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A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost
This white paper provides suggested measures for the three dimensions of the Triple Aim, accompanied by data sources and examples, and describes how these measures might be used along with process and outcome measures for particular projects to create a learning system to achieve the Triple Aim.
New Payment Models Drive Value
Standardizing processes, enhancing efficiency of care delivery systems, and optimizing capacity across care delivery systems are all essential in driving value and preparing care teams for managing patients in a bundled payment program.
This Coalition of 20 Companies Thinks It Can Change US Health Care
Based on IHI’s learning from work with employers to improve health care, this article offers five strategies to help employers — like those in the recently formed Health Transformation Alliance — achieve better care and better health for their employees, while also lowering costs (the Triple Aim).
The Employer-Led Health Care Revolution
Intel is using Lean improvement methods to manage the quality and cost of its health care suppliers in Portland, OR. Their Healthcare Marketplace Collaborative model holds potential for employers, with their large purchasing power, to take the lead in securing better health for local populations and lowering costs for employees and companies alike.
Achieving Hospital-wide Patient Flow
This white paper guides health care leaders and quality improvement teams through an in-depth examination of a system-wide view of patient flow within (and outside) the hospital, including high-leverage strategies and interventions to achieve hospital-wide patient flow.
10 IHI Innovations to Improve Health and Health Care
This curated publication highlights 10 ideas that have emerged from IHI's systematic 90-day innovation approach, including reflections on the Triple Aim, the concept of a health care Campaign, the Breakthrough Series Collaborative model, and other frameworks and fresh thinking that have been replicated around the world.
A Simple Way to Involve Frontline Clinicians in Managing Costs
This article describes the building blocks of a value-management system in health care. The approach that IHI co-developed includes a simplified method to understand quality, cost, and workforce capacity on a weekly basis; a visual management system to present and analyze this data regularly; and daily, point-of-care communication to support continuous improvement.
Personalized Perfect Care
The authors propose measuring quality from the patient’s perspective as an expression of his or her personalized health needs. The Personalized Perfect Care Bundle combines several distinct measures into one and is scored as “all-or-none,” with the patient’s care being counted as complete if he or she has met all of the quality measures for which he or she is eligible.
Care Coordination Model: Better Care at Lower Cost for People with Multiple Health and Social Needs
This white paper outlines methods and opportunities to better coordinate care for people with multiple health and social needs, and reviews ways that organizations have allocated resources to better meet the range of needs in this population. The elevated cost of care in this population offers a tremendous opportunity to craft a service delivery plan that meets their needs more effectively at a significantly lower cost.
Avoiding Overuse: The Next Quality Frontier
In this editorial, IHI President Emeritus Don Berwick makes the case that quality of care — that is, better matching care to needs, and practice to science — is central to addressing underuse of effective care and overuse of ineffective care. The editorial accompanies the "Right Care" series of articles that explores medical underuse and overuse worldwide.
Going Lean in Health Care
Lean management principles have been used effectively in manufacturing companies for decades, particularly in Japan. IHI believes that lean principles can be successfully applied to the delivery of health care.
Applying Radical Redesign Efforts
MemorialCare Health System's (California) strategy to provide high-quality care, reduce waste, and keep costs in line demonstrates three of the ten “New Rules for Radical Redesign in Health Care” developed by IHI Leadership Alliance members: standardize what makes sense; make it easy; and return the money.
ACOs: A Step in the Right Direction
Accountable care organizations (ACOs) can be a step forward in the journey toward aligning payment and delivery mechanisms to achieve better care and better health at lower costs. This article includes recommendations that may serve to accelerate our collective efforts toward achieving cost- and quality-related improvements at scale.
Medicare at 50: Reflections from Former CMS Administrator Donald M. Berwick
IHI President Emeritus Don Berwick comments on the 50th anniversary of the US Medicare program, including the shift to payment based on the quality of care provided to patients, and the role of accountable care organizations (ACOs) in improving quality of care and reducing costs.
Healthy Employees, Lower Premiums and Costs
Employers, providers, and health plans have a new shared aim of collaboratively working together to improve the health of employees and reduce health care costs.
A Three-Part Approach to Patient Safety: Balanced Strategy Improves Value, Reduces Costs
This article describes the Institute for Healthcare Improvement's three-part approach for improving the bottom-line performance in hospitals and other health care settings.
Enhancing the Effectiveness Effectiveness of Follow-Up Phone Calls to Improve Transitions in Care: Three Decision Points
This study used a nonsystematic review of the literature focused on the use of telephone follow-up to improve postdischarge processes and reduce avoidable readmissions, and examined use of such calls among organizations participating in the STate Action on Avoidable Rehospitalizations (STAAR) initiative.
Enhancing Prehospital Emergency Care
This article makes the case that earlier prehospital interventions can positively affect downstream hospital patient outcomes and costs of care, describes how emergency medical services (EMS) are increasingly becoming part of an integrated care system, and discusses the expanded role of ambulance services and paramedics to increase access to care.
Patient-reported measures help clinicians and patients assess whether a patient’s symptoms, lifestyle, daily activities and functional status have improved as a result of care provided, and are a mechanism for patients to have a voice in their treatment planning and decision making based on their own self-assessments.
Preventing Infection After Hip and Knee Replacements
IHI's Project JOINTS initiative is helping to speed the adoption of proven practices to prevent surgical site infections (SSIs) after hip and knee replacement surgery. This article describes simple, affordable, evidence-based practices organizations can put into place to reduce such infections.
Health Care, the Whole Person, and Community Engagement: Church Health Center of Memphis, Tennessee
The Church Health Center in Memphis, Tennessee, is committed to encouraging healthy living for individuals as well as communities. Their work provides an inspiring example of a community that is working toward achieving the Triple Aim.
Hospital Inpatient Waste Identification Tool
The Hospital Inpatient Waste Identification Tool provides a systematic method for hospital frontline clinical staff, members of the financial team, and leaders to identify clinical and operational waste and subsequently prioritize and implement waste reduction initiatives that will result in cost savings for the organization.
Increasing Efficiency and Enhancing Value in Health Care: Ways to Achieve Savings in Operating Costs per Year
This white paper proposes a set of steps health care organizations can undertake to systematically identify and eliminate inefficiencies to create a portfolio of work leading to a 1 percent to 3 percent savings in operating costs per year.
Reducing Costs Through the Appropriate Use of Specialty Services
This white paper describes a framework that primarily focuses on changing professional practice culture by engaging physicians in developing and implementing practice standards that will work best in local circumstances.
Leaders Challenged to Reduce Cost, Deliver More
This article discusses leadership strategies to overcome common challenges for creating culture in which it is possible to improve quality and simultaneously realize cost savings.