Healthcare Operations Management: Triple Aims

In October 2007 the Institute for Healthcare Improvement (IHI) launched the Triple Aim initiative, designed to help health care organizations improve the 1) health of a population, 2) patients' experience of care (including quality, access, and reliability) while lowering—or at least reducing the 3) rate of increase in—the per capita cost of care. Pursuing these three objectives at once allows health care organizations to identify and fix problems such as poor coordination of care and overuse of medical services. It also helps them focus attention on and redirect resources to activities that have the greatest impact on health.

Without balanced attention to these three overarching aims, health care organizations may increase quality at the expense of cost, or vice versa. Alternatively, they may decrease cost while creating a dissatisfying experience for patients. Many problems that health care systems face can be linked to one or more of these objectives. Problems like supply-driven care, preventable readmissions, and overbuilding may represent a failure on all three counts.

To achieve the Triple Aim, health care organizations must broaden their focus to organize care to meet the needs of a defined population. Payers, especially those with little direct influence on health outcomes and patient satisfaction, find they must forge new kinds of partnerships with providers. Success requires a willingness to take on new roles and a commitment to honest self-appraisal—otherwise it is easy for health care organizations to continue to work on objectives that play to their existing strengths and neglect those that do not.

IHI encouraged participants to adapt five principles when designing a new model of care:

1. Involve individuals and families when designing care models;

2. Redesign primary care services and structures;

3. Improve disease prevention and health promotion;

4. Build a cost-control platform; and

5. Support system integration and execution.