Pursuing the Triple Aim: The First Seven Years

A Team from the Organization That Developed the Framework Analyze What’s Needed for Success

(Graphic: Business Wire).

(Graphic: Business Wire).

NEW YORK & CAMBRIDGE, Mass.--()--In 2008, the Institute for Healthcare Improvement (IHI) proposed the Triple Aim, a strategic framework to achieve better health and system performance based on the simultaneous pursuit of improved care for individuals, better health for populations, and reduced per capita health care costs. This concept became an important part of the care redesign innovation opportunities built into the national strategy developed as a result of the Affordable Care Act of 2010.

In a new study in the June 2015 issue of The Milbank Quarterly, an IHI team that has played a leading role helping organizations pursue the Triple Aim looks at how this work has progressed in the last seven years—specifically, why some organizations have made progress implementing the Triple Aim and others have not. They describe three principles that are essential for health care organizations to successfully pursue the Triple Aim. The paper highlights numerous examples from around the country and the world, of health systems or communities that are making progress—and how they’re doing it.

“The Triple Aim has had an influence beyond our wildest dreams—in the nation and around the world,” states John W. Whittington, one of the framework’s original architects, and lead author of the study with IHI Senior Fellow Kevin Nolan, IHI Executive Director Ninon Lewis, and IHI Senior VP Trissa Torres. “It’s the configuration that has caught on—a simple framework focusing on three goals simultaneously.”

Background
In 2007, IHI began recruiting organizations from around the world to participate in a collaborative to implement what became known as the IHI Triple Aim. The 141 participating organizations included health care systems, hospitals, insurance companies, and others in health care. Other groups were represented, such as public health agencies, social service groups, and community coalitions. IHI’s work with the collaborative provided a structure for observational research.

Findings
The three principles essential for health care organizations to successfully pursue the Triple Aim:

  • Create the right foundation for population management
    Focus on a population or populations for which all three dimensions of the Triple Aim are important. Populations were chosen for economic, geographic or medical reasons. Overall, the IHI team noted that there was much success with enrolled populations (groups of individuals who are receiving care within a health system).
  • Manage services at scale for the population
    Assess the needs and assets of the population—and create a portfolio of projects that meet the needs of this population.
  • Establish a learning system to drive and sustain the work
    Build a learning system that fosters testing and provides feedback loops to compare performance with specific aims and measures for a specific population.

About The Milbank Quarterly
Continuously published since 1923, The Milbank Quarterly features peer-reviewed original research, policy review, and analysis from academics, clinicians, and policymakers. The Quarterly’s multidisciplinary approach and commitment to applying the best empirical research to practical policymaking offer in-depth assessments of the social, economic, historical, legal, and ethical dimensions of health and health care policy. The Milbank Quarterly is published in March, June, September, and December on behalf of the Milbank Memorial Fund by John Wiley & Sons. www.milbank.org/the-milbank-quarterly

About the Institute for Healthcare Improvement
IHI is a leading innovator in health and health care improvement worldwide. For more than 25 years, we have partnered with visionaries, leaders, and front-line practitioners around the globe to spark bold, inventive ways to improve the health of individuals and populations. Recognized as an innovator, convener, trustworthy partner, and driver of results, we are the first place to turn for expertise, help, and encouragement for anyone, anywhere who wants to change health and health care profoundly for the better. To advance our mission, IHI’s work is focused in five key areas: Improvement Capability; Person- and Family-Centered Care; Patient Safety; Quality, Cost, and Value; and Triple Aim for Populations. Learn more at ihi.org.

Contacts

The Milbank Quarterly
Judith Zimmer, 212-355-8400
jzimmer@milbank.org
or
CXO Communication for IHI
Sandy George, 617-413-6126
sandy@cxocommunication.com

Release Summary

Milbank Quarterly publishes 7 years of learning in pursuit of the Triple Aim, a strategic framework to optimize health system performance developed by the Institute for Healthcare Improvement (IHI).

Contacts

The Milbank Quarterly
Judith Zimmer, 212-355-8400
jzimmer@milbank.org
or
CXO Communication for IHI
Sandy George, 617-413-6126
sandy@cxocommunication.com