IHQSE Highlights

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Dec 20, 2024

Quality improvement experts at Children’s Hospital Colorado, including Dr. Sandra Spencer (IHQSE Faculty) and Dr. Alexandria Wiersma (IHQSE Graduate), developed a novel fast-track model, typically seen in emergency departments, and implemented it in an urgent care. We spoke with IHQSE graduate Dr. Alexandria Wiersma about key takeaways from this project and how those findings can be used as a model for other urgent care settings.

Dec 13, 2024

In-basket burden is frequently cited as a contributor to burnout. In a research letter published in JAMA Network Open, IHQSE graduate, Dr. Eden English, discusses her recent study of the use of large language models (LLMs) for drafting replies to patient messages within a large health system. This study underscores the potential of LLMs to reduce clinician burnout and enhance patient care, while also emphasizing the importance of transparency and continuous refinement of AI tools in healthcare.

Nov 25, 2024

Using patient-reported outcome measures to guide clinical care is associated with improved outcomes and widely regarded as a best practice in mental health. However, many systems have struggled to routinely adopt the practice. In an article in Psychiatric Services, IHQSE alumni and members of the University of Colorado Department of Psychiatry describe how they used technology to address major barriers to using this best practice in their design and implementation of the Measurement-Assisted Care (MAC) program. We spoke with lead author and IHQSE graduate Dr. Dana Steidtmann about how this work took shape and the potential impact it could have on mental healthcare.

Oct 30, 2024

IHQSE Grad, Ally Fuher, MD, was recently featured in the University of Colorado Department of Medicine News article discussing her "Teachable Moment" essay published by JAMA Internal Medicine. Her essay, "The Harm of Inappropriate Central Line Blood Cultures in Clinical Practice," uses the story of a dialysis patient to highlight issues of increased risk of false positive results (and patient harm) in blood samples drawn from a central line rather than a peripheral vein.

Oct 29, 2024

IHQSE graduate Dr. Jillian Cotter is co-author on an invited commentary published in JAMA Network Open . The article discusses the need for increased efforts to identify and measure common instances of low-value clinical practices in pediatric trauma care, enabling quality leaders to set goals aimed at reducing these practices.

Oct 21, 2024

IHQSE Grad, Ally Fuher, MD, is lead author on a "Teachable Moment" essay published by JAMA Internal Medicine. Her essay, "The Harm of Inappropriate Central Line Blood Cultures in Clinical Practice," uses the story of a dialysis patient to highlight issues of increased risk of false positive results (and patient harm) in blood samples drawn from a central line rather than a peripheral vein.

Oct 18, 2024

IHQSE Faculty, Dr. Sarah Tevis, led an analysis of Reddit posts made by breast cancer survivors, finding that many have emotional and financial concerns that often go unnoticed and unaddressed. The research, which will be presented at the American College of Surgeons (ACS) Clinical Congress 2024, highlights the need for increased attention to patients' emotional and financial concerns during and after treatment, as well as improved resources to help patients with coping, treatment decision-making, and understanding diagnoses and prognoses.

Oct 2, 2024

HQSE Faculty Michelle Knees, DO and team led a mixed methods study involving surveys and focus groups with hospitalists from 24 academic institutions, finding that, while secure messaging enhances communication efficiency, it also increases multitasking, cognitive load, and alters interpersonal dynamics. The study underscores the need for clear institutional guidelines for SM use and emphasizes the importance of collaborating with frontline workers to improve communication practices. We spoke with Dr. Knees to discuss some of the advantages and challenges for SM and what implications these findings may have on the way providers communicate in the future.

Aug 21, 2024

Are patients safer than they were in the 4th Century BCE? A recent editorial published by Madeline Higgins, MD and IHQSE faculty Sarah Tevis and Jeff Glasheen, reviews the patient safety movement from the time of Hippocrates to today. The authors call for patient safety models that provide accurate information and timely methods to measure harm for all patients, in all care settings, and for all organizations.

