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 the GME/IHQSE Quality and Safety Academy, Director of Quality and Safety Programs for GME, and he is an Associate Vice Chair for Quality for the Department of Medicine. He is an active coach for multiple projects and his own Quality Improvement work is focused on high-value care with a specific focus on simplifying processes and influencing user behavior at the point of care.
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.
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.
Kim DiMaria is currently the Interim Director of Quality and Safety for the Heart Institute at Children’s Hospital Colorado and an Assistant Professor at the University of Colorado School of Medicine. She received her Nurse Practitioner degree from the University of Pennsylvania and her Doctor of Nursing Practice degree from Johns Hopkins University. Kim has been a pediatric critical care nurse and NP in both the Pediatric and Cardiac Intensive Care Units at Children’s Hospital Colorado for over fifteen years. As a leader in quality improvement within the Heart Institute, she oversees and supports over a hundred multidisciplinary team members participating in QI projects designed to improve outcomes and processes.
Kim is also the co-director of the Heart Institute Resuscitation Improvement program and has published and lectured extensively on a variety of critical care topics. Her research interests include all things quality improvement, but she is most passionate about resuscitation science, neurodevelopmental outcomes, sedation optimization, reduction of preventable harm, and engaging the clinical teams in advancing outcomes for patients with congenital and acquired heart disease.
Sloan is the Program Coordinator for the IHQSE. She earned her bachelor’s degree in Public Health from Texas State University and a master’s in Public Health in Health Systems, Management & Policy from the University of Colorado School of Public Health. Prior to joining the IHQSE, Sloan worked for UCHealth as a Patient Access Representative.
Jeffrey J. Glasheen, MD, MHM 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 Associate Professor within the Division of Hospital Medicine 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 is faculty within the Institute for Healthcare Quality, Safety and Efficiency where she is the Director of the Improvement Academy and specializes in coaching frontline clinical teams in improvement work. She also has multiple educational roles within the University School of Medicine and Internal Medicine Residency Program, teaching learners of all levels and across the health professions about principles of medical leadership and quality improvement.
Dr. Mike Guthrie is Executive-in-Residence at the University of Colorado- Denver campus in the School of Business, Program in Health Administration. He is also an executive coach, focused exclusively on supporting physician executive performance improvement.
He leads learning collaboratives on healthcare issues for health care executive teams, boards of trustees, and physician leader groups in organizations of various types. He is well known as a thought leader regarding physician engagement and physician relationship strategy for hospitals and health systems.
Mike has special experience in the area of physician leadership development; helping physicians, hospital and health systems work effectively together to improve quality, safety, and cost. He is also a strategic business advisor to several healthcare companies.
Mike has been a practicing physician, a medical director, a chief operating officer, a health system CEO, and a senior executive for a large national healthcare alliance.
Dr. Guthrie graduated from Amherst College and received his medical degree from the University of Pennsylvania. He took his internship in medicine at Denver General Hospital and his residency in consultation psychiatry at the Hospital of the University of Pennsylvania. He received his Masters in Business Administration from the School of Business at the University of Colorado. He is board certified by the American Board of Psychiatry and Neurology and was in private practice prior to becoming a physician executive in 1979. He is a past President of the American Academy of Medical Directors and past President of the American College of Physician Executives.
Dr. Guthrie is a frequent speaker for health systems and national organizations on topics including physician leadership, physician organizations, team management, and healthcare strategy. He works frequently with the American College of Physician Executives, the American College of Healthcare Executives, the Health Management Academy, the Society of Hospital Medicine, and Sg2, as well as selected health system clients. He has served on the editorial advisory board for several national healthcare journals and has published over 50 articles on healthcare management and physician leadership topics. He serves on the executive advisory boards for companies that service the healthcare industry sector in information technology, business services, and customer support.
