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How to Achieve the Triple Aim for All

By Mary Pisciotta | Wednesday, October 3, 2018
Leadership Alliance blog

The IHI Leadership Alliance is a dynamic collaboration of health care executives who share a goal to work with one another — as well as in partnership with their patients, workforces, and communities — to make breakthrough achievements toward the Triple Aim. In the summer of 2017, members of the Alliance recognized that equity has not been as central to the dialogue and efforts around achieving the Triple Aim as it should be. IHI presented an opportunity for members to exercise their collective voice to address this issue. Individuals from 10 member organizations came together to explore how the Alliance could best contribute to advancing health equity in the United States.

Two initial goals emerged:

  1. Harness the power of health professionals to achieve health equity in the United States.
  2. Inspire the public, patients, providers, payers, and policymakers to take the necessary steps to make health equity a reality.

From July 2017 to the December 2017, the Leadership Alliance Health Equity Steering Committee, under the leadership of chairperson Stephen Mette, MD, produced the Achieving Health Equity Call to Action. One of its key principles asserts that the Triple Aim cannot be realized without health equity. It proposes actions to ensure that Leadership Alliance organizations achieve the Triple Aim for all.

The members of the Leadership Alliance Health Equity Steering Committee understood that a systematic, multi-faceted, and thorough set of strategies is necessary to have substantive impact. Members committed to do the following, either as individuals or within their organizations:

  • Serve as advocates at the local, state, and national level for policy changes that remove health equity barriers.
  • Partner with leaders from private, public, and governmental sectors on specific equity-focused policy and system changes.
  • Adopt a public “zero tolerance” position on all forms of discrimination.
  • Adopt the IHI Achieving Health Equity framework, specifically committing to reducing institutional racism.
  • Adopt development, recruitment, and retention strategies to build a workforce that more closely reflects the true demographics of a community.
  • Seek to qualitatively and quantitatively understand the populations and communities we serve.
  • Require the collection and use of REAL (Race, Ethnicity, and Language) data and assessment of social determinants data to address health disparities.
  • Educate health care providers about the importance of cultural norms and values, and about the impact of social and environmental factors on overall health and health care outcomes.

Furthermore, the members committed to the following in partnership with communities:

  • Create health system and community partnerships focused on promoting health equity and reducing health disparities.
  • Partner with vulnerable and at-risk communities to have a direct voice in the policy decision processes, including at town halls, community gatherings, and on community advisory panels.

In summer of 2018, the Alliance Health Equity Action Team (HEAT) formed to suggest tools, resources, and supports to help one another make the Call to Action a reality. HEAT members are thrilled to continue sharing in-depth examples of its efforts in pursuit of health equity through the month of October. In the next iteration of this work, which is set to begin in October 2018, HEAT members plan to move from sharing, learning and individual efforts to collective action. Members share a particular interest in workforce development, recruitment, and retention strategies, and will leverage their own work and strategies from others — including the Democracy Collaborative — to improve inclusive local hiring. By sharing, learning, and acting, we expect to accelerate both individual and joint efforts.

Mary Pisciotta, MPH is a Senior Project Manager at the Institute for Healthcare Improvement. Stephen Mette, MD, is Executive Associate Dean for Clinical Affairs, University of Arkansas for Medical Sciences and Chair of the Leadership Alliance Health Equity Action Team.                                                               

Editor’s note: The IHI Leadership Alliance plans to continue sharing more in-depth examples of its efforts in pursuit of health equity through the month of October. Look for more on the IHI blog and the This Week @ IHI newsletter.

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Lesson from Kansas: Start Addressing Health Equity in Your Own Backyard

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