48% Reduction in 1-year Mortality after Implementing Hip Fracture Protocol
Permanente Journal 2017
CREATING THE SCIENCE
Sustaining Change: 5 Years Later Antibiotic Stewardship Project Maintains 26% Reduction in Use
48% Decrease in Cancelled/No-show Primary Care Appointments
CREATING THE SCIENCE
Positive Deviance Theory Drives Reduction in Time-to Thrombolysis in Stroke Patients
American Journal of Quality 2013
$916,548 Annual Savings Through Pyxis Optimization
35% Fewer Complications in Pancreatic Surgery Patients
Welcome to the Institute for Healthcare Quality, Safety and Efficiency (IHQSE). Our overarching goal is to fundamentally improve the care we provide our patients.
Since our founding in 2012, we have experienced tremendous growth and expansion guided by our mission of creating a healthcare system that ensures every patient receives the highest quality of care while avoiding harm, minimizing inefficiencies and developing leaders in quality and safety.
The core foundation of IHQSE is our team. Comprised of dedicated and gifted faculty, our team not only teaches the fundamentals of leadership, how to initiate change, and how to improve healthcare outcomes but they also guide and inspire participants to become better leaders and more effective catalysts of sustainable change. Our formula for success combines expert training, intensive, tailored coaching and a deep catalog of successful projects to tap into.
I invite you to take advantage of our extensive opportunities to help you transform your healthcare delivery system.
Jeff Glasheen, MD IHQSE Director
Faculty & Staff
Business operations improvement has been Dustin's passion for over 20 years. A proven leader in process and performance improvement, Dustin has led projects and successfully built teams to drive improvement aimed at reducing expenses, increasing revenue and ultimately improving customer and patient satisfaction. Dustin's education and wide variety of business experiences have contributed to successes in healthcare, specifically at Children's Colorado Hospital, where he implemented best practices and improvement tools and methodologies in all operational areas of the hospital.
Tyler Anstett, DO is a hospitalist in the Division of Hospital Medicine at the University of Colorado. He completed his residency training in Internal Medicine at the University of Colorado where he was an inaugural member of the Hospitalist Training Program Leaders Track and went on to complete a fellowship in Hospital Medicine with a focus on Quality Improvement and Health Systems Leadership. His academic interests lie at the intersection of Quality Improvement, Leadership, and Medical Education across all levels of learners. Accordingly, his leadership roles include Director of Education for the Division of Hospital Medicine, Quality Improvement Curriculum Director for the Hospitalist Training Program, Director of the GME/IHQSE Quality and Safety Academy, and he is an Associate Vice Chair for Quality for the Department of Medicine. He also sits on the national Education Committee for the Society of Hospital Medicine.
Lalit Bajaj currently serves as the Medical Director of Clinical Effectiveness at Children’s Hospital Colorado. In addition, he is a Professor of Pediatrics and Emergency Medicine at the University of Colorado School of Medicine. Dr. Bajaj has been an attending physician in the Children’s Colorado Emergency Department for 15 years. He received his MD from the University of California, San Francisco in conjunction with a Master’s in Public Health from the University of California, Berkeley in 1996. He then completed a pediatric residency, chief residency, and pediatric emergency medicine fellowship at the University of Colorado/Children’s Hospital Colorado. Dr. Bajaj has served as Research Director of the section of Emergency Medicine; as well as the Medical Director in the CHCO Research Institute. In addition, he has also served on many national leadership committees including the Steering Committee of PECARN (Pediatric Applied Care and Research Network), and the AAP Executive Committee of the Section of Emergency Medicine. Most recently, he has joined the Children’s Hospital Association steering committee for value based care.
David Brumbaugh is the Associate Chief Medical Officer at Children’s Hospital Colorado, where his primary focus in inpatient operations. He is an Associate Professor of Pediatrics in the Section of Pediatric Gastroenterology, Hepatology, and Nutrition in the University of Colorado School of Medicine. He was previously the Clinical Medical Director for the Digestive Health Institute at Children’s Hospital Colorado. He received his MD degree from Vanderbilt University School of Medicine and completed his pediatrics residency at Children’s Hospital Colorado, where he was also Chief Resident in Pediatrics. He was a general pediatrician for three years in the Yakima Valley, WA, before returning to Children’s Hospital Colorado for a fellowship in gastroenterology. He currently serves on the Executive Committee of the Section of Gastroenterology, Hepatology and Nutrition of the American Academy of Pediatrics.
