Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA.
Mercy Health, Grand Rapids, MI, USA.
BMC Res Notes. 2020 Jul 31;13(1):362. doi: 10.1186/s13104-020-05199-8.
Healthcare is battling a conflict between the Quadruple Aims-reducing costs; improving population health, patient experience, and team well-being-and productivity. This quasi-experimental pilot study tested a 2 week intervention aimed to address the Quadruple Aims while improving productivity. Participants were 25 employees and their patients in a primary care clinic. One provider and their team implemented an efficiency-focused intervention that modified work roles and processes focused on utilizing all team members' skills as allowable by applicable licensure restrictions. The five remaining providers and their teams comprised the reference group, who continued patient care as usual. Study outcomes were measured via provider/staff and patient surveys and administrative data.
In total, 46 team surveys and 156 patient surveys were collected. Clinic output data were retrieved for 467 visits. Compared to the reference team, the intervention team performed better in all Quadruple Aims and productivity measures. The intervention group offered 48% more patient slots than the average reference team. These preliminary results support the feasibility of introducing substantial process changes that show promising improvement in both the Quadruple Aims and productivity. A larger-scale study over a longer time period is needed to confirm findings and examine feasibility and cost-effectiveness.
医疗保健行业正面临着四重目标（降低成本；提高人口健康水平、患者体验和团队幸福感）与生产力之间的冲突。这项准实验性试点研究测试了一项为期两周的干预措施，旨在实现四重目标的同时提高生产力。参与者是一家初级保健诊所的 25 名员工及其患者。一名医生及其团队实施了一项以效率为重点的干预措施，修改了工作角色和流程，重点是利用所有团队成员的技能，但须遵守适用的许可限制。其余五名医生及其团队构成了对照组，他们继续照常进行患者护理。研究结果通过医生/员工和患者调查以及行政数据进行衡量。
共收集了 46 份团队调查和 156 份患者调查，检索了 467 次就诊的门诊数据。与对照组相比，干预组在四重目标和生产力衡量方面均表现更好。干预组提供的患者就诊名额比平均对照组多 48%。这些初步结果支持引入重大流程变革的可行性，这些变革有望在四重目标和生产力方面取得显著改善。需要进行更大规模、更长时间的研究来确认这些发现，并检验其可行性和成本效益。
