Health Care’s Quadruple Aim in Action

This issue of NEJM Catalyst Innovations in Care Delivery includes articles, case studies, and research reports on hospital transfers, outpatient antibiotic therapy, pediatric care quality, pediatric cardiac care, musculoskeletal care costs, frontline clinician support, patient portals, an AI digital assistant, and home-based care.The Quadruple Aim -an extension of the Triple Aim popularized by the Institute for Healthcare Improvement -has been widely accepted for its balanced explication of care delivery.The original elements of a better patient experience, improved population health, and lower cost of care were bolstered by consideration of provider well-being.The contents of this issue of NEJM Catalyst Innovations in Care Delivery show the interplay between these four essential elements of health care delivery.For certain procedures, high-quality patient care is best accomplished in tertiary care centers, which have the necessary physical infrastructure and technical expertise.Yet transfers can take precious time.In "The Procedure -Only Transfer Pathway: An Alternative to Standard Interhospital Transfer to Address Time -sensitive Procedural Needs," Michael Hendricks, M.D., F.H.M., and colleagues at Oregon Health & Science University describe a novel workflow through which patients hospitalized at rural or community hospitals can receive necessary tertiary care procedures at an urban, academic hospital without the need for full interhospital transfer.Health care extends beyond the hospital stay, of course.And postdischarge outpatient care especially faces challenges in care coordination."Creating a Coordinated Complex Outpatient Antibiotic Therapy Program to Improve Outcomes and Reduce Costs in a Multihospital System" by Alyssa Christensen, Pharm.D., and associates at HealthPartners Hospitals and Clinics and the HealthPartners Institute profiles the health system's Antimicrobial Stewardship Program, which was associated with sharply reduced duration of therapy -50.3 days preintervention versus 34.7 days postintervention.No population's health is more important than that of children.An article, "