Governing to Achieve the Triple Aim: Broadening the Board's Perspective

By Carolyn F. Scanlan

The Triple Aim of improving the experience of care, improving the health of populations and reducing per capita costs of health care is a nationally recognized goal that provides context for much of the work now underway to redesign existing systems for care, payment and collaboration to achieve better health outcomes for all Americans.

Board members of hospitals and health systems across the country are having discussions about population health, value-based care, bundled payments and greater engagement of patients, families and clinicians in improving care processes and health outcomes, within and outside of their health systems. They understand that this transformational work is core to their organization’s mission and central to the board’s responsibility and accountability as stewards of community health. What is beginning to set leading organizations and their boards apart from the rest, however, goes beyond their willingness to systematically define, implement and oversee the work necessary to achieve the Triple Aim. These organizations also recognize the importance of connecting the dots among key elements of the work and its impact at all levels of the organization, including governance.

During my four years on the board of Penn Medicine Lancaster General Health, I have seen the evolution of our organization’s Triple Aim work and framework to help the board comprehensively oversee what our system is doing to achieve it. Our journey has encompassed many steps that help our organization deliver greater quality and value to our communities. Among these are:

  • our merger with Philadelphia-based Penn Medicine;
  • a commitment to high reliability and continuous improvement through a Lean Management System;
  • implementation and expansive operationalization of a powerful health information system and the data analytics necessary to understand and monitor performance at the individual patient, outpatient practice, hospital unit and population levels; and
  • appointment of a Physician Executive for Quality working with other clinical leaders in areas such as quality and safety, health information and population health.

These important relationships and expanded resources have enabled our board and leadership to ask key questions and implement further operational changes and investment needed to continue our journey.

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