The Triple Aim for ELFT
- Overview
- IHI Annual visit 2019 – Highlights and Progress
- Triple Aim Learning Set 1
- Building connections and partnerships in Child and Adolescent Mental Health Service (CAMHS)
- Directorate updates – Triple Aim
- How to use LifeQI for Triple Aim Projects
- Three Part Data Review
- Community Health Services QI Celebration
- Identifying a Population
- Learning from Bellin Health, an integrated healthcare provider in Wisconsin (US)
- High Performance Healthcare Model – achieving Triple Aim Results in Populations
- ELFT and The Institute for Healthcare Improvement working together on the Triple Aim
- ELFT’s approach to improving the quality of life for those we serve
- The Triple Aim Journey: Improving Population Health and Patients’ Experience of Care, While Reducing Costs
- Signature Health: A Triple Aim Improvement Story
- Health Improvement Partnership of Santa Cruz County: A Triple Aim Improvement Story
- Healthy Shelby Initiative: A Triple Aim Improvement Story
- Quality Conference 2018 highlights
- Working Together on the Triple Aim
- Illustrating the Triple Aim at ELFT
- Working Together on the Triple Aim at ELFT
- High-Impact Leadership: Improve Care, Improve the Health of Populations, and Reduce Costs
- Triple Aim: Improving the health of our local populations
- Pursuing the Triple Aim
- A Guide to Measuring the Triple Aim
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The Triple Aim is a framework that describes an approach to optimising health system performance through the simultaneous pursuit of three dimensions:
- Improve population health
- Improve the quality
- Improve value for the system
It highlights the importance of deliberately working on all three arms of the triple together in order to optimise outcomes for the system.
The Triple Aim framework was developed by The Institute for Healthcare Improvement (IHI). They tested the framework with more than 100 organisations globally in settings ranging from integrated health systems, social service providers, regional coalitions and healthcare providers.
In this collection you can find out more about how East London NHS Foundation Trust are using the Triple Aim to guide our mission to improve the quality of life for all we serve
Find related stories and resources highlighted in the tiles below:
IHI Annual visit 2019 – Highlights and Progress
This October we were delighted to welcome our partners from the IHI to The Trust for their annual three day visit.
This was the 6th annual IHI visit. This year we welcomed Derek Feeley, President and CEO, Trissa Torres, Chief Operations Officer and Pedro Delgado, Head of Europe and Latin America to The Trust
Over their three day visit, Derek, Trissa and Pedro offered invaluable support and guidance to a variety of teams across the directorates, met with QI Coaches and Sponsors and sat down with our QI Department. The trio managed to meet with hundreds of staff, service users and carers, you can see an overview of what they did and where they met below.
At the end of their visit we sat down with Derek, Pedro and Trissa to ask them how they found their visit, any highlights they had and what progress they had noticed. You can see the full interview here.
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Triple Aim Learning Set 1
Thank you to everyone who attended our first Triple Aim Learning Set on 22 July 2019 via WebEx. It was a great opportunity for us all to learn from each other’s efforts in improving population health.
We were joined by over 35 colleagues dialling in from across 13 trust sites as well external guests Catherine Craig (IHI) and Dr Farhana Mann (Psychatirist and Welcome Institute Researcher).
Here are some useful resources:
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Building connections and partnerships in Child and Adolescent Mental Health Service (CAMHS)
Jamie Stafford, Improvement Advisor and Fiona Stockley, Business and Performance manager discuss their project for a population of adolescents at risk of self-harming.
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Directorate updates – Triple Aim
This month we caught up with project teams across the directorates to check in with all the work they’re doing on Triple Aim projects
City and Hackney
The City and Hackney Triple Aim team have analysed their three part data review (6 service user and staff interviews, one neighbourhood focus group, neighbourhood case studies, and a raft of database data including DIALOG and health outcomes data). We have identified 2 key areas of need in the data: loneliness (contentedness and social isolation), and resilience for our population of focus – people who experience SMI in City and Hackney. We are looking to invite stakeholders now around these key needs.
We are most proud of our ability to restart and review, evolve our learning through reflecting on the three part data review. Acknowledging and identifying such a key area of focus around loneliness has been very important to help focus our energy. It feels like we are having less traditional conversations, from a service/staff side, and uncovering important service user experiences.
