CSSI adopts the IHI “Triple Aim” for 2008

The CSSI Program was founded in 2004 to encourage quality improvement efforts focused around the Institute of Medicine (IOM) goals for crossing the “Quality Chasm” that exists in health care: that medical care be Safe, Effective, Patient-centered, Timely, Efficient and Equitable.

Yet more and more we understand that “crossing the quality chasm” is not simply a question of improving the current system, adding a best practice here or better access there. It’s more fundamental change, of system transformation. We have the most expensive health care system in the world that is increasingly becoming unaffordable for both families and businesses. Yet it produces only lower-tier health outcomes with millions added to the numbers of those who have no health insurance and consequently are at risk for worsening health each year.

Even if we can finally provide universal access to health care, which is long overdue on the American political agenda, for universal access is to be truly sustainable we will need to find new ways of working, new alignments of financial incentives, and new organizational models.

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The Institute for Healthcare Improvement has defined three “Transformational Aims” as the goals for the new system:

• Improving the health of a population— reducing morbidity, increasing functionality and longevity and decreasing health risk,
• Improving the experience of care for the individual, both in terms of their satisfaction and the reliability with which they receive evidence-based care, and
• Improving the cost per capita.

This is termed the “Triple Aim:” One cannot achieve improvement in one dimension without attending to improvement in the others.

The IHI is challenging health care organizations to rethink how they currently contribute to achieving the Triple Aim and how they might create new integrated systems of care to achieve those aims more effectively, potentially with other organizations linked together as a virtual system with common purpose, policy and values.

CareOregon has accepted that challenge and has joined with 14 other health care providers/ systems in a six-month collaborative demonstration project using the Triple Aim. The Triple Aim will be featured at the IHI 2007 National Forum in Orlando, Florida, Dec. 11–12, as part of a Transformation Track in the sessions.

For 2008, CSSI has adopted the Triple Aim as a part of its program goals. In the hope of challenging applicants to think more broadly about projects that will not simply improve but transform the way health care is delivered, those who are requesting CSSI funding are being asked to describe how the project will promote or achieve the goals of the Triple Aim. For example:

• Creating a system to improve and maintain health in addition to treating illness,
• Creating patient-centered processes to ensure that appropriate care and services are delivered, while
• Improving effectiveness and efficiency to optimize cost.

If you have questions about the CSSI Program, contact Diana Wolford at 503-416-1725, or e-mail wolfordd@careoregon.org.