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Three essential components for success have emerged from years of work on the Triple Aim.
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From Aspiration to Results: How to Successfully Implement the Triple Aim

By Kimberly Mitchell | Thursday, June 11, 2015

Drawing on IHI's seven years of experience, a new article describes three essential components for Triple Aim success. In this blog post, Ninon Lewis, MS, Executive Director of IHI’s Triple Aim for Populations Focus Area and co-author of the newly-published article in Milbank Quarterly, summarizes the work done in the seven years since the publication of the seminal article on the Triple Aim in Health Affairs in 2008. Ms. Lewis is also author of the popular IHI blog post that defines Triple Aim terminology.


The June 2015 Milbank Quarterly article, co-authored by John Whittington, Kevin Nolan, Ninon Lewis, and Trissa Torres, describes an observational study of 141 organizations that partnered with IHI over the last seven years to test practical ways of implementing the Triple Aim. The group of organizations included integrated health systems; health plans; local, state, and national governments; public health departments; social services organizations; and community coalitions. This heterogeneous group across ten countries took on the Triple Aim to improve the health of the populations they serve. Through our analysis of the lessons, challenges, successes, and failures of those working to implement the Triple Aim, we identified three principles that are essential for health care organizations to successfully pursue the Triple Aim, as briefly described below and in more detail within the article.

Create the Right Foundation for Population Management

The organizations and coalitions described in the Milbank article worked hard to set up their foundation to manage populations for the long haul. By focusing on populations for which all three dimensions of the Triple Aim are crucial for results, building and aligning the governance and leadership structures to guide the work, and driving the work forward with a clear purpose statement for why the Triple Aim was strategic for them, these organizations made longitudinal decisions on how they would better meet the needs of the people they served. By establishing this foundational infrastructure, they built the capability and capacity to think about and serve populations in new ways that would influence their overall strategy over time and enable them to take on new populations of focus as they saw results within initial subpopulations.

LEARN MORE: Leading Population Health Transformation, Feb. 22-24, 2017, in San Diego, California

Manage Services at Scale for the Population 

Organizations we studied had to understand their populations’ needs and build upon their assets. The goal was to determine the heart of how best to serve a population every day. Based upon this deep understanding, these organizations were able to build a portfolio of projects and investments that, in concert, would best meet those needs and achieve the Triple Aim, while thinking strategically about how to go to full scale for that population over time.

Establish a Learning System to Drive and Sustain the Work 

The organizations we analyzed learned that they had to set up the right feedback loops to understand whether or not they were getting results over time. This learning system fostered small-scale testing while also using specific aims and measures for the specific populations.

In the article, we bring these principles to life by describing a host of examples from the organizations that worked with IHI. Whether you have been on the Triple Aim journey for years or you’re just starting to engage your leadership or a segment of your population, we cite cases that can offer you guidance by laying out many of the Triple Aim building blocks in a very practical way. At the end of the day, the Triple Aim is about better understanding the needs of the population you serve and giving the best care and services to meet those needs. Whether you’re a frontline practitioner or a community stakeholder, you need to better understand how to most effectively use your resources, maximize the assets of your population, and then build the right structures to meet their needs.

The Triple Aim provides a simple framework that resonates as both a galvanizing strategy for organizations, communities, and governments and as a set of balancing measures for best serving populations — a framework that has taken off more than we ever could have imagined. We are thrilled to bring you seven years of learning that you can apply within your work on your journey toward managing populations.

You may also be interested in:

The Milbank Quarterly - "Pursuing the Triple Aim: The First Seven Years"

A Primer on Defining the Triple Aim

Populations, Population Health, and the Evolution of Population Management: Making Sense of the Terminology in US Health Care Today

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