CAMHS
Project teams have formed base in four schools across Luton, Bedfordshire, City & Hackney and Newham. We have formed partnerships with the school staff, local authorities, third sector organisations, and young people to better understand self-harm, and think what we can do systemically to promote and support wellbeing.
We are most proud of the trust we have already built in our collaborations. This has really enabled us to think more broadly about the health and wellbeing of the young people in the schools, and to break down the traditionally ‘siloed’ nature of our public services. By really listening to the voices of young people talking about such a sensitive and complex subject, we have been able to think about changes that we can make to the system to better support them, and to help them better support each other.
Now, each of the four teams are highlighting some initial tests of change to try when schools resume in September. We are also developing a measurement strategy so that we can understand the impact of the changes both locally within the schools, and collectively across the four geographies.
Community Health Services, Newham
We have almost completed our three part data review for housebound adults with BMI over 40 living in Newham. This has highlighted the need for better integration and networking of all services and social assets for this overlooked and isolated population. The staff responses to this work has been overwhelming, and this is something that we are really excited and proud of! We look forward to testing two change ideas this month.
Tower Hamlets Community Health Service (THCHS)
Our three part data review has revealed the scale of the problem in many aspects for this population such as poorer health outcomes, unmet mental and cultural needs, and social isolation due to being housebound.
To start, we will be focusing our improvement effort in the South West locality of Tower Hamlets. We have chosen to start a QI project at SW locality (team 2) for an estimate of 200 patients who require insulin injections as part of their diabetes care. We aim to empower patients and carers to take a more active role in their disease management. We feel this project will give patients and carers more independence and satisfaction with their care, will free up nursing time to manage complex cases, and ultimately contribute towards the Triple Aim portfolio of work.
Tower Hamlets Adult Mental Health
We’ve completed the three part data review and have been developing plans for how to focus the project. We’re going to be partnering with 2 hostels initially, Daniel Gilbert House and Edward Gibbon House, and are forming a project team to take forwards the work, led by a psychologist, working within the hostels. We’ve been also thinking about how we can measure progress in the three areas of the Triple Aim.
We are really excited that there is a huge amount of will and commitment within the borough to really make a difference for people who find themselves homeless. It is equally challenging and poses lots of hurdles and highlights the need for a big systems approach, but that in itself is something that we are keen to do!
We are now working to arrange meetings to review the strategy and develop first tests of change and develop further work to refine our measures.
IAPT
The project is in the testing phase and a Driver Diagram has been added to Life QI. We’ve also worked with the QI team to develop a first version of our data dashboard.
The most exciting and proud part of the project has been networking with local community organisations; finding out about how these services have been established for a long time and that there is already a developed group of services users who have been working behind the scenes with services across national and local NHS and government to raise profile and develop services for this clinical population
Our next step is to see if testing will help services to integrate and work more collaboratively to support recovery and improved quality of life for this population in Newham and to try to find solutions for the gaps in current provision in the local areas.
Learning Disabilities
We’ve been focusing on developing and engaging people from across the system in the project. We held an event at the end of June, which was attended by 40 people. The event focused on getting people’s ideas and input in terms of strategy and priorities for the project. This included identifying assets and ‘untapped potential’ which we could better use to improve the lives of people with LD, reflecting on people’s own personal challenges and how we can support each other with these and identifying first ideas for change.
We are delighted with the enthusiasm and interest from our partners outside of ELFT and that they see this as an opportunity to make real improvements to people’s lives. We are excited to carry on working with our service users as the work develops.
We’re meeting soon to process everything we got from the engagement event. In mid-August we’ll be meeting with our newly revitalised project team, which will have on it partners from outside ELFT who have said they want to be involved. We’ll continue work to develop our measures.
Newham adult mental health
We’ve completed our three part data review and used this to build our driver diagram. We’ve refined and agreed our project statement. We’ve gathered some really rich narrative and themes from our citizen interviews that enabled us to build our driver diagram. Our Project Team has developed and has a diverse membership, which has fostered innovative thinking and driven the project forward. We’ve also got some changes we are planning on testing over the next few weeks and we are starting to think about building our measurement system
Forensics
Forensics is changing the way they work with service users at Wolfson House, the Trust’s low secure unit. Service users explained that their relationships with staff, friends and family are very important to leading happier, more meaningful and productive lives in the unit and beyond. To improve this, the Triple Aim project team has been working with the wards to test ways of improving relationships, starting with a new induction process for all new service users. The team is excited about how the voice of service users is showing new ways to make and sustain improvements, in particular for those who get stuck in services.
