Operationalizing the Quintuple Aim of Health System Improvement Through Equity-Oriented Health Care

Area of Science:

• Health services research
• Public health policy
• Healthcare management

Background:

• Canadian health systems are experiencing significant strain from syndemic shocks and political-economic pressures.
• These pressures negatively affect health equity, staff well-being, recruitment, and retention.
• Increasing privatization of publicly funded healthcare poses risks to equitable access and outcomes.

Purpose of the Study:

• To examine current health system improvement approaches.
• To assess their alignment with the quintuple aim (patient experience/outcomes, efficiency, provider well-being, health equity, and system resilience).
• To evaluate Equity-Oriented Health Care (EOHC) as an alternative.

Main Methods:

• Literature review and analysis of existing health system improvement models.
• Comparative assessment of private sector models (Lean, Six Sigma) against the quintuple aim.
• Examination of EOHC's potential to address system pressures and equity concerns.

Main Results:

• Private sector quality improvement models (Lean, Six Sigma) can increase costs and negatively impact provider well-being and patient experience.
• These models may improve specific care processes but have not been well-tested for equity when added as an afterthought.
• EOHC presents a viable alternative aligned with the quintuple aim.

Conclusions:

• Existing private sector-derived models may not adequately address the complex challenges facing health systems.
• Equity-Oriented Health Care (EOHC) is a promising, innovative approach for health system improvement.
• EOHC can mitigate system pressures, enhance service effectiveness, and improve population health outcomes.