Aiming for health equity: the bullseye of the quadruple aim

Olayiwola, J. Nwando; Rastetter, Mark

doi:10.21037/jhmhp-20-101

Cited by 7 publications

(4 citation statements)

References 10 publications

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“…Current healthcare transformation efforts are being guided by the Quadruple Aim, which is centred on four key and interrelated goals: improve the patient experience of care; improve the health of populations; improve the healthcare provider experience; and improve value for money (Olayiwola and Rastetter 2021). Zagrodney et al (2023), in this regard, have helped to demonstrate how achieving wage parity can enable the achievement of these four aims.…”

Section: Our Path Forwardmentioning

confidence: 99%

Commentary: Minding the Gap – Why Wage Parity Is Crucial for the Care of Older Canadians

Kokorelias,

Sinha

2023

hcpol

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Zagrodney and colleagues (2023) have highlighted the pay differences that exist between those working in the home and community care (HCC) sector and other healthcare sectors. The authors argue that achieving wage parity could significantly mitigate the current HCC human resource crisis, support the overall sustainability of Ontario' s healthcare system and improve patient outcomes. We build on their argument by highlighting issues that have contributed to wage disparities within healthcare systems and discuss how addressing them can create more equitable systems for both those receiving and those providing care. We further note how other healthcare systems that have wage parity have demonstrated that it is not a "nice to have" but an essential element of establishing a sustainable health human resources strategy. Finally, the new 10-year bilateral healthcare funding agreements that the federal,

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Section: Our Path Forwardmentioning

confidence: 99%

Commentary: Minding the Gap – Why Wage Parity Is Crucial for the Care of Older Canadians

Kokorelias,

Sinha

2023

hcpol

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“…Some have argued that health equity is the "bullseye" of the Quadruple Aim. 7 A 2016 Agency for Healthcare Research and Quality White Paper introduced a Quintuple Aim that included health equity. 3 Given the pervasiveness of health inequities in the United States and their devastating impact on health outcomes, we believe that adding health equity as a distinct aim is long overdue.…”

Section: Rationale For the Quintuple Aimmentioning

confidence: 99%

Academic Health Centers and the Quintuple Aim of Health Care

Farrell¹,

Greer²,

Bennie³

et al. 2022

Academic Medicine

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The Quintuple Aim of health care adds health equity to the existing Quadruple Aim of improving the individual experience of care for patients, improving the health of populations, reducing the per capita cost of care, and improving the experience of health care professionals. Health equity has previously been subsumed within the other 4 aims. Elevating health equity to the status of a distinct aim is necessary to address persistent health inequities that disproportionately affect underrepresented and minoritized groups. Academic health centers (AHCs) bear a unique responsibility to advance health equity due to the societal importance of their 4 missions: patient care, education, research, and community collaboration. Interprofessional education and practice provide natural connection points that enable AHCs to prepare both health professions students and practicing health care professionals to address all 5 aims. AHCs are well positioned to assess health outcomes related to health equity, develop a health care workforce that is representative of their communities, develop innovative research questions regarding health equity, and engage and invest in the communities they serve.

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“…We all aspire to achieve the Quadruple Aim for our nation: lower costs, improved patient experiences, population health, and optimized care team experiences. To do this, however, we must center a commitment to achieving health equity for all, 8 ensuring that every member of our society has the best opportunity to reach their full health potential without a myriad of barriers that undermine that proposition.…”

Section: Treating Bias In Our Own Backyardmentioning

confidence: 99%

Not in My Backyard: Centering Health Equity in the Quadruple Aim

Olayiwola

2022

Otolaryngol.--head neck surg.

Self Cite

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Early in my career, I treated a young African American adolescent with persistent and recurrent ear infections. He lived in a low-income housing apartment in urban Connecticut. For years, he struggled with ear infections, ultimately resulting in hearing loss and chronic ear pain that eventually required ear tubes.Examining the root causes of his affliction, we could point to any number of origins and accelerants. Outside the walls of the clinic, studies on environmental racism in the form of substandard living conditions, urban pollution, and excessive noise account for elevated risk of middle ear infections that often go untreated. 1 As a result of these festering conditions, academic performance suffers. 2 My patient's constant ear pain and absenteeism exacerbated challenges in an urban classroom already underfunded and overcrowded. Further upstream, we could identify a range of structural biases like employment and housing discrimination that limited available options where his family could settle and the kind of health services they were able to afford. And then there is the cumulative impact of stress on his body that all these factors intensified. 3 Inside the exam room, prejudice was commonplace in his clinical encounters. 4 While the patient's lived experience was informed by his gender, race, and socioeconomic status, a mere fraction of providers delivering his care had any cultural alignment with the patient. This is deeply concerning, as data indicate that greater congruence between patients and providers yields better care delivery, better outcomes, and better adherence to care plans. 5 Moreover, processes and stereotypes ingrained in medical education play a significant role in shaping the biases of providers; in fact, clinical encounters routinely begin with assumptions of a patient's age, gender identity, and race/ethnicity. One systematic review of unconscious bias in care delivery found strong evidence of the impact of bias on clinical judgment and treatment of the patient. 6 In sum, there were scarcely any environments for this young man and his family that were not influenced by or vulnerable to prejudice.

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Aiming for health equity: the bullseye of the quadruple aim

Cited by 7 publications

References 10 publications

Commentary: Minding the Gap – Why Wage Parity Is Crucial for the Care of Older Canadians

Commentary: Minding the Gap – Why Wage Parity Is Crucial for the Care of Older Canadians

Academic Health Centers and the Quintuple Aim of Health Care

Not in My Backyard: Centering Health Equity in the Quadruple Aim

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