Resources: June 3, 2010, WIHI program

Learning by Data and by Doing: Low-Cost, High-Quality Health Care in America

Today’s guests:
 Tom Nolan, PhD, Statistician and Member, Associates in Process Improvement; Senior
Fellow, IHI
 John M. Hogan, President and CEO, Capital Health Plan
 Carol Beasley, Director of Strategic Projects, IHI
 Laura K. Landy, President and CEO, Fannie E. Rippel Foundation

Resources

All guests referred to the Dartmouth Atlas of Health Care.

http://www.dartmouthatlas.org/

Guest, Tom Nolan, introduced the term Hospital Referral Regions (HRRs) with a map.
http://www.ihi.org/IHI/Programs/StrategicInitiatives/HowWillWeDoThat.htm?TabId=3

Don Berwick mentioned other promising initiatives now underway in the spirit of the Triple Aim:
 A Robert Wood Johnson Foundation initiative, Aligning Forces for Quality (AF4Q):
Improving Health and Health Care in Communities Across America
http://www.forces4quality.org/welcome

 Re>Think Health, an initiative of the Fannie E. Rippel Foundation

http://rippelfoundation.org/rethink_health.html

 A Beacon Communities initiative funded by the US Office of Health and Human Service’s
Office of National Coordinator for Health Information Technology (ONC)
http://www.hhs.gov/news/press/2010pres/05/20100504a.html

 Several Accountable Care Organization (ACO) collaborative pilot projects, including:

o Brookings-Dartmouth ACO pilot, a joint initiative of the Engelberg Center for
Health Care Reform at the Brookings Institution and the Dartmouth Institute for
Health Policy and Clinical Systems
https://xteam.brookings.edu/bdacoln/Documents/ACO_Learning_Network.pdf
o Premier ACO pilot
http://www.premierinc.com/about/news/10-may/aco052010.jsp

A listener noted in chat: “There are several dozen multi-stakeholder regional health improvement
collaboratives around the country working on cost, quailty, and patient experience at the regional
level. Most of the leading collaboratives are members of the Network for Regional Healthcare
Improvement.”
http://www.nrhi.org

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Learning by Data and by Doing: Low-Cost, High-Quality Health Care in America – June 3, 2010
 IHI’s Triple Aim Initiative

IHI’s Triple Aim™ initiative was at the heart of today’s WIHI discussion. In this growing
international program, participating teams are developing and testing new designs for health care
that simultaneously accomplish what IHI sees as three critical objectives: improve the health of the
population; enhance the patient experience of care (including quality, access, and reliability); and
reduce, or at least control, the per capita cost of care.
http://www.ihi.org/IHI/Programs/StrategicInitiatives/TripleAim.htm

Guest, Carol Beasley, pointed listeners to a Triple Aim concept design:

http://www.ihi.org/NR/rdonlyres/86BB36CC-CCBB-48D1-9E9E-
02D4E3C1585E/0/ConceptDesign.pdf

Background:
 Starting in October 2007, IHI began working with a group of 15 organizations in the US,
England, and Sweden that were committed to implementing the five design components of
the Triple Aim.
 In the summer of 2008, this group expanded to include over 40 organizations from the US,
Canada, England, Scotland, and Sweden.
 IHI is currently in its fourth phase of work, with more than 70 participating organizations
from eight countries.
 IHI seeks interested and capable organizations worldwide to join this effort. For more
information, please contact IHI’s Nelly Ganesan at nganesan@ihi.org or 617-301-4916.

Related reading:
 A January 2009 Healthcare Executive article, The Triple Aim: Optimizing health, care and
cost.
http://www.ihi.org/NR/rdonlyres/B243B861-74E9-4777-9CA0-
933E7032ED72/0/BeasleyTripleAim_ACHEJan09.pdf
 A 2008 Health Affairs article by IHI’s Don Berwick and colleagues Tom Nolan and John
Whittington, The Triple Aim: Care, health, and cost.
http://content.healthaffairs.org/cgi/content/full/27/3/759

How Will We Do That?

Guest, Carol Beasley, described an IHI initiative closely aligned with the Triple Aim called How
Will We Do That? She and Don Berwick both discussed how the project grew out of a convening of
health care visionaries in July 2009 in Washington, DC. Initially dubbed How Do They Do That?,
the initiative has matured and evolved in the past year, in part thanks to valuable new research data
made available. Carol reported on promising discussions at the second major meeting of this group
last month; 13 sites came together with project leaders to assess findings and consider where to go
from here.
http://www.ihi.org/IHI/Programs/StrategicInitiatives/HowWillWeDoThat.htm

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Learning by Data and by Doing: Low-Cost, High-Quality Health Care in America – June 3, 2010
Related reading:

 The Cost Conundrum, a widely read and cited June 1, 2009 New Yorker article by Atul
Gawande.
0297501A49A/0/GawandeTheCostConundrumNewYorkerJun09.pdf

 10 Steps to Better Health Care, an August 12, 2009 New York Times opinion piece by
leaders of the How Will We Do That? initiative, Atul Gawande, Donald Berwick, Elliott
Fisher, and Mark McClellan.
http://www.nytimes.com/2009/08/13/opinion/13gawande.html?_r=3&pagewanted=1&ref=o
pinion

 A paper presented in February 2010 by IHI Senior Fellow Tom Nolan to IHI’s Board, in
which he suggests that regional solutions may be most promising for national health care
reform.
http://www.ihi.org/NR/rdonlyres/07730B39-FCF0-43CC-AA40-
2DCAC2B22491/0/IHINolanUSHealthCareReformbyRegionFeb10.pdf

 A June 12, 2009, University of Chicago Commencement Address by Atul Gawande.

F6097EB0E76/0/GawandeUChicagoCommencementAddressJun09.pdf

 County Health Rankings: National comparisons of the healthiest and least healthy counties
in each US state.
http://www.countyhealthrankings.org/

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Learning by Data and by Doing: Low-Cost, High-Quality Health Care in America – June 3, 2010