Jul 29, 2024

IHQSE faculty member Dr. Emily Gottenborg and IHQSE alumna Dr. Emily Lines were both featured in a front-page Denver Post article on CU School of Medicine’s innovative longitudinal integrated clerkship curriculum, where medical students follow a panel of patients over the course of the year, allowing them to experience the healthcare system from a patient perspective.

Jul 2, 2024

Drs. Christina Stuart and Robert Meguid, recently published findings of a retrospective cohort study evaluating the incidence and consequences of incidental perioperative hypothermia exposure in the thoracic surgery population. They found that more than 90% of patients undergoing robotic-assisted thoracic surgery lung resections experience some degree of inadvertent perioperative hypothermia and that patients that developed hypothermia had associated increased rates of 30-day morbidity and infectious complications. Based on these data, Drs. Stuart and Meguid were awarded an IHQSE Clinical Effectiveness and Patient Safety grant to study structured and interval-specific interventions aimed at decreasing rates of inadvertent perioperative hypothermia and subsequent complications. We spoke with IHQSE colleague and grantee, Dr. Christina Stuart, to discuss this important work.

May 1, 2024

Diagnostic error may result in serious harm for more than 500,000 patients and contribute to an estimated 10% of all patient deaths. Understanding diagnostic accuracy is crucial for improving patient outcomes and ensuring effective healthcare delivery. IHQSE Faculty, Drs. Michelle Knees and Katie Raffel, along with colleagues from the University of Colorado Division of Hospital Medicine, recently published an AHRQ Issue Brief aimed at furthering efforts to enhance diagnostic accuracy. The brief reviews a substantial body of literature on the impact of cognitive load on diagnostic accuracy, identifies areas for future research, and provides recommendations for integrating existing knowledge into current practice.

Apr 9, 2024

The Institute for Healthcare Quality, Safety and Efficiency received a two-year grant from the Gordon and Betty Moore Foundation to develop a Diagnostic Excellence Capacity Building Program. As part of the Achieving Diagnostic Excellence through Prevention and Teamwork (ADEPT) collaborative, the IHQSE will use the grant funds to create a model for developing and implementing diagnostic excellence programs at 15 hospitals across the country. IHQSE Director, Dr. Jeff Glasheen, discussed the new grant and how it will support efforts to address and improve diagnostic accuracy across the country.

Apr 9, 2024

Orders for IV antimicrobials (OPAT) were being omitted or listed inaccurately in more than 50% of discharge summaries and were leading to near misses and patient harm events, according to a 2-year study led by Lorna Allen and funded by an IHQSE grant. To address the issue, she, with data assistance from IHQSE faculty Heather Hallman, MSHS, MHA, CSSGB, implemented a streamlined treatment order in the electronic health record that standardized the discharge process across units so that OPAT ordering occurs seamlessly on nearly 99% of after-visit summaries.

Apr 5, 2024

Physical therapy consultation in the hospital is a valuable, yet limited resource, and ordered for a large proportion of admitted patients. IHQSE faculty members, Dr. Emily Gottenborg and Dr. Moksha Patel, recently published their work to address inappropriate overuse of physical therapy consultation. Their team found that nearly 25% of all consultations were inappropriate, and by creating an EHR order integrating clinical decision-making support and restructuring nursing roles to empower them to assume PT – ordering responsibility, they decreased inappropriate ordering to <10%. This work highlights the value of eliminating inefficiencies in the inpatient setting to reduce waste and improve patient care!

Feb 9, 2024

Diagnostic error is common, morbid, and mortal. IHQSE faculty member, Dr. Katie Raffel, along with Dr. Andrew Auerbach and other experts on diagnostic error, recently published findings from a multicenter retrospective cohort study in which 2500 hospitalized adults who experienced ICU escalation or death were evaluated for diagnostic error. This study adds to a body of literature highlighting the importance of diagnostic safety within hospital medicine. We discussed the larger implications of this study with Dr. Katie Raffel in this edition of 3Q's for QI.