Heather Hallman, MSHS, MHA, is the Program Manager for the CU Department of Medicine (DOM) Quality & Patient Safety Program and the IHQSE Clinical Effectiveness and Patient Safety Grant Program for CHCO and UCH. In her roles, she manages several programs including the Leaders in Informatics, Quality & Systems (LInQS) Fellowship, the DOM Systems Improvement Conference and the DOM Quality Council. She has guided several quality and safety efforts in the DOM, many of which have become hospital-wide initiatives. Heather earned her Master of Healthcare Administration from Colorado State University and her Master of Healthcare Sciences from The George Washington University. She is an American Society for Quality certified Six Sigma Green Belt and is working towards her black belt certification. Heather has been with the CU School of Medicine since 2006 when she was the Clinical Trials Manager for Breast and Sarcoma Oncology in the CU Cancer Center managing 100+ Phase 1-3 NIH- and industry-sponsored investigational drug trials.
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 financial operations and the research program at the Ludeman Family 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.
Michelle Knees, DO completed internal medicine residency training at the University of Colorado in 2021 with a focus on healthcare systems. She spent an additional year as Chief Resident of Quality and Patient Safety, where she helped lead residency and hospital-wide quality and patient safety initiatives. She now works for the Division of Hospital Medicine at the University of Colorado as an academic hospitalist. She also works part-time with the IHQSE as faculty for the Improvement Academy, where she helps coach multidisciplinary quality and process improvement projects. She is ultimately working toward becoming a health services researcher with a focus on hospital medicine cognitive load and workforce best-practices.
Dr. Janet Kukreja completed her residency training in urologic surgery at the University of Rochester and a urologic oncology fellowship at MD Anderson Cancer Center prior to being recruited to the University of Colorado. She is passionate about research to improve the quality of care provided to patients, patient decision making and bladder cancer. She has published multiple quality improvement projects and continues to work with the hospital to decrease hospital acquired catheter associated urinary tract infections.
Moksha Patel is an Assistant Professor 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.
Read G. Pierce. M.D., is an experienced clinician, healthcare leader, coach, and facilitator who enjoys fostering transformation of organizational culture and complex clinical systems. He serves as Chief Quality Officer at Denver Health Medical Center.Prior to this he served as the Division of Hospital Medicine and Associate Chair for Faculty Development and Wellbeing at the Dell Medical School for three years.
From 2019 to 2020, Dr. Pierce served as Vice President of Culture Transformation and Strategy at the Institute for Healthcare Excellence (IHE), and in this role worked with health systems around the country on clinical transformation, creating healthy workplace culture, and increasing performance of physicians, clinical teams, and healthcare leaders. He also helped found the Institute for Healthcare Quality, Safety, and Efficiency (IHQSE) in 2012 and has led organizational transformation initiatives through programs focused on quality, process improvement methods, culture, teamwork, systems redesign, finance, innovation, and leadership of change. As part of these efforts, he has worked with more than 100 clinical microsystems to improve quality, patient safety, experience, costs of care, and turnover.
In 2010, he founded the Hospital Medicine Section at the San Francisco VA Medical Center and served as Section Chief from 2010 to 2012. He subsequently spent two years leading the University of Colorado’s Hospital Medicine Division, coordinating a practice of more than 75 hospitalists. During his tenure he oversaw expansion of the group by nearly two dozen members and led the group to achieve the highest quality and safety performance of all service lines in the hospital. He also directed a major initiative to increase joy in practice, which reduced physicians’ and advanced-practice providers’ burnout by 27 percent and increased measures of psychological safety by 70 percent.
Dr. Pierce attended medical school at University of California, San Francisco, where he completed an area of concentration in Health Systems/Health Leadership, and then did his internship at Brigham and Women’s Hospital in Boston before returning to San Francisco for residency and chief residency in internal medicine. His personal interests include history, food, skiing, hiking, and anything that allows quality time with his wife, Vanessa, and their 2 boys.
Katie Raffel, MD is an academic hospital medicine provider at University of Colorado with a passion for diagnostic and systems improvement. She serves as the Medical Director of Acute Care Medicine Services at UC Hospital where she works with teams in quality and safety on five medicine units. Dr. Raffel also serves as a lead of the cross-site Achieving Diagnostic Excellence through Prevention and Teamwork research/improvement collaborative and dedicates remaining time to the Institute for Healthcare Quality Safety and Efficiency, where her focus is on coaching teams through the Certificate Training Program.
