Triple Aim


Systems change to improve patient and population health

The Institute for Healthcare Improvement has created a Triple Aim™ framework that can help practitioners and policy makers improve health outcomes by optimizing healthcare delivery through changes in systems and policies.

The framework is built upon the premise that quality improvement and change efforts need to

  • Focus on three goals – improving population health, enhancing the patient experience, and controlling per capita costs
  • Have measures and data that can help to identify areas needing further attention and show progress towards each of the three goals,
  • Recognize that to achieve these goals generally requires
    • Cutting across and integrating multiple health and social service systems so that the patient gets what h/she needs when h/she needs.
    • Having an entity, person, or groups of people responsible for making the necessary connections and assuring that integration occurs

    • The Regional Primary Care Coalition and Primary Care Coalition (PCC) of Montgomery County convened two “Thought Leader Seminars” to share information about the Triple Aim with others in the region.

    IHI invited PCC to participate in the Triple Aim Initiative at its inception in 2007, and since then PCC has completed two phases of the program and is currently beginning phase three with a focus on extending and incorporating Triple Aim practices into all of its programs.

     In the first phase, PCC developed the conceptual framework for an Emergency Department (ED) Utilization Program modeled on the three Triple Aim principles. The program seeks to reduce the number of avoidable Emergency Room (ER) visits by linking patients to primary care homes (through navigators) and surveying patients who use the ER for non-emergent services. The responses to these patient interviews, which are apart of PCC’s current Triple Aim project for the year, are expected to help PCC sort through the underlying reasons people (those with and without insurance) rely on the ER for care they can get from primary care facilities and clinics. PCC is now evaluating more of its programs (like the Care for Kids program, for example) through the lens of patient experiences with care, population health, and per capita costs.

    PCC’s participation in IHI’s Triple Aim Initiative has sparked the interest of other regional players—with the DC Primary Care Association (DCPCA) recently partnering with the Department of Health (a Triple Aim Team) to execute their Chronic Care Initiative (CCI)—a program that seeks to improve the population health of the chronically ill through access to improved services. When the Department made a presentation on the CCI to all of the national Triple Aim Sites in September of 2009, they made special mention of their connection with the DCPCA and how the Association is actively involved in integrating the Triple Aim principles into its work.

    Additional Resources

    Triple Aim Concept Design Detail

    Institute for Healthcare Improvements Triple Aim Initiative - An overview of the initiative and links to materials