IOM ( Institute of Medicine )
Q1: Answer the following questions:
(2 Article will be send by email with the order no…… )
- Crossing the Quality Chasm A New HC System
- Triple Aim Care Health Costs.
1.How do the Six Aims of the IOM relate to the Triple Aim ?
2.How do the six Aims of the IOM relate to Donabedian’s 7 attributes?
3.How do Donabedian’s attributes relate to the Triple Aim ?
Q2: List three key points that were made by the IOM in the article to Error is Human?Give an example for each key point.
Six Aims of the IOM Relationship to the Triple Aim
The six objectives of Institute of Medicine (IOM) achieve a similar effect compared to the Triple Aim. The effective objective of IOM seeks to make the use of scientific knowledge to provide services to as many people as possible but refrain from applying the services to people who are not likely to gain. This approach aims at reducing wastage of resources by trying to use services to people who cannot benefit. Applying the scientifically based services to such individuals will require costs that will yield no results whereas these resources can be utilized elsewhere are likely to achieve more (Berwick, Nolan & Whittington, 2008).
This aspect of the useful objective creates efficiency in the sense that it increases the number of people benefiting from a particular service. The similarity is evident in the third goal of Triple Aims, which is, reducing per capita costs of care of populations. This goal aims at using as little as possible funds to reach as many people as possible. Effectiveness is highly improved by this objective just as the IOM effective target does. The IOM practical purpose also means that more individuals will be reached by the care services hence improving their experience and that of the larger population (Berwick, Nolan & Whittington, 2008).
The IOM safe target is supposed to reduce or eliminate the number of injuries from a health care service that is intended to help such individuals. Reducing these injuries translates to also the costs that are utilized to deal with them varnishing. The funds can then be used to reach more people with health problems, which achieve a similar objective just like the per capita costs of a population. The IOM safe purpose also produces a similar result as the Triple Aim of making the individual experience of care better. When the experience of most of the individuals is improved by eliminating injuries, the health of the larger population also becomes better hence satisfying the second aim of the triple aims (IOM, 2001).
The third IOM objective, that is, patient-centered care also achieves similar results as the Triple aims. Care that is responsive and respectful to the requirements to particular patients requirements, and values, and ensuring that clinical decisions are guided by the patient values achieves a satisfaction of individuals relying on that care. The Triple Aims’ first objective advocates for the improvement of each particular individual experience hence resonates with the IOM of patient-centered care. The second aim of the Triple Aims advocates for improved services for the entire population (Berwick, Nolan & Whittington, 2008).
When the experience of an individual patient is improved, then the whole community is made better. The patient-centered objective also reduces the per capita cost by ensuring that individual patient’s issues are dealt with appropriately hence reducing chances of recurring and demanding for more resources counter. The costs that would be used to combat recurring problems can be used to reach more people in a population (IOM, 2001).
The IOM Timely objective is intended to re duce the waiting time for caregivers and receivers. This goal ensures that caregivers can attend to as many people as possible in a given time duration. This factor results in the health of a particular population being improved because many patients are attended to. The population also reduces the capita costs by eliminating the need of additional caregivers to make up for the lost time waiting for lags. Reduction in patients’ wait improves their individual experience hence improving the experience of many people in a population, which is the intention of the second Triple AIMs (Berwick, Nolan & Whittington, 2008).
The efficient aim ensures that resources are not wasted regarding equipment, supplies, energy, and ideas. This objective intends to achieve a reduced cost in serving a particular population hence relates to the Triple Aim of per capita costs reduction. The costs saved from this aim can be channeled to improving the experience of individual patients and hence making the entire population care better (Berwick, Nolan & Whittington, 2008).
The final IOM objective is equitable which intends to ensure the quality of care provided is uniform regardless of personal characteristics such as gender, geographic location, ethnicity, and socioeconomic status. The objective achieves a personal satisfaction to the people of getting services that are no affected by particular characteristics. The health population is also improved when individuals are assured of services any time regardless of their status. The aim also achieves a reduced per capita cost by ensuring disease cases can be diagnosed and treated early hence preventing them from advancing to levels that require many resources to deal with (IOM, 2001).
The connections identified above between the IOM objectives and the Triple Aims shows that every IOM goal has an effect to the three Triple aims. The IOM Triple Aims are a result of implementing the IOM objectives whereby each one of them affects the three triple goals (IOM, 2001).
IOM Aims relationship to Donabedian’s 7 attributes
According to Donabedian, seven characteristics of health care define its quality. The features include the efficacy, which is the ability of care to improve health. The attribute works in a similar manner as the efficiency objective of the IOM. The second attribute is effectiveness, which is the degree of realization of attainable health improvements. The characteristic compares to the IOM effective goal, which improves the services of care to reach as many people as possible. The Donabedian effective attribute advocates for improvement in health, hence leading to the larger population being reached (Arch Pathol Lab Med., 1990). .
The third Donabedian attribute is efficiency, which is the ability to use the lowest costs to achieve greatest health improvements. Using low cost to improve health implies that more people can be reached by the improved health, and the surplus can be used to reach even a bigger number of individuals. The attribute compares perfectly to the IOM efficiency quality. Optimality is another quality that focuses on balancing the costs of health services and benefits. The attribute does not link directly to the IOM aims but when applied can achieve the efficiency and efficacy objectives (Arch Pathol Lab Med., 1990). .
Acceptability is another attribute, which, can be compared to timely care purpose of IOM. The timely care goal and the acceptability attribute emphasizes on the availability of caregivers and receivers relationships, and how they can contribute to reduced costs hence improved care. Legitimacy is a quality concerned with social preferences conformity regarding the above attribute. The legitimacy and the equity characteristics can be compared to the IOM equity objective regarding target achievements (Arch Pathol Lab Med., 1990). .
The Donabedian attributes relate to the IOM aims in their functionalities. The objectives and the characteristics when implemented achieve similar results. Unlike the comparison of the IOM and the Triple objectives where one is a product of the other. The only exception is the optimality attribute that leads to efficiency and efficacy. However, one of the attributes can compare to two objective and vice versa (Arch Pathol Lab Med., 1990). .
Donabedian’s characteristics relate to the Triple Aim
The Donabedian’s attributes work in a similar manner as the IOM goals. The fact the attributes work just like the IOM aims implies that they compare to the Triple in a similar fashion. Each of the attributes has the capability to affect all the triple objectives. For instance, the equity attribute stipulates that the health professionals must take into account the patients and the social preferences. When the social and the patients are taken into consideration, the individual experience is improved; more people are likely to be friendly to the system and hence enhance the health of the population. The friendliness of the scheme will mean that problems can be identified and solved early hence prevent their advancing which would call for more resources. The attribute will hence reduce per capita costs (Arch Pathol Lab Med., 1990).
Key points that were made by the IOM in the article to Error is Human
-The primary objective of IOM in ‘to err is to human’ is to ensure that the health system does not do harm to the patients that it is supposed to help. The article set a goal to reduce the errors in the health sector by 50% in five years (IOM., 2001).
-Improving the health care industry for the well-being of individual patients and population
-Targeting the entire system to solve the health care issues (IOM., 2001)
Berwick, D. M., Nolan, T. W., & Whittington, J. (2008). The Triple aim: care, health, and cost. health affairs, 27(3), 759-769. doi:10.1377/hlthaff.27.3.759
Institute of Medicine (IOM). (2001). Crossing the quality chasm. Institute of medicine. doi:10.17226/10027
Arch Pathol Lab Med. (1990, November). The seven pillars of quality. – Pubmed – ncpb. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/2241519