I n 2007 the Institute for Healthcare Improvement presented what is now called the "Triple Aim" as a framework that describes an approach for optimizing health system performance. The institute has indicated that new designs are needed to simultaneously pursue the 3 dimensions of the Triple Aim: (1) improving the patient experience of care (including quality and satisfaction), (2) improving the health of populations, and (3) reducing the per capita cost of health care. 1 The primary focus of the Triple Aim is patient care. Patient care is widely accepted in the United States as an important agenda, but the Triple Aim also has 2 secondary goals: improving the patient experience and reducing costs. 2 This article addresses the health care provider's work environment, the Triple Aim, and the evolution of what is known as the "Quadruple Aim." Healthy work environments are related to the goals of the Triple Aim. Improvement of the work environment provides an opportunity to promote joy in the workplace. Interventions to improve the work environment of health care providers are consistent with the Healthy Work Environment standards of the American Association of Critical-Care Nurses (AACN). 3 Healthy Work Environments and Patient SafetyHealth care organizations are seeking ways to improve the work environment because research has shown a direct link between a healthy work environment and patient safety. 4,5 Problems in nurses' work environments can lead to feelings of being overwhelmed at work, emotional exhaustion, and burnout. Lyndon 6 has reported that burnout is common among health care workers and that the characteristics of the health care environment that contribute to burnout include time pressure, lack of control over work processes, role conflict, and poor relationships between professional groups and with leadership. Other factors contributing to stress and burnout are lack of support for the staff