Michael DiStefano is Chief Medical Officer for Children’s Hospital Colorado – Colorado Springs. Prior to taking this position in 2019, he served as Director of Clinical Operations for Children’s Hospital Colorado Emergency Departments and Urgent Cares, and the Medical Director of the Emergency Department at Children’s Hospital Colorado. In 2012, Michael came to the University of Colorado School of Medicine from Baylor College of Medicine where he was the associate medical director for Texas Children’s Emergency Department. During his time at Baylor College of Medicine, Michael earned a Black Belt in Lean Six Sigma. He received his MD from Baylor College of Medicine in Houston, TX. Michael completed both his residency in pediatrics and fellowship in pediatric emergency medicine at Texas Children’s Hospital.
Ethan Cumbler is an Internal Medicine and Pediatric trained Hospitalist at the University of Colorado Hospital (UCH). He is a pioneer in the study and practice of inter-professional team-based hospital quality improvement. He created the Acute Care for the Elderly (ACE) Service at UCH and is the Medical Director for UCH’s ACE unit. This serves as a crucible for testing QI methods for reducing iatrogenic events such as falls or hospital acquired infections using teams of professionals across disciplines. He spearheaded a series of initiatives reducing treatment time for stroke patients recognized by the American Stroke Association. His QI programs for in-hospital stroke and hospital care for the elderly service serve as national models. He heads the National Stroke Association’s In-hospital Stroke QI initiative and speaks nationally on how to improve systems of hospital care for stroke patients. He also serves as faculty for the UCLA Leadership and Management in Geriatrics course and his invited lectures on improving care for the hospitalized elderly have been presented at the National American College of Physicians and Society of Hospital Medicine conferences. Within UCH, he chairs the Geriatric Hospital Leadership Committee and has served in many capacities for the Hospital Medicine Division over the years, including work on patient safety and medical error. His educational approach to teaching patient safety is published by the Association of American Medical Colleges and has been utilized by academic medical centers around the world. Ethan has been a recipient of awards at UCH for excellence in leadership, humanism, education, and quality improvement. He received the annual 2012 National Society of Hospital Medicine Award for Team-Based Quality Improvement for his work over 6 years improving response to in-hospital stroke. Ethan seeks to bring a collaborative approach to system change such that physicians are partners with other disciplines, and the hospital, to create a culture which fosters continuous quality improvement.
Timothy Givens is the Vice Chair for Clinical Operations for the Department of Pediatrics at the University of Colorado. Prior to taking this position in September, 2017, he served as Section Chief of Pediatric Emergency Medicine/Urgent Care at Colorado for 8½ years, and the Medical Director of the Emergency Department at Children's Hospital Colorado. Before moving to Colorado, Tim held several administrative positions (Section Chief, ED Medical Director, PEM Fellowship Program Training Director) at a number of academic children's hospitals, including MUSC Children's Hospital in Charleston, SC; Monroe Carell, Jr. Children's Hospital at Vanderbilt in Nashville, TN; Kosair Children's Hospital in Louisville, KY; and The Children's Hospital of Alabama in Birmingham, AL. He received his MD from Vanderbilt University School of Medicine and completed a residency in pediatrics and a fellowship in pediatric emergency medicine at Cincinnati Children's Hospital Medical Center.
Jeffrey J. Glasheen, MD, SFHM is the Director for the Institute for Healthcare Quality, Safety and Efficiency, the Associate Dean for Clinical Affairs—Quality and Safety Education and a Professor of Medicine with Tenure at the University of Colorado School of Medicine.
Dr. Glasheen was an Alpha Omega Alpha graduate of the University of Wisconsin School of Medicine and completed his residency training, including a chief residency year, at the University of Colorado Health Sciences Center. As the director of the University of Colorado Hospital Medicine Group from 2003-2015, he oversaw the growth of the program from 2 to 70+ members. Dr. Glasheen served as the Chief Quality Officer (CQO) for the University of Colorado Hospital from 2015-2020 and as the CQO for UCHealth from 2017-2020.
