Fourth Aim Facilitation System Elements

  • A description of the current environment, challenges to be dealt with, regulatory responsibilities, and resources that are available to support needed work.
  • An agreed to purpose or aim that is built through consensus of the group. Of all the elements, this is the most critical. Groups most often have fluid or non-existing purpose statements.
  • Identification of key customers or beneficiaries of the work to be accomplished.
  • Selection of the work products that will be offered to the customers or beneficiaries.
  • Identification of the processes needed to create the work products.
  • Development of performance measurements to evaluate process implementation, outcomes and quality of provided products, and customer satisfaction.


Fourth Aim Advisers Group Facilitation Steps

Step 1: Survey participants
Step 2: Summarize results using system elements
Step 3: Provide discussion on current change environment
Step 4: Review survey findings with group
Step 5: Use workgroups to refine findings
Step 6: Establish champion for each accepted process/strategy
Step 7: Establish follow-up next steps .

Fourth Aim Group Facilitation

Fourth Aim Advisers Facilitation

Traditional business planning involves growth strategies, increasing market share, identifying strengths, weaknesses, opportunities and threats. While these elements continue to play a role in organizational development more needs to be done to explore the emerging roles a healthcare organization will take concerning responsibility to patients, employees, community stakeholders and collaboration partners. 

Fourth Aim Facilitation Agenda

The Fourth Aim agenda provides an approach that links key components to the overall project purpose and can be summarized in a single drawing referred to as a system map. The process has been model after the Deming principles of system thinking and evaluation. 

The first step in this planning structure involves a participant survey, typically 10 questions or less related to the key elements identified above.  The survey work is completed before the first face to face meeting with the group. This process has been used with large and small organizations, internal divisions of a larger healthcare system, and a number of diverse community collaborative groups with the same level of success. 

The planning agenda is phased to lead the group through the structure needed to achieve desired purpose.  It has the following elements:

  • Presentation on the need for a systems approach and structure to achieve desired results.
  • Presentation on the environmental scan and key drivers of need and change. This is the place for initial data sharing, if available.
  • Workgroups to clarify participants understanding of the current environment and key drivers of change.
  • Small workgroups to review initial survey findings, clarify content, and revise initial aim, customers, processes, and desired work products.
  • Finalize and prioritize next implementation steps.