Jan 23, 2024

Faced with rising maternal mortality, the first prenatal visit is essential but, in many cases, important topics are missed. An IHQSE small grant supported the redesign of the first visit, dividing it into a nurse-led telemedicine visit and an in-person visit with an obstetric clinician. Clinic no-shows dropped (9.9%-4.2%), the topics covered in the first prenatal visit increased (70.0%-95.6%), and improvements were observed for all key themes. We spoke with Dr. Diane Christopher about her recent publication, Redesigning the First Prenatal Visit: A Quality Improvement Initiative, and her team's work to improve care for expecting mothers.

Dec 8, 2023

Few hospitals have created surveillance programs for diagnostic errors. Fewer have programs to translate those opportunities into improvement efforts to prevent future harm. The Achieving Diagnostic Excellence through Prevention and Teamwork (ADEPT) collaborative is a 16 site AHRQ funded project which is developing measurement frameworks for diagnostic safety, and then using these frameworks to aid with implementation of diagnostic excellence programs. We spoke with IHQSE Faculty Dr. Katie Raffel about ADEPT and its potential impact.

Dec 4, 2023

IHQSE Faculty Dr. Janet Kukreja is one of the most prolific robotic cystectomists in North America, completing 100+ surgeries a year and leading the way in the field of robotic surgery. Now she is leading pilot project that’s developed a web-based app to help patients choose the urinary diversion that best suits their personal circumstances and preferences, giving them power and choice in an overwhelming situation.

Jul 31, 2023

Most patients requiring prolonged mechanical ventilation in Cardiothoracic Intensive Care Units (CTICU) – which treat some of the hospitals’ sickest patients – remain sedated and bedridden for the bulk of their stay. A team of IHQSE Alumni are helping to change that and improve patient outcomes, starting with one strong-willed young woman named Chenille.

Jun 6, 2023

A IHQSE team, including Dr. Norman Friedman, engaged clinicians and staff across multiple services to revise the perioperative pathway for children having a T&A. Published in The Laryngoscope, the team found that 75% of children who qualified as “high risk” patients by the American Academy of Otolaryngology’s clinical practice T&A overnight monitoring guideline were off oxygen within 3 hours of surgery.

Mar 29, 2023

A team including IHQSE Faculty member Dr. Tyler Anstett engaged clinicians from different specialties to rethink the design of blood transfusion orders in the EHR at University of Colorado Hospital. This project, ultimately aimed at improving adherence with transfusion guidelines, was recently published in the January volume of Applied Clinical Informatics. We caught up with Dr. Brad Morse and Dr. Tyler Anstett to learn more about the motivation behind this project and what it could mean for future EHR design improvements.

Feb 1, 2023

A team from the Cardiothoracic Intensive Care Unit that completed the IHQSE Improvement Academy recently launched their SOAR (Sedation Off, Awake, Rehabilitate) initiative which is aimed at weaning patients off deep sedation sooner to mitigate adverse outcomes related to prolonged sedation periods. The intervention allowed the team to mobilize one of its most critical patients on ECMO. We spoke with Dr. Mikita Fuchita, one of the doctors spearheading this initiative to learn more about the SOAR initiative and its impact.

Nov 7, 2022

The cycle of workplace violence in healthcare facilities is detrimental to providers as well as patients. IHQSE Faculty Katie Raffel, MD, along with Jenica Cimino, and Lyza Hilton, RN, discuss how trauma-informed transformations may help to reduce violent episodes in hospitals on MedPage Today’s KevinMD.

Oct 25, 2022

IHQSE Alum Candice Kmetz-Parkinson was recently featured on Colorado's 9NEWS discussing UCHealth's new Virtual Respiratory Therapist program that is helping to streamline workflow and get patients off ventilators sooner.

Aug 8, 2022

Studies find that most patients undergoing cancer treatment receive little to no information on the possible effects that treatment may have on their sexual well-being. In this US News & World Report article, IHQSE Faculty member, Dr. Sarah Tevis, discusses the need for providers to give honest information to patients about these side effects early in the treatment process.

