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!

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!

Cross the streams...

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 doesBuffy the Vampire Slayerhave to do with Patients?

She was just a girland 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?

Comparison of Spending on Health (1980–2007)

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80

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U.S.FranceSwitzerlandGermanyCanadaNetherlandsNew ZealandSwedenNorwayItalyU.K.Australia

Total expenditures on health(% of GDP)

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

Patient, Family & Community-Driven Care

Chronic Care Model CommunityResources &PoliciesSelf-management Support

Health System Health Care OrganizationDelivery System Design Decision Support Clinical Information Systems

InformedActivated

Patient

Prepared, Proactive

Practice Team

FamilyCaregiverSelf

Pop culture Friends Neighbors Civic organizations Religious Institutions Social Media

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 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 does this all MEAN to ME?

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 a Personal 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!