Pursuing the Triple Aim: The First 7 Years

Whittington, John; Nolan, Kevin; Lewis, Ninon; Torres, Trissa

doi:10.1111/1468-0009.12122

Cited by 172 publications

(140 citation statements)

References 13 publications

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“…Internationally, the Institute for Healthcare Improvement's ‘Triple Aim’ programme aims to improve health, care and cost, but many of the 141 organisations enrolled have found pursuing all three aims challenging (Whittington et al . ).…”

Section: Introductionmentioning

confidence: 97%

Analysing barriers to service improvement using a multi‐level theory of innovation: the case of glaucoma outpatient clinics

Turner

Vasilakis

Utley

et al. 2018

Sociology Health & Illness

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The development and implementation of innovation by healthcare providers is understood as a multi-determinant and multi-level process. Theories at different analytical levels (i.e. micro and organisational) are needed to capture the processes that influence innovation by providers. This article combines a micro theory of innovation, actor-network theory, with organisational level processes using the 'resource based view of the firm'. It examines the influence of, and interplay between, innovation-seeking teams (micro) and underlying organisational capabilities (meso) during innovation processes. We used ethnographic methods to study service innovations in relation to ophthalmology services run by a specialist English NHS Trust at multiple locations. Operational research techniques were used to support the ethnographic methods by mapping the care process in the existing and redesigned clinics. Deficiencies in organisational capabilities for supporting innovation were identified, including manager-clinician relations and organisation-wide resources. The article concludes that actor-network theory can be combined with the resource-based view to highlight the influence of organisational capabilities on the management of innovation. Equally, actor-network theory helps to address the lack of theory in the resource-based view on the micro practices of implementing change.

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Section: Introductionmentioning

confidence: 97%

Analysing barriers to service improvement using a multi‐level theory of innovation: the case of glaucoma outpatient clinics

Turner

Vasilakis

Utley

et al. 2018

Sociology Health & Illness

View full text Add to dashboard Cite

show abstract

“…Contemporary evidence from international health systems suggests it is very difficult to balance priorities such as individual patient experience, population health gain and cost containment, as the recent evaluation of the Triple Aim initiative instigated by the Institute for Health Improvement in the US demonstrates. 8 Whilst a small number of the 141 participating organizations succeeded in the Triple Aim goals of improving individual experience of care, improving population health and reducing per capita costs, the majority were unable to pursue all 3 elements at the same time. More worryingly, findings from investigations into major healthcare failures, such as the United Kingdom Francis Inquiry into Mid Staffordshire National Health Service (NHS) Foundation Trust highlight the harm that can be caused to patients if an organization becomes distracted or too intently focused on pursing some aims at the expense of others:…”

Section: What Do Mean By 'Competitive Advantage' In Healthcare?mentioning

confidence: 99%

Necessary but Not Sufficient… Comment on “Knowledge Mobilization in Healthcare Organizations: A View From the Resource-Based View of the Firm”

Harvey¹,

Kitson²

2015

Int J Health Policy Manag

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The challenge of mobilizing knowledge to improve patient care, population health and ensure effective use of resources is an enduring one in healthcare systems across the world. This commentary reflects on an earlier paper by Ferlie and colleagues that proposes the resource-based view (RBV) of the firm as a useful theoretical lens through which to study knowledge mobilization in healthcare. Specifically, the commentary considers 3 areas that need to be addressed in relation to the proposed application of RBV: the definition of competitive advantage in healthcare; the contribution of macro level theory to understanding knowledge mobilization in healthcare; and the need to embrace and align multiple theories at the micro, meso, and macro levels of implementation.

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“…Getting there requires: (1) population management approaches, (2) robust learning systems, and (3) managing change processes to achieve at-scale improvements. 19 These are critical components of complex, adaptive health systems, which aim to increase value for all who stand to benefit, thereby yielding system-level outcomes and improvements.…”

Section: Approachmentioning

confidence: 99%

Can a Healthcare "Lean Sweep" Deliver on What Matters to Patients? Comment on "Improving Wait Times to Care for Individuals with Multimorbidities and Complex Conditions Using Value Stream Mapping"

Verma

Amar

2015

Int J Health Policy Manag

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Disconnects and defects in care -such as duplication, poor integration between services or avoidable adverse events -are costly to the health system and potentially harmful to patients and families. For patients living with multiple chronic conditions, such disconnects can be particularly detrimental. Lean is an approach to optimizing value by reducing waste (eg, duplication and defects) and containing costs (eg, improving integration of services) as well as focusing on what matters to patients. Lean works particularly well to optimize existing processes and services. However, as the burden of chronic illness and frailty overtake episodic care needs, health systems require far greater complex, adaptive change. Such change ought to take into account outcomes in population health in addition to care experiences and costs (together, comprising the Triple Aim); and involve patients and families in co-designing new models of care that better address complex, longer-term health needs.

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Pursuing the Triple Aim: The First 7 Years

Cited by 172 publications

References 13 publications

Analysing barriers to service improvement using a multi‐level theory of innovation: the case of glaucoma outpatient clinics

Analysing barriers to service improvement using a multi‐level theory of innovation: the case of glaucoma outpatient clinics

Necessary but Not Sufficient… Comment on “Knowledge Mobilization in Healthcare Organizations: A View From the Resource-Based View of the Firm”

Can a Healthcare "Lean Sweep" Deliver on What Matters to Patients? Comment on "Improving Wait Times to Care for Individuals with Multimorbidities and Complex Conditions Using Value Stream Mapping"

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