Emily Gottenborg is an Assistant Professor within the Hospital Medicine Group at the University of Colorado, with an interest in system redesign, patient safety, and leadership in the healthcare setting. She has received advanced training during a Chief Residency in Quality Improvement and Patient Safety at the University of California, San Francisco, as well as through Intermountain Healthcare's Advanced Training Program, and the Institute for Healthcare Quality, Safety, and Efficiency. Dr. Gottenborg has served as the Director of the Medicine Ward Service at the University of Colorado since 2014, and has multiple educational roles within the University, teaching learners of all levels and across the health professions about principles of medical leadership, quality improvement, and patient centered care.
Dr. Daniel Hyman is the Chief Quality Officer at The Children's Hospital of Philadelphia (CHOP). He was previously the Chief Medical and Patient Safety Officer at Children's Hospital of Colorado, and, prior to that, the Chief Children’s Quality Officer and the Chief Medical Officer for Ambulatory Care at New York Presbyterian Hospital. Dr. Hyman spent 13 years in general pediatric practice in the Philadelphia area and also served as Medical Director for a Physician/Hospital Organization at CHOP. He received his MD from Albert Einstein College of Medicine, completed a Pediatric residency at CHOP, and received a Master’s Degree in Medical Management from Tulane University. Dr. Hyman previously served on national committees engaged in improving pediatric quality and patient safety, including the CHA Quality and Performance Improvement Board Committee, Child Health Quality Council for NACHRI, the Strategic Policy and Advisory Committee for NICHQ, the Quality and Performance Committee for Children’s Hospital Association, and the Steering Committee for the Quality and Safety Leaders Forum for Children’s Hospital Association (formerly CHCA/NACHRI).
David M. Keller, MD is Professor and Vice Chair for Clinical Strategy and Transformation in the Department of Pediatrics at the University Of Colorado School Of Medicine and Children’s Hospital Colorado (CHCO). He is responsible for leading initiatives to improve practice efficiency and effectiveness, as well as developing the capacity of the faculty to provide comprehensive high-value care to children in Colorado and throughout the Mountain West Region. On a state level, he serves as Co-Chair of the Health Impact on Lives Subcommittee of the Program Improvement Advisory Committee of the Colorado Accountable Care Collaborative; Co-Chair of the Health Information Technology Workgroup for the implementation of the Colorado State Innovation Model (SIM) Award; and serves on the Physician Advisory Board of Center for Improving Value in Health Care (CIVHC), Colorado’s all-payer claims database. On a national level, he serves on the Standing Committee on Pediatric Measures of the National Quality Forum and is the Chair of the Federation of Pediatric Organizations (FOPO). Prior to moving to Colorado, Dr. Keller spent 22 years on the faculty of the University Of Massachusetts School Of Medicine, where he practiced primary care pediatrics, initiated novel community-based programs with a variety of collaborators and served as an Associate Medical Director for Medicaid in Massachusetts. He was a Robert Wood Johnson Foundation Health Policy Fellow in the office of the Assistant Secretary for Planning and Evaluation at the US Department of Health and Human Services from 2009-10.
As the IHQSE Program Manager, Anne directs the Institute's day-to-day operations, oversees its portfolio of programs, and leads impact-reporting efforts. Anne earned her bachelor's degree in Russian Literature from Duke University and a Master's in Slavic Languages & Literature from the University of Kansas. She also holds an MBA in Health Administration from the University of Colorado Denver. Prior to joining the IHQSE, Anne oversaw the financial operations and research program at the Center for Women's Health Research on the CU Anschutz Medical Campus.
If Patrick had a mantra, he might steal the words of artist Clyfford Still: “It’s intolerable to be stopped by the frame’s edge.” He revels in challenging long-held assumptions to facilitate the human(e) potential of individuals and teams. His work cultivating thriving healthcare environments is anchored in a simple, if not easy, principle: start with human relationships. Dr. Kneeland is VP of Medical Affairs at DispatchHealth where he leads AdvancedCare and Extended Care – service lines dedicated to bringing hospital and SNF-level care to patients’ homes.
Previously, Patrick served as the Executive Medical Director for Patient and Provider Experience at UCHealth, where he led the development of a system-level interdisciplinary patient and provider experience team and strategic blueprint. He is an Associate Clinical Professor of Medicine at the University of Colorado and a founding faculty member of the University of Colorado’s Institute for Healthcare Quality, Safety, and Efficiency (IHQSE) where he has been instrumental in the creation of a groundbreaking healthcare leadership development program. After completing training in internal medicine at the University of California-San Francisco, Patrick completed a fellowship in Academic Hospital Medicine where he focused on the transformation of clinical delivery systems and the role of culture in improving patient safety. He is a certified Patient Safety Officer and has advanced training in user-centered design from Stanford’s d.school.
