Publications

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Apr 1, 2026

The surgical co-management program (Surgical Hospitalist Assisted REcovery, or SHARE Team) at Children's Hospital Colorado has become one of the flagship enterprises for this endeavor nationally. Patients with extreme medical complexity are admitted post-operatively to a Hospitalist service, where surgical and medical providers collaborate to optimize care. This system has increased nursing and patient satisfaction, augmented communication amongst clinical staff and improved overall outcomes. The IHQSE program was instrumental in creating SHARE Team. With its official roll-out in September 2022, the program has received national acclaim, with recent publication by CHCO providers Adriana Martin, Shannon Acker, Todd Hankinson and Jason Zamkoff highlighting SHARE Team.

Feb 1, 2026

In a new study by IHQSE faculty and QIWG participant, Dr. Michele Loi, featured in Critical Care Nurse, a multidisciplinary team demonstrated a 46.5% reduction in health care-associated conditions with a protocol of targeted pediatric intensive care unit rounds at Children's Hospital Colorado. The approach involved interprofessional teams focusing on patients at high risk for conditions such as central line-associated bloodstream infections and pressure injuries.

Jan 26, 2026

In a new study published in the Journal of General Internal Medicine, Drs. Michelle Knees and Katie Raffel (IHQSE faculty) and their co-authors found that diagnostic error risk varied by inpatient care team model among high-risk medical patients. While the causal mechanisms are unknown, this may be related to number of clinicians caring and thinking about a patient, or due to differences in workload. As hospitals rethink staffing approaches, these findings underscore the importance of considering how team design supports clinical reasoning and diagnostic safety!

Nov 5, 2025

Tonsillectomy is one of the most common pediatric surgical procedures performed with over 550,000 operations annually. Stratification of which children do not require overnight monitoring has major implications for healthcare value both financially and for the family experience. The American Academy of Otolaryngology/Head & Neck Surgery’s tonsillectomy clinical practice guideline recommends overnight observation for any child less than 3 years of age. Our most recent investigation of clinical outcomes for toddlers who underwent a tonsillectomy provided further evidence that children who were off oxygen with 3 hours of surgery and passed an asleep room air challenge (AsRAC) are good candidates for same day surgery. Over 80% of toddlers were off oxygen within 3 hours and only 1.3% (n=7) were briefly placed back on oxygen following passing an AsRAC. The tonsillectomy outcome research at CHCO will be at the forefront when the American Academy of Otolaryngology/Head&Neck Surgery revises the tonsillectomy clinical practice guidelines.

Nov 1, 2025

Deep sedation, delirium, and immobility are common challenges for patients receiving mechanical ventilation in the ICU. To help address these, members of the SOAR (Sedation Off, Awake, and Rehabilitate) initiative at the University of Colorado Hospital Cardiothoracic ICU developed a hands-on interprofessional simulation training to support the use of the ABCDEF Bundle. After the training, clinicians reported feeling more comfortable performing spontaneous awakening trials and more confident working together across disciplines to help ventilated patients get out of bed. These early results suggest that simulation-based training may strengthen interprofessional ICU teamwork and support effective care delivery to improve patient outcomes.

Sep 24, 2025

During the fall 2022 respiratory virus surge, pediatric emergency departments and urgent cares across the country experienced record volumes and long waits. A multidisciplinary team at Children’s Hospital Colorado North Campus combined ED/UC used rapid-cycle quality improvement methods to respond in real time. By repurposing administrative offices into new patient care space, creating a provider-led intake system, and optimizing staffing, the team reduced Left Without Being Seen (LWBS) rates from a peak of 40% to < 5% and shortened door-to-provider times despite unprecedented demand. These quick, low-cost interventions sustained performance gains even after the surge subsided, strengthening long-term patient flow and safety.

Sep 5, 2025

Point-of-care ultrasound (POCUS) is increasingly used to improve diagnosis in internal medicine, but residency programs lack standardized curricula. A Delphi study led by Amiran Baduashvili and several Division of Hospital Medicine colleagues asked 21 U.S. POCUS education leaders to establish consensus on essential POCUS skills, teaching methods, and evaluation strategies for internal medicine residency programs. Panelists identified 53 discrete skills spanning lung, abdominal, procedural, cardiac, musculoskeletal, and vascular domains, along with 14 preferred teaching methods and 5 evaluation strategies. Emphasis was placed on supervised scanning, longitudinal curricula, and portfolio development, while most simulation-based approaches were excluded. These consensus-based recommendations offer a practical framework to promote consistent, skill-focused POCUS training across programs and support future standard-setting efforts in internal medicine education.

Sep 2, 2025

Children with sickle cell disease (SCD) often come to the emergency department (ED) for severe pain, but care can vary across hospitals. This study looked at more than 9,000 ED visits in the U.S. to see whether giving opioid pain medicine quickly affected hospital admissions. Children who received their first dose within 60 minutes were less likely to be hospitalized, and the chance of admission dropped even further when a second dose was given within 30 minutes. These findings highlight the importance of timely pain treatment and suggest that faster opioid delivery can improve outcomes and reduce unnecessary hospital stays for children with SCD.

Aug 6, 2025

A landmark study led by infectious diseases specialists at University of Colorado Anschutz Medical Campus/Children’s Hospital Colorado was recently published in The Lancet Infectious Diseases. The article is the first from a multicenter clinical research pilot study run through the National Institutes of Health's Vaccine Research Center’s Pandemic REsponse REpository through Microbial and Immune Surveillance and Epidemiology (PREMISE) program. The PREMISE pilot study conducts immunologic surveillance and data collected from the first year, 2022-2023, provides insight into what was driving the large post-pandemic rebound of common respiratory pathogens in children. Data also allowed for the recreation of past viral circulation patterns and model predictions for future outbreaks with greater accuracy and precision, helping hospitals, health agencies, and policymakers better prepare for future outbreaks.

Jul 1, 2025

A large academic acute care therapy department successfully transformed from discipline-based teams to an interdisciplinary service-line structure, achieving measurable improvements in staff productivity, morale, and operational efficiency. Led by IHQSE-trained leaders, this quality improvement project followed Kotter’s 8 Steps for Leading Change and was implemented over the course of a year. Outcomes included improved staff-to-supervisor ratios, direct patient assignments, and an increase in staff engagement. This work offers a blueprint for other health systems navigating growth, burnout, and operational challenges through structured, data-informed change.