UNC School of Medicine, UNC Health Care officially adopt Quadruple Aim

Read a memo from William L. Roper, MD, MPH, CEO, UNC Health Care, Dean, UNC School of Medicine, and Wesley Burks, MD, Executive Dean, UNC School of Medicine, outlining the steps the UNC School of Medicine and UNC Health Care are taking to address provider burnout.

Dear colleagues,

Provider burnout is a national, complex and systemic issue that is receiving increasing attention from those both within and outside the field of healthcare.  Medicine is facing an era of rapid and continuous change in nearly every way: payment models, technology, standards for clinical practice, and consumer driven healthcare.

As we navigate in an increasingly stressful environment while attempting to continue the same level of academic productivity, we, like all institutions across the country, have witnessed increasing rates of provider burnout.  National studies have shown that burnout can lead to decreased productivity, increased medical errors, poorer patient satisfaction, provider attrition, and it is shown to impact individuals across all ages, gender and career stages. At UNC we are taking this issue seriously.

The way forward requires novel approaches that integrate and add wellness as a critical metric in our collective performance as an institution. In addition to the traditional triple aims of enhancing patient experience, improving population health, and reducing costs, we must add a fourth aim, improving provider work life.  Taken together, these encompass what has become known as the “Quadruple Aim” (Bodenheimer and Sinsky, 2014).

Today, we at the UNC School of Medicine are formally adopting the Quadruple Aim.

UNC has been a leader in providing assessment and treatment for provider burnout through the successful Taking Care of Our Own Program that was founded in 2012 and is directed by Dr. Samantha Meltzer-Brody.  Demand for services from this program continues to grow, so we are pleased to announce that it has recently been refunded by UNC Faculty Physicians.  In addition, several other new programs aimed at the Quadruple Aim are currently underway or in development:

  • Implementation of the Mayo Clinic-designed provider well-being tracking tool.
  • Administration of the AAMC Faculty Engagement Survey to measure burnout, its causes and suggest solutions.
  • Launch of a peer-led Emotional Support Program for all providers in the SOM and HCS impacted by adverse patient events, funded by UNC Hospitals.
  • Growth of the institutional Wellness Committee to identify current issues and develop programming and innovative solutions.
  • Creation of a program coordinator position in the SOM to assist in development and implementation of wellness initiatives and resource dissemination.
  • Enhancement of medical student wellness programs, including: the Advisory College System; Healer’s Art Course; Intensive Integration Course; and the Professional Development Course.
  • Launch of the CPR2 (Commitment to Positive Respectful Relationships) campaign, which aims to increase awareness that environmental factors and burnout, as well as individual factors, contribute to lapses in our patient care and our learning environment.
  • Continuation of Passing the Torch: Fostering Medical Humanism Through Faculty Role Models. 
  • Launch of a new Doris Duke Foundation grant called “Caregivers at Carolina” to support and retain scientists with caregiving demands.

We are greatly encouraged by the number of individuals across the institution that are dedicated to improving provider wellness, engagement and satisfaction.  This national issue is one that will require all of us to work together to develop innovative ways of addressing the challenges facing today’s healthcare system.

The email address for all questions and comments regarding these new programs is wellnessprograms@med.unc.edu

Thank you for all that you do each day to fulfill the mission of the UNC SOM: to improve the health and wellbeing of North Carolinians and others whom we serve through excellence and leadership in the interrelated areas of patient care, education and research. We are very proud to work with such an outstanding team.


Bill Roper & Wesley Burks