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