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How to use LifeQI for Triple Aim Projects
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Three Part Data Review
Triple Aim: How to undertake the 3 part data review. Please click on the image to open document.
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Community Health Services QI Celebration
Each directorate in ELFT has had the privilege of spending some time with our partners from the Institute for Healthcare Improvement (IHI) during their annual visit to ELFT in 2018. Words by Nynn Chang, Improvement Advisor.
This year was a very special one for Community Health Services. It was the first time we hosted a joint QI event across Bedfordshire, Newham and Tower Hamlets community health services and we had an impressive turnout of over 60 people who attended on the day from the three localities! It was a delight to connect with staff, clinical commissioners, service users and carers on the day. Dr Trissa Torres, from the IHI, also gave a talk on how to tackle ELFT’s new mission on population health – ‘To improve the quality of life for all we serve’ – via the Triple Aim approach.
To find out more about what happened on the day, or to simply re-live the energy of the event, we have captured it for you in the video below. We hope you will enjoy watching it as much as we did taking part on the celebration day, and we hope to see you at our next joint QI event!
If you are part of ELFT Community Health Services you can attend a monthly QI forum in your directorate. Here are the dates:
Newham Community Health Services
Second Tuesday of each month, 09:30 – 10:30, Room F01, 1st Floor, Vicarage Lane Health Centre.
Tower Hamlets Community Health Services
First Thursday each month, 12:30 – 13:30, Meeting room 1 or 2, 3rd Floor, Beaumont House, Mile End Hospital.
Bedfordshire Community Health Services
Tbc- we are working hard to set up this.
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Identifying a Population
Use this resource to help you think about how to Identify a Population. Click on the image to download.
Things to consider when choosing a population
You might have a number of potential population segments in consideration. Below are some key things to consider when picking where to start:
- Is there a segment of the population that is failing to thrive, where there might be some inequity apparent?
- Will the work be able to impact on all three parts of the triple aim?
- Can you get your arms around the population? (Can you count who is in the population?)
- Is existing work taking place and is this work a priority to those in the system?
- Are there other partners who share responsibility for this population that are willing to partner with us in this work?
- Is there readily available data that people are willing to share?
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Learning from Bellin Health, an integrated healthcare provider in Wisconsin (US)
Chris Woleske, Chief Operating Officer at Bellin Health (and due to take up the CEO role from October), spent three days at ELFT last week sharing her experience and Bellin’s model for delivering high performance healthcare.
Bellin Health is widely renowned as one of the highest performing integrated care systems in the US. It operates in Green Bay, Wisconsin, (home to the Green Bay Packers American football team!) and comprises a range of hospitals, healthcare providers and community-based partners. Bellin Health is a strategic partner to the IHI, just as ELFT is, and so we have managed to learn a lot from Bellin over the past few years. Our new ELFT strategy has incorporated lots of learning from Bellin’s strategy.
During a three-day visit to East London NHS Foundation Trust, Chris Woleske learnt about ELFT’s progress with its new strategy, and spent time with several groups working to deliver the strategy. She also delivered a masterclass, sharing Bellin’s high performance healthcare model which comprises:
1 – the strategic dimension
2 – the system of production
3 – the system of measurement
4 – the system of improvement
5 – the system of communications
6 – high performance culture
She left this message for all ELFT staff after the High Performance Healthcare Model masterclass on 16 August:
The presentation can be found here.
Over the past twenty years, Bellin Health has developed a ‘high performance health care model’ which integrates planning and improvement into the way the organisation is run. Bellin Health has also undertaken a large amount of triple aim work to improve population health, quality of care and cost of care, with much of this being done in partnership with the local community. Bellin’s work has been instrumental in helping us at ELFT develop our new mission and strategy.
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High Performance Healthcare Model – achieving Triple Aim Results in Populations
Bellin Health is widely renowned as one of the highest performing integrated care systems in the US and comprises a range of hospitals, healthcare providers and community-based partners. During a three-day visit to East London NHS Foundation Trust, Chris Woleske learnt about ELFT’s progress with its new strategy, and spent time with several groups working to deliver the strategy. Here’s her Masterclass presentation slides.