Aug 1, 2022

IHQSE Alumni Dr. Jennifer Kemp and Sherry Knott, NMTCB, have been asked to present their work, ‘Adding Friction to the Electronic Health Record to improve adherence with best practices for diagnostic testing across multiple hospital system intensive care units,’ at the Scientific Assembly and Annual Meeting of the Radiological Society of North America in November 2022.

Jul 15, 2022

IHQSE Alumni Drs. Laura Leonard, Danielle Abbitt, Edward Jones, Andrew Berry and nurses Emily Englehaupt and Sara Davidson presented their work, ‘post-operative readmissions in an aging veteran population,’ which won the award for the Best PRO/Patient Centeredness abstract at the American College of Surgeons 2022 Quality and Patient Safety Conference.

Jul 10, 2022

IHQSE Lead Physician Informaticist, Moksha Patel, MD, gave an inspirational talk about mental health awareness and overcoming adversity, discussing his own journey with severe OCD as a template, at the Matiya World Cultural Convention.

Mar 1, 2022

The Institute for Healthcare Quality, Safety and Efficiency was launched in 2012 with the aim of developing leaders and transforming processes to create lasting organization-level change and fundamentally improve patient care. In March 2022, the IHQSE celebrates 10 years of work and nearly 2000 individuals trained.

Dec 3, 2021

The COVID-19 pandemic has created numerous challenges across all clinical specialties. One set of challenges for residency programs is finding balance between the elevated clinical needs in hospitals and the educational needs of residents. In this article from The Hospitalist, IHQSE faculty member Dr. Emily Gottenborg speaks about the willingness of CU residents to meet challenges head-on and adapt to change, caring for high volumes of critically ill patients while still maintaining a focus on education.

May 12, 2021

Working with a team of clinicians and informaticists, IHQSE Director Dr. Jeff Glasheen helped create and implement an EHR-driven tool that accurately predicts inpatient mortality. A recent feature by EHR Intelligence highlights how the team leveraged EHR data and multiple models to create this highly predictive tool in just one month. Tested on over 80,000 patients, the tool was developed to aid decision making in scare resource situations, such as COVID-19 ventilator shortages.

Oct 4, 2019

Two recent publications, one from TJC and the other from the CDC highlight Certificate Training Program graduates Drs. Sarah Parker, Jason Child and Christine MacBrayne’s innovative ‘handshake stewardship’ program. Developed during of their time in the Certificate Training Program, the program does not rely on traditional stewardship policies such as preauthorization of antimicrobials.

Jun 1, 2017

Certificate Training Program graduates were recognized for significant improvements in pancreas surgery outcomes. The team highlighted the importance of “building relationships, identifying stakeholders, creating a business case--important work that we didn’t know how to do before IHQSE” as well as the need to enhance communication and build care pathways.

Mar 1, 2017

In an interview with the University of School of Medicine, Dr. Read Pierce, IHQSE faculty member noted the importance of robust data systems, clinician engagement and creating a sense of urgency in driving improved outcomes in sepsis.

Apr 21, 2016

IHQSE is proud to announce the Children’s Colorado Hospital Ortho Spine Team was presented with the Excellence in Quality & Patient Safety Award at Children’s Hospital medical Staff dinner on April 21, 2016.

Mar 1, 2015

The Society of Hospital Medicine awarded IHQSE the Innovation Award for their work in developing the program. The program, selected from a over 100 innovation presentations was recognized for developing high-functioning clinical teams that are trained, resourced and aligned with broader organizational goals in order to improve the value of the care provided.

Feb 3, 2015

The IHQSE Certificate Training Program helped set the path to creating a Comprehensive Unit-based Safety Program for the program’s 2014 Esophageal Surgery Team. After achieving their primary goal of standardizing care, they decide to set another goal in reducing the average length of stay by one day.