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The Quintuple Aim for Health Care Improvement: A New Imperative to Advance Health Equity
This article proposes expanding the original Triple Aim (improving population health, enhancing the care experience, reducing costs) beyond the "quadruple aim" (addressing clinician burnout) to a "quintuple aim" that includes advancing health equity.
Thriving Together: A Springboard for Equitable Recovery and Resilience in Communities across America
This guide highlights numerous actions that communities, organizations, businesses, governments, and funders can take in the wake of COVID-19 and other related threats to the US — to create the vital conditions that all people and places need to thrive.
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.
WIHI: How to Fail Forward (Quickly) on the Road to Population Health
June 29, 2017 | Learning from failure is an important part of the quality improvement process in health care. Groups focused on improving the health of communities are also discovering the value of "failing forward;" leveraging the learning from failure to accelerate progress.
Better Care for Complex Needs
For individuals with complex health and social needs, high utilization rates (and their associated costs), poor outcomes, and low satisfaction scores indicate that current care systems are not meeting their needs. This article describes five key priorities for health care leaders to consider as their organizations endeavor to improve care for high-need, high-cost individuals.
WIHI: Claiming the Edge with Quality Improvement in Communities
February 23, 2017 | Communities in Wisconsin, Scotland, and Boston are building coalitions to change the trajectory of people’s lives and health for the better. Using quality improvement methods and tools to tackle socioeconomic issues is proving to be a game changer in all three locations.
WIHI: Moving Upstream to Address the Quadruple Aim
December 15, 2016 | In this Special Edition WIHI Podcast, Dr. Rishi Manchanda discusses why it’s important for health care to “move upstream” to address the social determinants contributing to many patients’ poor health.
Triple Aim in Canada: Developing Capacity to Lead to Better Health, Care, and Cost
This article reports on the work of nine Canadian health care organizations to embed the Triple Aim (better care, health, and cost) across Canada. The nine sites participated in IHI’s Triple Aim Improvement Community in order to build a solid Triple Aim infrastructure, develop quality improvement capacity, and foster a culture of health care improvement.
WIHI: 100 Million Healthier Lives: From Vision to Reality
July 28, 2016 | Hundreds of communities around the world are working with kids, veterans, elders, and others on move-the-needle priorities like nutrition, mental health, and equity — the price of admission to 100 Million Healthier Lives, an unprecedented collaboration of change agents across sectors.
Improving the Health of Populations
With the rapid growth of accountable care organizations, health care delivery organizations are expanding their scope of accountability and changing how they identify and define their immediate goals and longer-term aspirations. Yet the terms to describe this approach — “population health” and “population management” — are often used interchangeably. This article makes the case that a common language is needed, provides clarification around terminology, and offers five questions for health care leaders to explore.
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).
Healthy Shelby: A Triple Aim Improvement Story
This Triple Aim improvement story examines the work of the Healthy Shelby Initiative in Tennessee, a community pursuing a regional focus to improve population health by linking public health, hospitals, health care providers, social service providers, academic institutions, the faith community, local government, and funders to work together to tackle some of the county’s most critical health problems: infant mortality, chronic disease management, and end-of-life care.
Indian Health Service Chinle Service Unit: A Triple Aim Improvement Story
This Triple Aim improvement story on the Indian Health Service Chinle Service Unit is an example that demonstrates how an organization funded and directed by the US government can take on the challenge of the Triple Aim for a Native American population.
Bellin Health: A Triple Aim Improvement Story
Bellin Health is an example that illustrates the evolution of a health system that began working on the Triple Aim with an enrolled population, built skills over time, expanded its Triple Aim work to include more populations, and eventually became involved with a multistakeholder group focused on a regional population.
WIHI: How Health Care Organizations Can Create Equity in the Community
October 29, 2015 | Health and health care improvement communities in the US are focusing on equity and racial disparities in some important new ways.
Health Improvement Partnership of Santa Cruz County: A Triple Aim Improvement Story
This Triple Aim improvement story examines the work of one community pursuing a regional focus to improve population health, and the backbone organization that established the Triple Aim as its guiding framework for improving health outcomes of those served by safety net clinics, with a focus on vulnerable populations — in particular, low-income childless adults, undocumented people, and young entrepreneurs — all of whom had little or no access to health care.
WIHI: Relationships Count: Community Health Workers and Team-Based Care
October 15, 2015 | Community health workers (CHWs) are increasingly being utilized to bridge gaps for patients between health care, home, and the community. This WIHI explores the growing interest in CHWs that is sparking some important discussions and the development of innovative programs.
Signature Healthcare: A Triple Aim Improvement Story
By creating a process to improve care for the frail elderly Medicare population with complex needs, and by building the supporting infrastructure in primary care, Signature Healthcare was successful in decreasing emergency department utilization and reducing acute admissions while maintaining patient satisfaction. The organization was a participant in the IHI Triple Aim Community from 2012 to 2014.
Assessing Community Health Needs
This article presents four practical ways hospital leaders can improve the linkage between the community health needs assessment process, community benefit spending, and efforts to improve population health in the communities they serve.
Community Health Workers for Patients with Medical and Behavioral Needs: Challenges and Opportunities
This article by IHI authors outlines challenges to successful community health worker programs for patients with medical and behavioral needs, proposes two design considerations for community-based behavioral health integration, and suggests ways in which quality improvement methods might help with both challenges.
Guide for Developing an Information Technology Investment Road Map for Population Health Management
This article proposes an organized approach with specific steps to help health care organizations invest in population health management information technology, to enhance their chances for a successful transition from volume-based to value-based care.
Cross-Continuum Collaboration in Health Care: Unleashing the Potential
This articles proposes enabling factors for successful cross-continuum collaboration to ensure that relevant post-acute and primary care, as well as community services and supports, are available in a coordinated fashion to meet the needs of patients across the care continuum.
Community-Based Behavioral Health Integration: A Focus on Community Health Workers to Support Individuals with Behavioral Health and Medical Needs
The aim of the IHI 90-day innovation project described in this report was to develop an approach to managing patients with comorbid behavioral health and medical needs in community-based settings. The report identifies four populations who could be well-served by community-based behavioral health integration and potential interventions to support these populations; describes the role and key functions of community health workers; and discusses key areas for future research and improvement.
Can the Accountable Care Organization Model Facilitate Integrated Care in England?
Accountable care organizations (ACOs) in the US, in which groups of providers are responsible for the helath outcomes of a designated population, are regarded as having the potential to foster collaboration across the continuum of care. This article contends that ACOs could have a similar role in England’s National Health Service (NHS), provided that the differences in context are taken into consideration before implementing a similar model, adapted to suit the NHS’s strengths.
Behavioral Health Integration: A Key Component of the Triple Aim
Organizations seeking to move toward the Triple Aim must develop an integrated behavioral health strategy across the continuum of care. This article discusses an Institute for Healthcare Improvement research project that examined the core principles underlying several successful approaches to behavioral health integration around the US.