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ELFT and The Institute for Healthcare Improvement working together on the Triple Aim
In June 2018, Dr Trissa Torres and Catherine Craig from the Institute of Healthcare Improvement (IHI) visited the Trust to help us further develop our Triple Aim work.
Trissa and Catherine have extensive experience in supporting healthcare organisations and systems to work towards the triple aim of improving population health outcomes, experience of care and value for money.
Find out more about the ELFT Triple Aim work developing in East London and Bedfordshire in this short video:
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ELFT’s approach to improving the quality of life for those we serve
In this blog, Improvement Advisor Marco Aurelio explains the Population Health approach and describes which projects are currently under way at ELFT.
ELFT’s new vision is to improve the population of all we serve. This places us with a much broader remit within our local community and we need to think about how we deliberately work with our partners. This is reflected in our new mission:
By 2022, we will build on our success and lead on the delivery of integrated care. ELFT will do this by working purposefully in collaboration with communities and our partners, always striving towards continuous improvement in everything we do.
So how are we going to be supporting this? One way in which we are going to be doing this is by adopting a population health approach to working with our partners. Population health has been defined as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group”[i]. This is quite a broad term and so population can be thought of geographically, demographically or via a specific condition among other defining factors[ii]. Populations that people have previously identified as areas for improvement work are:
- Employees at Bellin Health Wisconsin USA
- Adults over the age of 65 with multiple complex conditions at NHS Kernow, Cornwall
- Black males with hypertension in Shelby USA.
What does this look like at ELFT?
Going forward we have a responsibility to work with our partners more closely and so over the next twelve months we will be providing improvement support to partners in London and Bedford. In London we are working as part of the Tower Hamlets Together system, which is a group of health and social care organisations across the borough including Barts, ELFT, Care Commissioning Group (CCG), Local authority and voluntary sectors. Whilst across Bedford we are working with a range of partners within the Sustainability and Transformation Partnership (STP).
One way we will be working with our partners to think differently about tackling problems in their population is through using the Triple Aim framework. Developed by the IHI, the Triple Aim understands that healthcare systems have a responsibility to simultaneously improve health outcomes, experience of care and improve value (reduce costs) for the specific populations they are targeting.
When beginning to think about undertaking work in pursuit of the Triple Aim, the first step is to consider which population we are going to be working with. To help with this, teams undertake a three-part data review looking at utilising data, feedback from clinicians and service users to understand the needs and assets of the population. Having narrowed a population, teams then work to develop and aim, driver diagram, theory of change, measurement systems and begin with testing changes using PDSA cycles.
Tower Hamlets Together
Within Tower Hamlets, work is aligned to three different “life course” work streams: Born Well, Growing Well (Children and Young People), Living Well (Healthy Adults) and Promoting independence (complex care). The aim is for each of these areas to identify a distinct population to work with and run one QI project. Since January we’ve help facilitate a number of development sessions introducing QI and the framework for triple aim work. Over the next few months we will be bringing the teams working on this together during 6 weekly learning sets to share learning and accelerate the work.
Bedfordshire
Our partners in Bedfordshire are also thinking about what populations they might like to use the triple aim framework to improve aspects of health. In May a range of stakeholders from commissioning, acute and primary care were brought together in a morning session alongside the Catherine Craig from the IHI. This provided an opportunity to explore working with local populations on some triple aim work. We are currently working with partners to identify a population to begin working with.
[i] Kindig, D., & Stoddart, G. (2003). What Is Population Health? American Journal of Public Health, 93(3), 380–383.
[ii] http://www.ihi.org/communities/blogs/population-health-population-management-terminology-in-us-health-care
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The Triple Aim Journey: Improving Population Health and Patients’ Experience of Care, While Reducing Costs
Case studies of three organisations participating in the Institute for Healthcare Improvement’s Triple Aim initiative shed light on how they are partnering with providers and organising care to improve the health of a population and patients’ experience of care while lowering—or at least reducing the rate of increase in—the per capita cost of care. The organizations—CareOregon, Genesys Health System and QuadMed —were selected to illustrate diverse approaches. Lessons from these organizations can guide others who wish to undertake or promote transformation in health care delivery.
