IHI patient view

Involving Patients as a Path to Achieving the Triple Aim
What Can You Do By Next Tuesday?
Institute for Healthcare Improvement Fellows 2011
How would pop-culture define the IHI Triple Aim?
Not as just another pyramid….
Not as just another failed pictograph.
What does it make you think of ?
How about…

The Temple of Gozer from Ghostbusters?
Or more precisely, does the IHI Triple Aim
remind you of those three misfits,
who saved the world by crossing the streams?

I have a radical idea.
The door swings both ways, we could reverse the particle flow through the gate.
How?
[hesitates] We'll cross the streams.
'Scuse me Egon?
You said crossing the streams was bad!
Cross the streams...
You're gonna endanger us, you're gonna endanger our client - the nice lady, who paid us in advance, before she became a dog...
Not necessarily. There's definitely a *very slim* chance we'll survive.
[pause while they consider this]
[slaps Ray]
I love this plan! I'm excited to be a part of it!
LET'S DO IT!

IHI Triple Aim
is not a triangle.
It is a
focusing
beam.

“Dawn’s in trouble, It must be Tuesday.”
What Can You Do By Next Tuesday?

So, what does
Buffy the Vampire Slayer
have to do with Patients?
She was just a girl
and she saved the world
… a lot.
This show played with the form,
It changed the paradigm.
Blond cheerleaders could fight the Big Bad.
We need Heroes.
We need patients and practitioners willing to speak up.

So who is the Big Bad we must defeat this week?
In a television series there are many foes to conquer.
Is it the monster of the week?
Is it the arch villain who has plotted all season?
Or do we fight the Big Bad who fought against us for years?
Is the Big Bad in medicine
overall spending on healthcare in the United States?

Total expenditures on health(% of GDP)
Comparison of Spending on Health (1980–2007)
Source: OECD Health Data 2009 (June 2009).

“Americans do not use medical care more than others… they just pay much more for the care they get.”- Washington Post, Aug 16, 2010

Or perhaps the Big Bad is a lower life expectancy due to
Healthcare-related issues?

Death due to Healthcare-Related IssuesDeaths per 100,000 population*

Perhaps we can defeat the Big Bad through Regulation
and Technology.
After all, a circuit board may seem complex and scary to look at.
But can you imagine life without the ease of communicating via cell phone?
Regulation can create the infrastructure and standards to improve communication.

Patient & Family Driven Care
Safe
Effective
Patient centered
Efficient
Timely
Equitable

Patient Involvement: a Paradigm Shift
Old method vs. New Method

Street Art by Banksy

Pop culture
Friends
Neighbors
Civic organizations
Religious Institutions
Social Media
Patient, Family & Community-Driven Care
Family
Caregiver
Self
Informed
Activated
Patient
Prepared, Proactive
Practice Team
Community
Resources &Policies
Self-management Support
Health System
Health Care Organization
Delivery System Design
Decision Support
Clinical Information Systems
Chronic Care Model

Patient & Family Driven Care
The greatest, untapped resource for improving healthcare is the knowledge, wisdom, and energy of the individuals, families and communities who face challenging health issues in their every day lives.
People must be engaged as co-producers of healthcare for themselves and their communities, not merely as patients or consumers of services.
Local communities must retrieve their own historical, cultural, and religious traditions of health and healing, and bring those into dialogue with contemporary medical systems.
Bill Doherty
University of Minnesota

What does this all MEAN to ME?
What can I do
For my health?
For the health of my family?
For the health of my community?
About how care is delivered?
About the cost of care?

What can you do to improve healthcare by next Tuesday?

What can
You do as a
Citizen?

What can you do as a
Health
Care
Provider or Employee?

Improve Your Health
You could
Get out and exercise!
Take personal responsibility for safety – wear a bike helmet; use your seat belt; keep your small children in proper car safety seats
Starting a family? Get prenatal care, and don’t choose to induce labor before 39 weeks!

Improve your Health Care
You could –
Keep a list of all the medicines you take, including supplements and over-the-counter medications

Start aPersonal Health Record
Your
personal
health
story

You Could
Encourage your primary care office to become a Person-centered medical home
Volunteer as a patient representative on quality committees at your local hospital
Make sure that you and your family members really understand the instructions your healthcare team gives you
Speak up and share health concerns using Social Media

Improve Health in Your Community
You could –
Wash your hands
Painted Hands by Guido Daniele
Because not all Little Beasties can be so easily seen.

You could
Get a flu shot
Help a neighbor in their healthcare needs
Learn how to take blood pressures and help
with screenings at a local church or community center
Have an Advance Directive, and participate in
advanced illness planning so you get the care you
want and need

Improve the Value of every Healthcare Dollar Spent
You could –
Learn about your health and medical conditions
Actively share with your doctor in making decisions about diagnosis and treatment
Ask for generic medicines
Ask if surgical procedures are necessary or if there is something else you can try before resorting to surgery
Don’t take antibiotics for viral infections

You must be the change you wish to see in the world.
- Ghandi
Painted Hands by Guido Daniele

What can you do by Next Tuesday ?
Now!

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IHI patient view

by Regina Holliday

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IHI patient view

by Regina Holliday

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