A broad and structured approach to improving patient safety and quality: lessons from Denver Health

• Published in: Health Affairs Vol. 30; no. 4; pp. 612 - 618
• Main Authors: Gabow, Patricia A, Mehler, Philip S
• Format: Journal Article
• Language: English
• Published: United States The People to People Health Foundation, Inc., Project HOPE 01.04.2011
• Subjects: American Recovery & Reinvestment Act 2009-US; Antibiotics; Colorado; Communication; Emergency medical care; Emergency medical services; Health care access; Health care policy; Health facilities; Health maintenance organizations; HMOs; Hospitals; Humans; Incentive plans; Indigent care; Information technology; Medical Errors - prevention & control; Medication Errors - prevention & control; Mortality; Multi-Institutional Systems; Organizational Case Studies; Patient safety; Physicians; Public health; Quality Assurance, Health Care - organization & administration; Quality improvement; Quality of care; Safety; Safety Management - organization & administration; Teams; Total quality; Colorado; Denver Colorado; United States > US
• DOI: 10.1377/hlthaff.2011.0042
• ISSN: 0278-2715

America's health care systems have not achieved the desired level of quality and safety. This may be due, in part, to the lack of clear and robust approaches for institutions to follow. Denver Health, an integrated, public safety-net institution, developed a multifaceted, structured approach to quality and safety improvement that has produced positive outcomes. For example, in 2010 Denver Health ranked first of 112 US academic medical centers in terms of actual mortality observed relative to the national mortality rate. Given these results, we 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.