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Signature Health: A Triple Aim Improvement Story
As part of its participation in the IHI Triple Aim Community from 2012 to 2014, Signature Healthcare in Brockton, Massachusetts, initiated its Complex Care Clinic, a 12-month pilot program focused on one of its most challenging patient populations — high-risk Managed Medicare elderly patients with complex needs. For this population, Signature decreased acute admissions by 43 percent, reduced emergency department utilization by 30 percent, and improved patient care by restructuring its primary care practice and connecting these patients with resources readily available throughout the surrounding community. This improvement story is based on an interview with Lorraine (Lori) Pigeon, NP, former Director of Clinical Geriatrics and High-Risk Populations at Signature Healthcare. The Complex Care Clinic at Signature Healthcare continues under the leadership of Marc Greenwald, MD, and Cristine Waldron, NP.
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Health Improvement Partnership of Santa Cruz County: A Triple Aim Improvement Story
The Health Improvement Partnership (HIP) of Santa Cruz County, California, serves as the backbone organization for a coalition of stakeholders: cultivating shared goals, collecting data from stakeholder groups, establishing venues for collaboration, communicating clearly and transparently, and incubating new care models. In this paper, Catherine Craig describes how HIP was formed and functions as the backbone organization for the county’s Triple Aim efforts, and how its governance structure defines and supports a portfolio of projects to improve the health of the community’s population.
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Healthy Shelby Initiative: A Triple Aim Improvement Story
The Healthy Shelby Initiative (Healthy Shelby) is one of five initiatives of Common Table Health Alliance, a regional health improvement collaborative in Shelby County, Tennessee. It provides leadership and backbone support for a broad stakeholder coalition: cultivating shared goals, collecting data from stakeholder groups, carrying out communication campaigns to increase public awareness of health, and cultivating the adoption of innovative care methods. In this paper, Catherine Craig describes this Triple Aim improvement story describes how Healthy Shelby began its work to improve population health, how it serves as a backbone organization for the community’s Triple Aim efforts, and how its governance structure supports the improvement of health outcomes in Shelby County.
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Quality Conference 2018 highlights
Over 400 people, including ELFT staff, service users, carers, governors as well as external guests, attended the annual Quality conference on 24th April 2018. Below you can read about the highlights of the day.
The ELFT Quality Conference 2018 was composed of powerful presentations, the revelation of the trust’s new mission statement and inspiring conversations. In her closing speech, ELFT CEO Dr Navina Evans emphasised that the 2018 Conference was special because it coincided with the launch of the trust’s new strategy, which embodies the trust’s priorities around the Triple Aim.
“We took our time, we really wanted to think about how this trust does that is relevant for the communities that we serve. Our new ambition is bold, it is challenging and our mission”, Dr Evans said. “We realised that we cannot continue to do what we do and to improve in isolation”, she added, whilst also making the point that without patient input into quality improvement it is a pointless discussion.
Earlier that week, the trust released its new strategy, which is the culmination of over 100 focus groups and discussion with more than 800 staff, governors and service users. “We want this strategy to be meaningful to every single person who works in this organisation, every single person who comes into contact with us and who uses our organisation and for every single person to hold us to account on what we promised to deliver.”
You can watch Dr Navina Evans’ full speech here.
At the start of the Conference delegates were greeted by the energetic ELFT Beats! drummers, supported by the expertise of the Pandemonium Drummers. A video celebrating highlights of the past year opened the day’s agenda, followed by remarks from the trust’s Chief Quality Officer Dr Amar Shah and Chair Marie Gabriel.
The first keynote address was delivered by Dr Jennifer Dixon, CEO of The Health Foundation. Her presentation focused on the role of improvement approaches to make progress on population health.
You can watch her presentation and view her slides here.
Breakout sessions
Delegates were also able to join two breakout sessions in the morning. In the World Cafe rooms, each attendee had the change to hear directly from three of a total of 18 project teams about their QI journey and what they have learned so far. Themes revolved around improving access, service user involvement, reshaping community services, enjoying work and learning from failure.
Short video presentations from all projects were also on display during the conference. You can access the content here.
The session S+P+C=O, which is short for Structure + Process + Culture = Outcomes, was led by James Innes, Associate Director of Quality Improvement, Duncan Gilbert, Head of Quality Assurance and colleagues from our City & Hackney Adult Mental Health Service. They presented work and achievements made in City & Hackney around reducing harm from violence. You can access the slides here.
In the afternoon, external delegates took part in four workshops. Materials used in those sessions can be accessed here: Leadership for Improvement; Tips and Tricks for getting started with QI; Research and Improvement; and Service User and Carer Involvement.
