Comprehensive Safe Start

The Journey from the Triple Aim to the Quadruple Aim

A white paper by:

Mark Kestner, MD
Chief Medical Officer, TractManager

Dee Donatelli, MBA, BSN, CMRP, CVAHP
Director, Value Analysis Consulting, TractManager

Kristin Stitt, DNP, APRN-BC
Value Analysis Consulting Manager, TractManager

Barry Dyer
Sr. Vice President, Consulting & Professional Services, TractManager

As part of TractManager’s ongoing commitment to innovative thinking in healthcare sourcing, contracting, and evidence-based research, this white paper describes how health systems can more effectively assess healthcare technologies in support of long-term strategic priorities.
To learn more about how TractManager can partner with your facility to reach financial, compliance, and patient care goals, visit today.

Comprehensive Safe Start: The Journey from the Triple Aim to the Quadruple Aim


Since 2008, healthcare professionals have been rising to the challenges issued by the Triple Aim. Developed by the Institute for Healthcare Improvement, this framework aims to optimize operations around three pillars: the patient experience, population health, and reducing healthcare costs.

Although widely adopted, the Triple Aim soon revealed a key shortcoming. It did not sufficiently engage clinicians in strategic clinical decisions, specifically in the area of sourcing. Without the support or formal structure necessary to allow healthcare providers some level of control in determining patient outcomes, physician satisfaction plummeted. The Quadruple Aim represents an attempt to rectify this oversight, and the Institute fully supports health systems that pursue it.