. 3.5 to >3.0 ptsFairParagraphs and sentences follow writing standards for flow, continuity, and clarity 60–79% of the time. … Purpose, introduction, and conclusion of the assignment is vague or off topic. 3 to >0 ptsPoorParagraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. … No purpose statement, introduction, or conclusion was provided. |
5 pts |
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This criterion is linked to a Learning OutcomeWritten Expression and Formatting—English Writing Standards:Correct grammar, mechanics, and proper punctuation. |
5 to >4.0 ptsExcellentUses correct grammar, spelling, and punctuation with no errors. 4 to >3.5 ptsGoodContains a few (one or two) grammar, spelling, and punctuation errors. 3.5 to >3.0 ptsFairContains several (three or four) grammar, spelling, and punctuation errors. 3 to >0 ptsPoorContains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. |
5 pts |
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This criterion is linked to a Learning OutcomeWritten Expression and Formatting—The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list. |
5 to >4.0 ptsExcellentUses correct APA format with no errors. 4 to >3.5 ptsGoodContains a few (one or two) APA format errors. 3.5 to >3.0 ptsFairContains several (three or four) APA format errors. 3 to >0 ptsPoorContains many (five or more) APA format errors. |
5 pts |
Total Points: 100
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The Quadruple Aim: care, health, cost and meaning in work
Rishi Sikka,1 Julianne M Morath,2 Lucian Leape3
1Advocate Health Care, Downers Grove, Illinois, USA 2Hospital Quality Institute, Sacramento, California, USA 3Harvard School of Public Health, Boston, Massachusetts, USA
Correspondence to Dr Rishi Sikka, Advocate Health Care, 3075 Highland Avenue, Suite 600, Downers Grove, Il 60515, USA; [email protected]
Received 5 March 2015 Revised 6 May 2015 Accepted 16 May 2015
To cite: Sikka R, Morath JM, Leape L. BMJ Qual Saf 2015;24:608–610.
In 2008, Donald Berwick and colleagues provided a framework for the delivery of high value care in the USA, the Triple Aim, that is centred around three over- arching goals: improving the individual experience of care; improving the health of populations; and reducing the per capita cost of healthcare.1 The intent is that the Triple Aim will guide the redesign of healthcare systems and the transition to population health. Health systems glo- bally grapple with these challenges of improving the health of populations while simultaneously lowering healthcare costs. As a result, the Triple Aim, although ori- ginally conceived within the USA, has been adopted as a set of principles for health system reform within many organi- sations around the world. The successful achievement of the
Triple Aim requires highly effective healthcare organisations. The backbone of any effective healthcare system is an engaged and productive workforce.2 But the Triple Aim does not explicitly acknow- ledge the critical role of the workforce in healthcare transformation. We propose a modification of the Triple Aim to acknow- ledge the importance of physicians, nurses and all employees finding joy and meaning in their work. This ‘Quadruple Aim’ would add a fourth aim: improving the experience of providing care. The core of workforce engagement is
the experience of joy and meaning in the work of healthcare. This is not synonym- ous with happiness, rather that all members of the workforce have a sense of accomplishment and meaning in their contributions. By meaning, we refer to the sense of importance of daily work. By joy, we refer to the feeling of success and fulfilment that results from meaning- ful work. In the UK, the National Health Service has captured this with the notion of an engaged staff that ‘think and act in a positive way about the work they do, the people they work with and the organ- isation that they work in’.3
The evidence that the healthcare work- force finds joy and meaning in work is not encouraging. In a recent physician survey in the USA, 60% of respondents indicated they were considering leaving practice; 70% of surveyed physicians knew at least one colleague who left their practice due to poor morale.2 A 2015 survey of British physicians reported similar findings with approximately 44% of respondents reporting very low or low morale.4 These findings also extend to the nursing profession. In a 2013 US survey of registered nurses, 51% of nurses worried that their job was affect- ing their health; 35% felt like resigning from their current job.5 Similar findings have been reported across Europe, with rates of nursing job dissatisfaction ranging from 11% to 56%.6
This absence of joy and meaning experi- enced by a majority of the healthcare workforce is in part due to the threats of psychological and physical harm that are common in the work environment. Workforce injuries are much more frequent in healthcare than in other industries. For some, such as nurses’ aides, orderlies and attendants, the rate is four times the indus- trial average.7 More days are lost due to occupational illness and injury in health- care than in mining, machinery manufac- turing or construction.7
The risk of physical harm is dwarfed by the extent of psychological harm in the complex environment of the health- care workplace. Egregious examples include bullying, intimidation and phys- ical assault. Far more prevalent is the psy- chological harm due to lack of respect. This dysfunction is compounded by pro- duction pressure, poor design of work flow and the proportion of non-value added work. The current dysfunctional healthcare
work environment is in part a by-product of the gradual shift in healthcare from a public service to a business model that occurred in the latter half of the 20th
EDITORIAL
608 Sikka R, et al. BMJ Qual Saf 2015;24:608–610. doi:10.1136/bmjqs-2015-004160
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