Rosenthal is an Associate Professor and the Assistant Dean of DNP Programs at
the University of Colorado, College of Nursing. She has 15-years of experience 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 Lung 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
Sandra P. Spencer, MD,is an Associate Professor in the Section of Emergency Medicine at Children’s Hospital Colorado and the Department of Pediatrics at the University of Colorado. She has a passion for promoting the spread of quality improvement work by mentoring QI leaders through manuscript publication. Dr. Spencer is the Director of the IHQSE Quality Improvement Writing group. Dr. Spencer helped develop this successful publication curricula with quality leaders from Nationwide Children’s Hospital, as highlighted in “Writing Group Increases Quality Improvement Writing Competency.” She has also provided similar writing lectures to national groups, including the Scholars Programs for both Emergency Medicine Services For Children (EMSC) and Pediatric Pandemic Network (PPN).
Dr. Spencer’s other QI interests include making change “stick” through reliability theory, emergency services process and quality improvement, and local and national guideline development.Dr. Spencer is a member of the American Academic of Pediatrics’ Council on Quality Improvement and Patient Safety’s Executive Committee, where she is the Chair of its Education Subcommittee and Vice Chair of the Committee on Guideline Development.
Finally, Dr. Spencer serves as the Director of Faculty Academic Development for the Children’s Hospital Colorado Section of Emergency Medicine, where she specifically supports career development for physician scholars with expertise and interests outside of classic research, including quality improvement, education, and operations.
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. Tad-y is the Associate Chief Medical Officer of Patient Flow at the University of Colorado Hospital. In this role, she oversees efforts to optimize operational efficiency and ensure patients receive the right care, at the right time, in the right setting. In addition, she is Medical Director for Capacity at UCHealth, guiding the strategy for optimal placement of patients within the system. She is a Professor of Medicine at the University of Colorado School of Medicine (CU) where she is an academic hospitalist. She teaches for the Quality and Safety Educators Academy, authored and co-directs the quality improvement curriculum and annual QI pre-course for the American College of Physicians and is an Assistant Editor for the Joint Commission Journal of Quality and Patient Safety. She serves on the Board for the Society of Hospital Medicine and Prime Health.
Dr. Tad-y’s prior leadership roles included Vice President of Clinical Affairs for the Colorado Hospital Association in which she led statewide quality and safety initiatives in Colorado hospitals, oversaw workforce development including physician engagement, hospital emergency preparedness and innovation.She is a faculty member of CU’s Institute for Healthcare Quality, Safety and Efficiency, and previously served as a director on the Board of Colorado’s state health information exchange, Contexture (parent company of CORHIO).
Dr. Tad-y earned her medical degree from St. George’s University, completed Internal Medicine residency atNYU Langone Hospital – Brooklyn and hospital medicine fellowship at Johns Hopkins Bayview.
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.
Anunta Virapongse, MD, MPH, is an Associate Professor and hospitalist for the Division of Hospital Medicine at the University of Colorado Hospital. She completed her medical school training at the University of South Florida College of Medicine, Internal Medicine Residency at Baystate Medical Center in 2006 and earned her Master of Public Health from the Harvard School of Public Health in 2007. She has completed extensive coursework in the areas of quality improvement and medical leadership, including a nonclinical fellowship at the Medical Innovation and Leadership Division at Blue Cross, Blue Shield of Massachusetts, the Clinical Quality Fellowship Program at the Greater New York Hospital Association and United Hospital Fund and the MiniATP course at Intermountain Health. Her areas of interest include clinical pathway development and outcomes driven improvement strategies. Dr. Virapongse is the Director of Quality and Patient Safety for the Division of Hospital Medicine, the Associate Vice Chair for Quality for the Department of Medicine, the Chair of the DOM Quality Council, the Director of the IHQSE Clinical Effectiveness and Patient Safety Grant Program for UCH and newly elected At Large Member of the UCH Medical Board.
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.
Institute for Healthcare Quality, Safety and Efficiency (IHQSE)