Adding provider satisfaction as another goal to the triple aim

This article in the Annals of Family Medicine addresses the problem of health care provider burnout as an impediment to the triple aim of health care. The authors call for the addition of a fourth goal, the implementation of measures to improve provider satisfaction, thus moving from the triple aim to the quadruple aim.

The article is well referenced and cites multiple lines of evidence which tie physician burnout to bad patient outcomes.

There are multiple causes of provider burnout but most of the factors cited in the article relate in one way or another to the electronic medial record. In fact, the authors' first recommendation was to offload physicians by reducing CPOE and other clerical duties:

Implement team documentation: nurses, medical assistants, or other staff, present during the patient visit, entering some or all documentation into the EHR, assisting with order entry, prescription processing, and charge capture.

CPOE was originally hyped as a quality, safety and efficiency driver and it was politically incorrect to speak of it otherwise. Clinical outcomes data in the ensuing years were disappointing and physician skepticism grew as CPOE failed to live up to its promise.

Via DB's Medical Rants.