Denver Health: Rocky Mountain High Quality

The April issue of Health Affairs is a themed issue on Quality. It contains a piece on Denver Health and its focus on quality improvement. I encourage you to read it--you'll note this is an impressive medical center, which is a safety-net, teaching hospital, integrated with the EMS system, outpatient clinics throughout the city, school-based clinics, and the public health department to create a seamless continuum of care. Of note, the observed:expected mortality (0.55) at Denver Health ranks lowest among the 112 academic medical centers in the University HealthSystem Consortium, and despite caring for the medically indigent, the hospital has produced a positive bottom line every year since 1991. Unlike the case at many academic medical centers, the physicians at Denver Health are not provided incentives to perform procedures. All of this speaks to superb leadership. The article also outlines several other markers of high quality, and its CEO and CMO "argue that regulatory bodies should refocus their oversight to consider an institution’s overall structured approach to quality improvement and safety, instead of monitoring individual small outcomes, such as a patient’s receipt of antibiotics for pneumonia within six hours of arriving in the emergency department." Go Denver Health! And a shout out to their hospital epidemiologist, Dr. Connie Price.

Also in the same issue, is a paper on the IHI trigger tool, which I've blogged about before in response to a previous paper in the New England Journal of Medicine. I was going to comment on this new paper as well, but will simply refer you to an excellent posting on this by Bob Wachter on his blog.