How to cite this paper:
Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series white paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2012. (Available on www.IHI.org)
[en français: French translation of this paper also available. See below.]
In 2008 Don Berwick, Tom Nolan, and John Whittington first described the Triple Aim of simultaneously improving population health, improving the patient experience of care, and reducing per capita cost. The Institute for Healthcare Improvement (IHI) developed the Triple Aim as a statement of purpose for fundamentally new health systems that contribute to the overall health of populations while reducing costs. The idea struck a nerve. It has since become the organizing framework for the US National Quality Strategy, for strategies of public and private health organizations around the world, and for many of the over 100 sites from around the world that have been involved in IHI’s Triple Aim prototyping initiative.
A useful system of measurement for the Triple Aim is essential to this work. Although no single organization or region has yet achieved an ideal, comprehensive measurement system for the Triple Aim, good examples and data sources are now available to illustrate how measurement can fuel a learning system to enable simultaneous improvement of population health, experience of care, and per capita cost of health care.
This white paper provides a menu of suggested measures for the three dimensions of the Triple Aim. The menu is based on a combination of the analytic frameworks presented in the paper and the practical experience of the organizations participating in the IHI Triple Aim prototyping initiative. The suggested measures are accompanied by data sources and examples. The paper also describes how the measures might be used along with increasingly specific, cascading process and outcome measures for particular projects to create a learning system to achieve the Triple Aim.