Achieving the Quintuple Aim in Healthcare

The cost of healthcare has been escalating over the past several years. Trying to contain and reduce this growth has become a major policy focus not only at the federal and state levels, but among employers and consumers too as they struggle to keep up with the ever-increasing cost of health insurance. Regardless of federal health reform, rising healthcare costs is something that must be discussed and controlled for the vitality and sustainability of employers and nationwide economic growth and stability. The truth is that rising costs are placing an unsustainable strain on state and federal healthcare programs and individual and employer sponsored health plans. So, what are the drivers of cost in these areas? Some of the most significant drivers include: lack of coordination of services among health providers, resulting in inefficiencies and duplication; unnecessary medical treatment, clinical variation, and costly medical errors; and a sky rocketing population of people with one or more chronic diseases. What can be done to address these cost drivers? In 2007 the Institute for Healthcare Improvement (IHI) began the Triple Aim initiative, which has evolved to the Quintuple Aim. The Quintuple Aim seeks to accomplish three objectives: improve patient experience, create better outcomes, lower costs, improve clinician well-being, and enhance health equity. What we have learned is that any future efforts that fail to balance each of these five objectives will have little to no success in improving healthcare delivery. Addressing costs alone is not enough, and looking at quality in a vacuum is not effective.

PANELIST: Lisa Smithgall, PhD, RNC-NIC, NEA-BC, CPNP-PC

Senior Vice President and Chief Nursing Executive

Ballad Health

Lisa Smithgall is the Senior Vice President/Chief Nursing Executive for Ballad Health.  She has 39 years of nursing leadership experience, 22 years of executive nursing leadership experience, and 41 years of experience as a Registered Nurse. 

She is a member of professional nursing organizations including the American Organization of Nurse Executives and Sigma Theta Tau International.  She maintains certifications in nursing practice and nursing leadership as a certified neonatal intensive care nurse, a certified pediatric nurse practitioner, and certified nurse executive.    

She serves as the Adjunct faculty at East Tennessee State University and Co-Director of the East Tennessee State University/Ballad Health Accelerated BSN Nursing Program at Kingsport initiated in 2016.

She received her Bachelor of Science in nursing degree at Bloomsburg University of Pennsylvania in Bloomsburg, PA, her Master of Science in nursing degree from the University of Tennessee, Knoxville, and her Philosophy of Science in nursing degree from East Tennessee State University in Johnson City.

PANELIST: Amit Vashist, MD

Senior Vice President and Chief Clinical Officer

Ballad Health

Overseeing clinical care delivery, quality and safety, process improvement, value-based initiatives, clinical innovation, and medical staff affairs, Dr. Vashist leads the Ballad Health Center for Clinical Transformation & Outcomes Optimization and serves as Chief Clinical Advisor to Ballad Ventures.

Recognized by Becker’s Healthcare over the last several years as a top healthcare leader, Dr. Vashist is dual board-certified in internal medicine and psychiatry. He has led key initiatives, including systemwide tiered safety huddles, medical staff bylaws standardization, and championing Ballad’s journey towards zero harm and High Reliability. His work has significantly improved multiple clinical metrics and outcomes, reduced readmissions, and lowered mortality for sepsis and chronic medical conditions. His work has been published and continues to be cited extensively in national healthcare publications.

Dr. Vashist is an alumnus of the Nashville Healthcare Council Fellowship, serves on the Medicare Evidence Development & Coverage Advisory Committee (MEDCAC), and is on the board of the Virginia Center for Health Innovation. A senior fellow of the Society of Hospital Medicine and a fellow of the American College of Healthcare Executives, he previously chaired Ballad’s Clinical Council and led its 200+ hospitalist division. He continues to practice clinically as a hospitalist physician.

PANELIST: Tammy Van Dyk, MBA, MSN, RN, CENP

Senior Vice President, TN Center for Patient Safety

Tennessee Hospital Association

Tammy Van Dyk is an accomplished nurse executive with almost three decades of experience in

healthcare quality, patient safety, and clinical leadership. She currently serves as the Senior Vice President of the Tennessee Center for Patient Safety at the Tennessee Hospital Association (THA), where she provides strategic direction on clinical quality, patient safety, regulatory initiatives, and advocacy efforts across the state. As Chief Quality Officer (CQO) for THA, she leads multiple statewide collaboratives, overseeing initiatives that drive measurable improvements in healthcare outcomes and safety culture.

A native of Knoxville, TN, Tammy dedicated over two decades to East Tennessee Children’s Hospital, holding roles ranging from staff nurse to Director of Quality Management & Patient Safety. She has extensive experience in high reliability principles, infection prevention, regulatory compliance, medical staff credentialing, leading transformational initiatives that improve patient outcomes, reducing hospital-acquired conditions, and strengthening safety culture.

Tammy holds a Master of Business Administration (MBA) in Healthcare Leadership from the University of Tennessee, a Master of Science in Nursing (MSN) Administration from the University of Phoenix, and a Bachelor of Science in Nursing (BSN) from the University of Tennessee, where she graduated Summa Cum Laude.

Recognized for her contributions to hospital patient safety, she received the Tennessee Hospital Association Patient Safety Leadership Award in 2019. She is a sought-after speaker at regional, state, and national conferences, sharing expertise in patient safety, high reliability, workplace culture, and quality improvement.

She maintains active involvement in professional organizations such as the American Organization of Nurse Leaders, Nashville Health Care Council, American Hospital Association, and National Association for Healthcare Quality. Beyond her professional commitments, Tammy serves as a board member for the American Red Cross and Tennessee Initiative for Perinatal Quality Care (TIPQC). In her free time, she enjoys reading, cheering on the Tennessee Vols, and

spending time with her family.

Moderator: Wesley Combs, MBA

Founder, Phiniti AI

Wesley Combs is a seasoned healthcare IT executive and tech innovator with over 25 years of experience transforming clinical operations and advancing value-based care. From the early 2000s, he has been at the forefront of quality measurement initiatives, beginning with the Physician Quality Reporting Initiative (PQRI) pilot in 2006—predecessor to PQRS—and HEDIS measures, through ACO reporting, population health analytics via health information exchanges, and comprehensive Triple Aim strategies to improve cost, quality, and patient experience.

As founder of Phiniti AI, Mr. Combs envisions a future where an AI-orchestrated healthcare ecosystem eliminates manual tasks across the care continuum—from ambient clinical documentation to seamless, real-time data flow among patients, providers, devices, and systems. He sees AI and robotics revolutionizing care for the elderly and chronically ill: affordable in-home companions that prevent falls, enhance mobility without canes or walkers, ensure medication adherence, and enable independent living at a fraction of traditional costs. Phiniti AI is actively building toward this future, delivering provider-friendly tools today that reduce clicks, ease cognitive load, and lay the groundwork for a frictionless, human-centered healthcare system where clinicians focus on healing and patients thrive with dignity.

Drawing on leadership roles as Chief Information Officer for State of Franklin Healthcare Associates and Holston Medical Group/Emergent ACO/OnePartner, and former Vice President of Clinical Solutions at NextGen Healthcare, he has consistently driven tech-enabled platforms that enhance care delivery, reduce administrative burden, and improve outcomes.

Guided by a patient-first, provider-centric philosophy, Mr. Combs is focused on shaping a healthcare landscape where technology orchestrates complexity and human connection remains at the heart of medicine.

This program has been developed and is presented locally by ACHE of East Tennessee. The American College of Healthcare Executives has awarded 1.5 ACHE In-Person Education hours to this program. To receive credit for this program, your name MUST appear on the sign-in sheet.

For any questions regarding this event, please contact Jessica Sanford at [email protected]