In addition to being a practicing hospital medicine physician, he is an experienced leadership coach, speaker, facilitator, system-designer and a zealous destroyer of all of those silos everyone always talks about. He serves on the faculty of several groundbreaking national healthcare leadership movements including the Institute for Healthcare Excellence, the Care Collaboratory, the National Taskforce for Humanity in Healthcare, and the Tulane-Ochsner Leadership Program.
Patrick lives in Denver, Colorado with his wife and two kids where they engage the city, the mountains, and their incredible friends and family with curiosity and wonder.
Andy Levy is a non-invasive academic cardiologist at Denver Health and Assistant Professor in the School of Medicine with an interest in quality, policy and informatics. He completed medical school (AOA, GHHS) and residency at the University of Chicago before moving to Denver for Cardiology fellowship. After completing non-invasive cardiology fellowship, he completed research training, including a Master's of Clinical Science degree and the IHQSE's Certificate Training Program, while participating in an NIH-funded T32 grant program with focus on improving the accuracy of heart attack diagnoses. In July of 2019, he joined the faculty with a clinical appointment at Denver Health and an academic appointment with the Data Science to Patient Value (D2V) Navigation Laboratory (NavLab). He is an active member of the American College of Cardiology and is the Early Career representative for Colorado. He has received intramural and extramural grant funding for his work related to improving systems of care, is a mentor to trainees in Cardiology and Internal Medicine, and teaches primarily in the Quality and Safety Academy (QSA) and the Leadership in Informatics, Quality and Systems (LINQS) fellowship. His future career goals include developing a national reputation in the area of Quality, Safety and Learning Health Systems. His personal goals include eventually learning how to play the drums. He loves living in Denver with his partner and three elementary-age children.
Moksha Patel is a Senior Instructor within the Division of Hospital Medicine at the University of Colorado. He has a profound interest in systems redesign, clinical informatics, leadership and provider experience. After residency, he completed a fellowship in Quality Improvement and Health Systems Leadership. During this time, he received specialized training in clinical informatics and began his Master of Business Administration. He is currently the Lead Physician Informaticist for the Institute for Healthcare Quality, Safety, and Efficiency.
Katie Raffel is a hospitalist at Denver Health, an anchor institution serving Denver's most vulnerable populations, with a passion for systems improvement education and implementation as well as diagnostic safety. Prior to transitioning to Denver Health in 2020, Katie completed her residency training and QI chief year at UCSF and joined faculty as Assistant Clinical Professor in the Division of Hospital Medicine. She served as the medical director of the Medicine Unit-Based Leadership team, assistant medical director of Mt. Zion clinical site, course director for MS4 and IM residency QI elective, and the Division of Hospital Medicine QI education lead. Katie was a member of the inaugural faculty in the UCSF Learning Health System cohort, an innovative program focused on developing faculty to lead transformative change in their clinical setting with faculty and trainees. She is looking forward to translating those developed skills to IHQSE leadership and programming.
Rosenthal is an Associate Professor and the Assistant Dean of DNP Programs at
the University of Colorado, College of Nursing. She also continues her 15-year
practice as an acute care nurse practitioner in the Division of Hospital
Medicine at the University of Colorado, Anschutz Medical Campus. In 2011, she
completed her Doctor of Nursing Practice (DNP) degree; a degree created to
prepare nurses for a continuously evolving healthcare landscape and to
contribute interventions to improve patient safety and quality of care in
populations and systems. For the past 8 years, Laura advised DNP students to
complete quality improvement projects to advance delivery of care in areas
including heart failure, bone marrow transplant, diabetes, osteoporosis,
hypertension, and surgical site infections. Her work and the work of her students has been
published and presented in the Journal of Nursing Administration, Journal of
Nursing Care Quality, the Journal of Healthcare Quality, and the International Society
of Heart and Lunt Transplant conference. Her main interests include use of
quality improvement methods to strengthen the curriculum within the Doctor of
Nursing Practice program to expand the excellence and scope of the 50 DNP QI
projects completed throughout the country on a yearly basis through the College
James is currently the Director of Process Improvement for UC Hospital. He has a background in healthcare, consulting, and manufacturing. He led ambulatory access improvement efforts in his prior role with Nebraska Medicine. He has a proven track record of working collaboratively with physicians, leaders, and staff to identify improvement opportunities, facilitate common-sense improvements, and coach others to use improvement tools to sustain results over time. James served as Director of Clinical Effectiveness and Quality at Norton Healthcare where he developed and deployed a process improvement coaching and mentoring program for over one hundred leaders while supporting a $40M cost-reduction initiative.
