The relative advantage of the intervention and its compatibility with perceived needs likely enhance buy-in, so interventions that simplify work processes and reduce work stress may be more effectively implemented.Īn intervention is needed that comprehensively targets the numerous demands faced in primary care delivery. Yet, obtaining buy-in from clinic staff is crucial for implementation success. Considering the many time-related demands and pressures that healthcare team members face in their daily work, the added responsibility of changing routine care practice or workflow can seem tedious and unimportant. Practice change, and the incorporation of research evidence into routine clinical practice can be extremely challenging for healthcare workers. While these intervention strategies can foster improvement related to the targeted issue, they often fail to address the root causes of stress and burnout, and may be a temporary fix for organizational problems that will eventually return. For example, interventions such as mindfulness and stress management are often used to improve the well-being of the healthcare team. Despite this, interventions tend to target one specific problem rather than comprehensively targeting the challenges experienced in primary care. These competing demands contribute to the burden that healthcare professionals are experiencing today, likely encouraging moral distress and burnout and creating a cycle that makes it even harder to provide high-quality care. These burdens trickle down within teams, creating a stressful environment wherein team members must work with administrative tasks instead of focusing on patient care. Despite these pressures, physicians are also dedicated to providing quality care to their patients. Many physicians spend hours of overtime completing EHR and other administrative tasks. These include expectations of physicians to generate wRVU by seeing more patients, suboptimal design of the EHR (electronic health record), shifting patient/consumer expectations of the provider-patient relationship, and a rapidly increasing alternative primary care sector, e.g., walk-in clinics, urgent care, concierge medicine, and online offerings. There are an increasing number of forces that create demands on providers’ performance and cognitive load. Thus, healthcare systems are facing 2 daunting yet seemingly opposed challenges: striving to achieve the goals proposed in the Quadruple Aim while increasing productivity. Most private insurers mimic this productivity-based reimbursement strategy. Reimbursement for care provided in the United States is based on productivity, i.e., work relative value units (wRVU), despite a shift towards value-based care by the Centers for Medicare and Medicaid Services. These foci are crucial for healthcare quality, yet healthcare systems must also consider other factors. These performance dimensions can be applied to far-reaching, crucial healthcare challenges, such as reducing the massive rates of burnout present in healthcare workers and combating rising healthcare costs. The framework encompasses reducing costs, improving population health and patient experience, with a new fourth domain: healthcare team well-being. In 2014, the Quadruple Aim-adapted from the widely-accepted Triple Aim -was suggested as a framework to optimize healthcare system performance. The Creative Commons Public Domain Dedication waiver ( ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
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