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Reading: Designing Outside the Lines to Achieve the Quadruple Aim


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Conference Abstracts

Designing Outside the Lines to Achieve the Quadruple Aim


Allison Loh-Kandylis ,

CBI Health, CA
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Kathleen McQueen

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The COVID-19 pandemic impelled healthcare organizations to rapidly innovate and integrate to ensure patients receive the care they need. In 2020/21, several Ontario hospitals and home and community-based partners collaborated to co-design, deliver and evaluate an integrated Restorative Health Approach targeting priority populations such as frail seniors to improve system capacity, while achieving sustainable health and system outcomes.

By involving people as partners and using existing technology in unprecedented ways to enable real-time information sharing, patient activation, and to achieve one integrated interdisciplinary care plan, we were able to better support clinical decision making, team collaboration and person centered care.

Aims Objectives Theory or Methods

The aim of the Restorative Health Approach is to create coordinated and continuous pathways that support safe, timely transitions of care, while focusing on person-centered goal attainment, shared decision making and enabling patients and families to reach their optimal level of functioning and well-being. 

To achieve these goals, partners took a flexible and intentional approach to integration; partnering with patients, caregivers, and health and social care partners to create one integrated team with shared goals focused around patient and family needs. To drive integration and enhance team satisfaction, technology was leveraged in innovative ways to collaborate and monitor health.

Highlights or Results or Key Findings

The engagement of clients and families was essential to goal achievement, supported by coordinated and integrated interdisciplinary teams and digital tools that were designed to enhance the care experience. Real-time information sharing at the point of care and one integrated person-centered interdisciplinary care plan was essential to an informed, collaborative and integrated care team focused on coordinating care around the patient’s needs. Remote patient monitoring was leveraged to not only monitor vital signs but also support patient self-management and adherence to clinical pathways.


Quadruple Aim Outcomes:

•           70% reduction in ED visits

•           50% decrease in service plans

•           30% decrease in hospitalizations

•           88% patients experienced sustainable functional improvement

•           60% patients discharged to self-care

•           88% patients experienced reversal in clinical frailty

•           80% caregivers report a positive change in loved one

•           92% providers feel empowered in their role

•           88% providers feel the program enables collaborative practice

•           100% patients feel safe and supported at home


Out of the box thinking is required to optimize and redesign technology to achieve the quadruple aim. Technology is a key enabler that not only accelerates integration across the care continuum but also supports a unique restorative health approach that results in superior outcomes.

Implications for applicability/transferability sustainability and limitations

Active involvement of people in design, implementation and evaluation of technology ensures digital tools are meaningful and supports integrated care, which is critical to adoption. People need to be a part of the design process and supported along the way to sustain change, enhance scalability and achieve desired outcomes.

How to Cite: Loh-Kandylis A, McQueen K. Designing Outside the Lines to Achieve the Quadruple Aim. International Journal of Integrated Care. 2022;22(S2):120. DOI:
Published on 16 May 2022.


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