This paper proposes an SST-CML-Hybrid (SCH) output driver, and its corresponding hybrid-path feed-forward equalization (FFE) scheme, to enhance the energy efficiency of a PAM-4 transmitter (TX). Specifically, the SCH driver features one SST branch + one CML branch to co-synthesize the PAM-4 data, reducing substantially the signaling power, switching power and equalization power. The PAM-4 TX further integrates a half-rate serializer with 4-bit 3-tap FFE, duty-cycle correction circuits and a T-coil output matching network. Prototyped in 28-nm CMOS, the PAM-4 TX achieves a broadband return loss <-10dB up to 50 GHz, and occupies a compact die area of 0.0345 mm. Operating at 40 Gb/s and at a 0.9-V supply, the TX dissipates 19.5 mW, of which 6.4 mW is due to the SCH driver. The corresponding energy efficiencies are 0.16 and 0.5 pJ/bit for the SCH driver and TX, respectively; both compare favorably with the prior art.