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Name
Capella University
NURS-FPX 6612 Health Care Models Used in Care Coordination
Prof. Name
Date
The hospital has adopted a care coordination approach aimed at achieving the Triple Aim, a framework introduced by the Institute for Healthcare Improvement (IHI). This framework provides a strategy to enhance healthcare system performance. The IHI developed the Triple Aim to address three key areas: improving population health, enhancing patient care experiences, and reducing the cost of care. It emphasizes the creation of new strategies to meet these objectives simultaneously. As healthcare systems across the globe move towards value-based care, many nations are adopting the Triple Aim model to improve the efficiency and quality of healthcare services (Kokko, 2022).
The Triple Aim framework aims to improve population health, healthcare quality, and system value. Since its inception in 2008, the model has been applied in various countries, including England, where it is a key focus of integrated healthcare. Despite its widespread use, there is a scarcity of research on how quality improvement methods can assist in achieving the Triple Aim (Pearcey & McIntosh, 2021). Studies, such as those conducted by Obucina et al. (2018), have highlighted the challenges in implementing the Triple Aim in primary care. Healthcare professionals often face difficulties with unclear goals and insufficient performance metrics, underscoring the need for more precise measures to support the Triple Aim framework in primary care.
The development of new healthcare models like Patient-Centered Medical Homes (PCMHs) and Accountable Care Organizations (ACOs) has propelled the Triple Aim forward by focusing on improving patient experiences, promoting population health, and reducing healthcare costs. These models have been instrumental in moving healthcare towards the Triple Aim, though challenges in implementation persist. According to Cantiello (2022), further research is needed to evaluate the long-term viability of these models. In another study, Yang (2020) found that one-sided ACOs have been more effective in reducing healthcare costs than two-sided models, highlighting the need for careful evaluation before shifting ACO models.
| Triple Aim Outcome Measure | Healthcare Model | Research Findings |
|---|---|---|
| Population health improvement | PCMHs, ACOs | Effective in improving outcomes, but implementation challenges exist. (Cantiello, 2022) |
| Reduction in healthcare costs | ACO (One-sided vs. Two-sided) | One-sided ACOs outperform in cost reduction (Yang, 2020) |
| Enhanced patient care experience | Transitional Care, COC | Improved outcomes through coordinated care models (Pedrosa et al., 2022; Gandré et al., 2020) |
Care coordination is crucial for managing complex patient needs, particularly in chronic disease care. Various models, such as the Transitional Care and Continuity of Care (CoC) models, have emerged to streamline the process of patient care transitions and improve outcomes (Pedrosa et al., 2022; Gandré et al., 2020). These models emphasize the need for collaboration among healthcare professionals, integrating multidisciplinary teams to provide patient-centered care. Evidence-based approaches are pivotal in shaping care coordination, using data to develop strategies that improve patient outcomes. For instance, the SBAR (Situation-Background-Assessment-Recommendation) model enhances communication within healthcare teams, leading to improved safety and patient satisfaction (Gupta et al., 2019).
Government regulations have a significant impact on healthcare disparities, particularly in the U.S., where fragmented healthcare delivery has led to inequalities in care access and treatment outcomes. The Triple Aim framework, combined with policies such as the Affordable Care Act, seeks to address these disparities by improving access to quality care and reducing healthcare costs (Rocco et al., 2018). Legislative reforms are encouraging the development of innovative care models, but further research is needed to assess their effectiveness in reducing disparities and achieving the Triple Aim goals (Wasserman et al., 2019).
To fully achieve the goals of the Triple Aim, healthcare systems must focus on improving not only patient outcomes but also the work environment for healthcare teams. By enhancing the well-being of healthcare professionals, it becomes possible to improve patient care, boost population health, and reduce costs. Achieving the Triple Aim requires a balanced focus on the care team’s well-being, which will lead to more sustainable healthcare delivery and better outcomes for patients.
The implementation of models aligned with the Triple Aim framework provides a pathway toward better healthcare outcomes, improved patient satisfaction, and reduced healthcare costs. However, ongoing research and process improvement efforts are needed to address the challenges of implementing these models effectively. By prioritizing the well-being of healthcare teams and refining healthcare delivery methods, the Triple Aim can be achieved, leading to significant improvements in healthcare systems.
Cantiello, J. (2022). To what extent are ACO and PCMH Models advancing the Triple Aim objective? Implications and considerations for primary care medical practices. Journal of Ambulatory Care Management, 45(4), 254–265. https://doi.org/10.1097/jac.0000000000000434
Chakurian, D., & Popejoy, L. (2021). Utilizing the care coordination Atlas as a framework: An integrative review of transitional care models. International Journal of Care Coordination, 24(2), 57–71. https://doi.org/10.1177/20534345211001615
Gandré, C., Beauguitte, L., Lolivier, A., & Coldefy, M. (2020). Care coordination for severe mental health disorders: an analysis of healthcare provider patient-sharing networks and their association with quality of care in a French region. BMC Health Services Research, 20(1). https://doi.org/10.1186/s12913-020-05173-x
Gupta, M., Soll, R., & Suresh, G. (2019). The relationship between patient safety and quality improvement in neonatology. Seminars in Perinatology, 1, 151173. https://doi.org/10.1053/j.semperi.2019.08.002
Kokko, P. (2022). Improving the value of healthcare systems using the Triple Aim framework: A systematic literature review. Health Policy, 126(4). https://doi.org/10.1016/j.healthpol.2022.02.005
Obucina, M., Harris, N., Fitzgerald, J. A., Chai, A., Radford, K., Ross, A., Carr, L., & Vecchio, N. (2018). The application of triple aim framework in the context of primary healthcare: A systematic literature review. Health Policy, 122(8), 900–907. https://doi.org/10.1016/j.healthpol.2018.06.006
Pearcey, J., & McIntosh, B. (2021). One year on: Lessons from COVID-19. British Journal of Healthcare Management, 27(4), 1–2. https://doi.org/10.12968/bjhc.2021.0041
Pedrosa, R., Ferreira, Ó., & Baixinho, C. L. (2022). Rehabilitation nurse’s perspective on transitional care: An online focus group. Journal of Personalized Medicine, 12(4), 582. https://doi.org/10.3390/jpm12040582
Rocco, P., Kelly, A. S., & Keller, A. C. (2018). Politics at the cutting edge: Intergovernmental policy innovation in the Affordable Care Act. Publius: The Journal of Federalism, 48(3), 425–453. https://doi.org/10.1093/publius/pjy010
Wasserman, J., Palmer, R. C., Gomez, M. M., Berzon, R., Ibrahim, S. A., & Ayanian, J. Z. (2019). Advancing health services research to eliminate health care disparities. American Journal of Public Health, 109(S1), S64–S69. https://doi.org/10.2105/ajph.2018.304922
Yang, C. C. (2020). Health expenditures and quality health services: The efficiency analysis of differential risk structures of Medicare Accountable Care Organizations (ACOs). North American Actuarial Journal, 1–21. https://doi.org/10.1080/10920277.2020.1793783
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