Patient Experience, Community Health Workers, and the Quintuple Aim

 

The Quintuple Aim is a framework developed by the Institute for Healthcare Improvement (IHI, 2025) to understand and improve health system performance.  Originally proposed as the Triple Aim in 2012, the model was widely adopted as a strategy to improve population health, patient experience, and reduce health care costs.  The Triple Aim has been expanded beyond quality and cost to include human and equity dimensions of care: population health, patient experience, cost, provider well-being, and health equity.   Last month, we explored population health, how it differs from public health, and the essential role community health workers play in the delivery of excellent team-based care.   The second dimension we will address is patient experience.   What is patient experience? The Agency for Healthcare Research and Quality (AHRQ, 2025) defines patient experience as “the range of interactions that patients have with the healthcare system, including their care from health plans and from doctors, nurses, and staff in hospitals, physician practices, and other healthcare facilities.”    This definition is expanded when we consider the Chronic Care Model (CCM, ACT Center, 2025).  Originally developed by the MacColl Institute (now the ACT Center), the Chronic Care Model serves as the foundation to understand the delivery of high-quality patient care.  In addition to the AHRQ definition, the CCM identifies communities and self-management as essential for productive interactions between informed patients and providers. These productive interactions drive improved patient experience and patient-centered quality of care.    Like population health and public health, the terms patient experience and patient satisfaction are often used interchangeably.  However, to understand patients’ experiences of care, we need to look beyond satisfaction to consider other factors that patients value: self-management support, shared decision making, getting information, communication with clinicians, access to care, courtesy and respect, care coordination, and culturally appropriate care.      AHRQ, 2025   What is the community health worker’s role in patient experience?   CHWs play a critical role in improving patient experience, which directly impacts population health and the Quintuple Aim.  Trusted in the community, they bring lived experience and cultural responsiveness to build trusting relationships with patients and families (CHCS, 2025).  CHWs address social, cultural, and other barriers that health care teams may not be able to resolve.  They accomplish this though education, care coordination, and connection to community resources.  CHWs build trust and contribute to factors patients value: self-management support, communication, getting information, access, and culturally appropriate care. The Practice Transformation Institute (PTI) CHW educational programs strengthen CHW knowledge, performance, and contribution to improved health outcomes.  PTI is an approved provider of Community Health Worker (CHW) training by the Michigan Department of Health & Human Services (MDHHS). The approval follows a rigorous application process and more than two years of PTI providing CHW training through community and health system partnerships and support. Among one of the CHW training programs approved by the state, PTI is the only organization with the coveted IACET* accreditation. The program teaches the National C3 Council skills and health knowledge necessary to function as a CHW in a variety of community settings. This robust training offers teaching excellence along with a leading-edge curriculum that supports the participants in achieving the learning objectives of the program. For more information on PTI CHW training, visit https://transformcoach.org/learning-solutions/community-health-worker-chw -program/ or call (248) 475-4736.    References: Agency for Healthcare Research and Quality (2025).  What is patient experience?  https://www.ahrq.gov/cahps/about-cahps/patient-experience/index.html. Anhang Price, R., Elliott, M.N., Zaslavsky, A.M., Hays, R.D., Lehrman, W.G., Rybowski, L, Edgman-Levitan, S., & Cleary, S. (2014).  Examining the role of patient experience surveys in measuring health care quality. Medical Care Research Review, 71(5), 522-54.  doi: 10.1177/1077558714541480. Epub 2014 Jul 15. PMID: 25027409; PMCID: PMC4349195. Center for Accelerating Care Transformation, https://www.act-center.org/application/files/1616/3511/6445/Model_Chronic_Care.pdf. Institute for Healthcare Improvement, https://www.ihi.org/library/topics/quintuple-aim. Wagner, E.H. (1998, seminal article).  Chronic disease management: What will it take to improve care for chronic illness? Effective Clinical Practice, (1), 2-4.