Prior to that position, he worked at Clark Memorial Hospital in several roles in Quality, Organizational Excellence and Strategic Planning. During that time, James became a National Malcolm Baldrige Quality Award examiner for six years. James has served as Director of the Louisville Center for Quality of Management, where he oversaw the training, advising and networking of senior leaders in driving comprehensive performance improvement.
As Quality Manager of two former automotive suppliers, he worked to meet the expectations of such customers as Ford, General Motors, and General Electric. James served as the Chapter Chair of the Central Kentucky Section of the American Society for Quality and has provided leadership training and support to numerous organizations in the United States and Japan. James is a Certified Professional Coach and has over 1,000 hours of individual and group coaching experience. James received his bachelor’s degree in Chemistry from Bellarmine University and his MBA from the University of Louisville.
Dr. Sarah Tevis completed her general surgery training at the University of Wisconsin School of Medicine and Public Health and a breast surgical oncology fellowship at MD Anderson Cancer Center prior to being recruited to the University of Colorado. She is passionate about quality improvement and patient centered care and dedicates her research to improving outcomes that are important to patients and shared-decision making as it relates to breast surgery. In her free time, she enjoys camping, hiking, and snowboarding with her family.
Jennifer Wiler is UCHealth's Metro Denver Chief Quality Officer. She is a graduate of the University of Buffalo School of Medicine and Biomedical Sciences and completed a residency in Emergency Medicine at Drexel University College of Medicine in Philadelphia, PA. She is the former Assistant Medical Director at Hahnemann University Hospital and Assistant Clinical Service Chief and Medical Director of Observation Medicine at Washington University in St. Louis. She has served in numerous state and national leadership positions and is currently an Alternate of the American Medical Association RBRVS Updates Committee (RUC), Immediate Past-Chair of the American College of Emergency Physicians (ACEP) EM Practice Committee, Alternate Delegate to the AMA House of Delegates for Emergency Medicine, a former Chair of the American Medical Association's Women Physicians Congress, a member of the ACEP Quality and Performance and Reimbursement Committees, and a member of the Board of Directors for the Colorado Medical Society. She has been nationally recognized for her expertise in professional reimbursement, operations, quality, patient safety and health policy and has published widely on the topics.
Jessica Wilson is a UCHealth Process Improvement Consultant with a passion for designing systems that solve problems and delivering learning that inspires action. She earned her bachelors in Public Administration from Regis University. At NinjaTrader (NT) Jessica redesigned customer training and user help guides to reduce the time it took users to convert to a live trading license. She earned her Master’s in Education from Regis University where her capstone focus was the deployment of high needs instructional strategies to the general classroom setting. It was in the course of this project she discovered her love of universal design. This passion connected Jessica with Colorado Choice Transitions (CCT) where she used her process improvement and education skills to redesign key demonstration services and create a statewide training program for CCT service providers. At this time she participated in an IDEO Human Centered Design challenge with the Program and Policy Training Unit (PPTU) to increase total positive parent/child communications between the ages of 0 and 5. While completing her work with CCT and the PPTU Jessica developed the prototype of Go2Orientation. When this product was selected by Foothills Community College Jessica joined the Innovative Educators team to build what would become their flagship product. Go2Orientation used universal design in its UX/UI and its content, successfully improving Fall to Fall retention in both pilots. Jessica implemented this product with 20 colleges and universities while working to develop the custom StudentLingo service, Orientation for Online learners, Enrollment Checklist and ParentLingo products. After completing work on ParentLingo in partnership with Bryant University Jessica joined the UCHealth team as a Practice Transformation Coordinator. There she helped teams work together to set goals, work through change and improve workflows. After joining the Process Improvement team Jessica received formal Lean Six Sigma Black Belt Training and worked to develop the UCHealth Green Belt Program.
Institute for Healthcare Quality, Safety and Efficiency (IHQSE)