Quality Standards for Diabetes Care Toolkit

References References for each Standard.

Underpinning frameworks

New Zealand Triple Aim

The Triple Aim is a health care improvement policy that was initially developed in the United States. It outlines a plan for better health care systems by pursuing three aims: improving patients’ experience of care, improving the overall health of a population and reducing the per-capita cost of health care. In New Zealand, the policy has been adapted by the Health Quality and Safety Commission (HQSC) and is one of the key tenets of the Integrated Performance Incentive Framework.

The HQSC of New Zealand strives to achieve the Government’s outcomes through the Triple Aim. The Triple Aim for quality improvement includes:

improved quality, safety, and experience of care

improved health and equity for all populations

best value for public health system resources.
To evaluate the Triple Aim, assessment tools and clinical indicators are applied in a variety of ways with a focus on structure, process or outcome:

Structure – refers to the health system’s characteristics that affect the system’s ability to meet the health care needs of individual patients or a community (eg, access to specific technologies and having clinical guidelines in place and revised regularly).

Process – refers to what the provider did for the patient and how well it was done (eg, the proportion of people with diabetes given regular foot care and the proportion of people with an individualised plan of care).

Outcome – refers to states of health or events that follow care and that may be affected by health care (eg, intermediate or end result outcomes) (Mainz 2003).