Arts at ELFT
Also as part of the Conference we unveiled our ‘Working together on the triple aim‘ illustration developed in partnership with Sonia Nosheen, who is also known as Sonia Sparkles. The illustration is a result of a collaborative art project, facilitated by ELFT Arts. The poster reflects how service users, carers and staff see trust’s Triple Aim journey.
You can learn more about the process that led to the creation of the poster below.
What to see more?
Below you can see a photo gallery and a video in which delegates comment on their experience.
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Working Together on the Triple Aim
At the 2018 Quality Conference we unveiled our illustration on the Triple Aim at ELFT. Working on the Triple Aim is a key part of the Trust’s new strategy to improve the quality of life for all we serve.
The ideas for this illustration were inspired by staff, service users and carers at a half day workshop in February 2018. Illustrator Sonia Sparkles then took these ideas and created our patchwork version of the Triple Aim.
Find out more about the creation of this work in the video below. You can access a high quality version of the illustration here >>
Learn more about the Triple Aim here >>
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Illustrating the Triple Aim at ELFT
Learn how ELFT staff, service users and carers came together to co-create our illustration of the Triple Aim with Sonia Sparkles.
The final version of the illustration is available here>>
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Working Together on the Triple Aim at ELFT
Please find our illustrated version of the IHI Triple Aim for ELFT. The ideas for this illustration were inspired by staff, service users and carers at a half day workshop in February 2018. Illustrator Sonia Sparkles then took these ideas and created our patchwork version of the Triple Aim.
Find out more about the creation of this work in this short video>>
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High-Impact Leadership: Improve Care, Improve the Health of Populations, and Reduce Costs
There is solid evidence that leadership engagement and focus drives improvements in health care quality and reduces patient harm.1-10 Leaders at all levels in care delivery organizations are struggling with how to focus their leadership efforts and achieve Triple Aim results for the populations they serve. Triple Aim results represent the shift from volume to value, which demands that health care leadership at every level of care delivery organizations focus on improving the experience and outcomes of care provided and reducing the cost of care for the populations they serve.
High-impact leadership is required to achieve Triple Aim results. To that end, this white paper presents three interdependent dimensions of leadership: new mental models, High-Impact Leadership Behaviors, and the IHI High-Impact Leadership Framework.
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Triple Aim: Improving the health of our local populations
During the IHI visit last week, Derek Feeley shared IHI’s learning from many years of work in systems across the world, helping improving health, improving the experience of care and lowering the cost of care.
There is a series of steps that has been found to be helpful in thinking about how to apply this framework.
1 – Choose a population to work with. This might seem simple, but often we start by thinking about services, rather than the population we want to serve. Choose a population that you can ‘get your arms around’, so one that is defined, and that you can actually count. And then get to know the needs of the population deeply.
2 – Articulate a Purpose that will hold all the stakeholders together. What would bring people together around a shared aim, and be aspirational?
3 – Develop a Systems approach. Develop the leadership and governance for the work. This can sometimes take a long time, so we might want to start with populations where this is already a stakeholder governance structure in place.
4 – Creating a Learning system, and choose Measures that will show improvement for the population. This is the stuff that we’re already familiar with from our QI work to date. The measures will need to cover all three aspects of the triple aim – health outcomes, care experience and cost.
5 – Develop a Portfolio (group) of projects that will help to deliver the triple aim results. No single project is likely to accomplish the triple aim by itself.
6 – Create a Team of people who can manage the work: executive sponsor, portfolio lead, project lead, improvement advisor etc… again, this is what we’ve already been doing for our QI work within ELFT
7 – Develop a plan for Execution – essentially this is the roadmap for the QI projects, using the Model for Improvement
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Pursuing the Triple Aim
In this article John W. Whittington, Kevin Nolan, Ninon Lewis, and Trissa Torres describe and provide examples of each of these 3 core components, as well as case examples of 2 organizations (Bellin Health of Green Bay, Wisconsin, and Chinle Service Unit of the US Indian Health Service), to illustrate the execution of all 3 of the Triple Aim’s components.
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A Guide to Measuring the Triple Aim
A useful system of measurement for the Triple Aim is essential to this work. Although no single organisation or region has yet achieved an ideal, comprehensive measurement system for the Triple Aim, good examples and data sources are now available to illustrate how measurement can fuel a learning system to enable simultaneous improvement of population health, experience of care, and per capita cost of health care.
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