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 s/he needs when s/he needs.
    • Having an entity, person, or group of people responsible for making the necessary connections and assuring that integration occurs

    • In recent years, RPCC has become interested in integrating IHI's Triple Aim framework into its work. In 2010, RPCC officially became part of the IHI Triple Aim Initiative and now has its own regional team with representatives from each of the region's four major jurisdictions. Currently, the team is focusing on understanding patients' experience of the health care safety net in our region. From an initial scan of cutting edge patient experience work from across the nation, the UK, and Canada, the team has created a resource guide containing information about innovative patient experience frameworks, surveys, and case studies: RPCC Patient Experience Resource Guide. The team also presented its patient experience work at the Communities Joined in Action conference in October 2011: Improving Health and Reducing Cost – Learning from Patients and Families.

    EXAMPLES OF TRIPLE AIM WORK IN THE REGION

    Primary Care Coalition of Montgomery County (PCC) was one of the original 14 sites invited by IHI to join to in the Triple Aim Initiative when it started in 2007. 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 a part of PCC's current Triple Aim project, 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. For further information on reducing ER usage, Click HERE. PCC is currently focusing on extending and incorporating Triple Aim practices into all of its programs.

    Learning from PCC’s experience as one of the first Triple Aim teams, RPCC saw the potential of the Triple Aim framework for the region. In 2009, RPCC collaborated with PCC to host two Triple Aim “thought leader” sessions, with the assistance of IHI Faculty Member Tom Nolan. The sessions were designed to educate stakeholders from health departments, hospitals, safety net clinics, and research organizations about the model and how it might be used in the region.

    DC Primary Care Association (DCPCA) was a leader of the Triple Aim team created as part of the DC Department of Health Chronic Care Initiative (CCI)—a program that sought to improve the population health of the chronically ill through access to improved services.

    Additional Resources

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