acceptable, dignified means of finding alternative employment.
The Quadruple Aim
The Institute for Healthcare Improvement instituted a framework describing the optimization of
health system performance, stating that three
mutually reinforcing dimensions must be simultaneously pursued. They promoted the Triple Aim
F Improving the patient care experience (quality
F Improving population health
F Reducing costs10, 11
The Quadruple Aim expands this by adding
a fourth component, provider well-being.
Enhancing quality and outcomes for patients
and organizations must be addressed with
the same effort as
improving the experi-
ence of providing care,
increased job sat-
and reduced burn-
out. 12 Our emphasis
on patient-centered care (“the needs of the
patient come first”) remains steadfast, but this
conversation expands to include a renewed
emphasis on the importance of provider sat-
isfaction and well-being. As the well-being of
patients and staff are both extremely import-
ant, it behooves a business in any industry
to develop its culture and values around the
interests of both employees and customers.
This business philosophy aligns with the service
profit chain concept that when a company puts
an emphasis on both employee and customer
satisfaction, profits follow. 13
Hearts and Minds
Creating a healthcare entity culture takes time.
A foundation of values must first be planted,
allowed to take root, and encouraged to grow.
Changing the hearts and minds of senior
members will be more challenging than hiring
into the new organization, where those responsible for recruiting can focus on identifying a
potential candidate’s fit into the system to help
ensure that carefully screened employees arrive
with behaviors and qualities that the organization desires.
While perhaps not necessarily comprehensively applicable to health care, the Zappo
company’s 10 core values feel real and worthy
of consideration (see “Zappo’s Core Values”). 14
When coordinating a merger of two or more
disparate philosophies or individuals, consider
creating and reinforcing a culture predicated on
these 10 core values. Perhaps emphasize “deliver
WOW through customer service,” while maybe
going light on “create a little weirdness.” Good
things will follow over time.
Peter Kalina, M.D., M.B.A., FACR, is a radiologist at
the Mayo Clinic in Rochester, Minnesota.
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Creating a healthcare entity culture
takes time. A foundation of values
must first be planted, allowed to
take root, and encouraged to grow.