2-day Reduction in LOS for Pulmonary Hypertension Patients


ED CT Scan Efficiency Drives $2 Million in Annual Savings

Journal of the American College of Radiology 2015


24% Reduction in Wait Time for an Endocrinology Appointment 


43% Reduction in Post-op Rescue Care in Pediatric Spine Patients


Overcoming Change Fatigue in Continuous Quality Improvement

Quality Management in Healthcare 2017


33% Reduction in Post-op Harm in Esophagectomy Patients 

IHQSE Outcomes

IHQSE programs focus on your development. The educational outcomes for our programs show significant gains in participant knowledge. However, it is the ability to transfer knowledge into skills and skills into outcomes that differentiates the IHQSE.

See below for a sampling of IHQSE project outcomes throughout the years. We have experience with over 100 types of projects and can help you apply our templates to help solve your quality, safety or efficiency challenges.

2021 IHQSE Project Outcomes

Opportunity: Most patients living with HIV have concomitant mental health, substance use disorders or other social issues resulting in high no-show clinic rates. 

Intervention: Created Comprehensive Care Clinic that combines PCP, mental health, social work and substance use counselor visits with transportation and incentives to attend.

Outcome: Reduced no-show rate from 37% to 16% amongst highest-risk patients. 

Opportunity: 22% of aging veterans return to the ED within 30 days of surgery with 10% getting readmitted.  Average length of stay for readmitted patients is 7 days.

Intervention: Standardized post-operative phone call to occur sooner, redesigned case management rounds and updated contact list for discharging veterans.

Outcome: Time to follow up phone call dropped from 13.3 days to 3.1 days. 
Opportunity: Hospitalized children of parents with limited English proficiency have twice the rate of preventable adverse events. 4% of patients have in-person interpreter during their care.

Intervention: Created process for in-person interpreter availability on morning rounds.

Outcome: 57% increase in the percentage of families receiving in-person interpretation during their hospital stay.

Opportunity: Over 40% of all ICU chest x-rays were ordered through daily standing orders as opposed to as needed, leading to excess harm and cost

Intervention: Removed electronic medical record option for daily CXR ordering

Outcome: Reduced daily CXRs by 90% resulting in more than 13,000 fewer CXRs per year.  Saved nearly $4 million dollars annually.

Spread: Spread across 12 hospital health system.

Opportunity: Late day chemotherapy admissions contribute to continued capacity challenges, leading to inefficient unit flow, patient and provider dissatisfaction, potential increased risk for adverse events, and lost revenue.  

Intervention: Created dedicated patient care areas, eliminated pre-admit outpatient visits and streamlined process for admitting patients earlier in the day.

Outcome: Increased from 4% to 75% of chemotherapy patients being admitted before noon (average now ~10am), reduced hospital LOS by 0.6 days and reduced patients getting pre-admit clinic visit by 75%.
Opportunity: About 30% of PICU patients have a complete and accurate medication reconciliation.

Intervention: Implemented care giver form to document home medications, added med rec tracking in EMR, and added pharmacist responsibility for addressing incomplete med rec.

Outcome: Patients with documented medication reconciliation upon admission increased from 30% to 100%.

Opportunity: Ventilator length of stay is more than a day longer than national average and 50% higher than expected. 88% of patients have one or more missed opportunities for down-titration.

Intervention: Integrated ventilator down-titration into the virtual ICU monitoring center.

Outcome: 1 day reduction in ventilator LOS and 28% reduction in device-related pressure injuries.

Opportunity: Only 80% of dosimeter badges are returned for monitoring resulting in over 3000 badges being unused or unreturned annually.  4% of returned badges have high exposure levels.

Intervention: Changed to less frequent badge returns, streamlined the exchange process and provided participants with access to dose report.

Outcome: Pending

Opportunity: 20% of referrals for orthopedic procedures do not schedule or receive those procedures..

Intervention: Enhanced staffing messaging, surgical scheduling process and standardization of paperwork across multiple clinics  

Outcome: Pending

2020 IHQSE Project Outcomes

Opportunity: 26% of physical therapy consultations deemed inappropriate.

Intervention: Daily measure of functional status populates order, nudging providers away from ordering PT in patients unlikely to benefit. 

Outcome: 89% reduction in inappropriate PT consultations.

Spread: Working to spread to all units in the hospital.

Opportunity: Reduce inappropriate sedation, allow more interaction with staff and family and accelerate wean from ventilators.  

Intervention: Implemented EHR-based ordered set, scripted rounding template, enhanced view of pain and sedation scores in EHR and educational campaign.

Outcome: 36% reduction in opiate exposure and 18 fewer hours on the ventilator.
Opportunity: 50% of patients with liver failure are not transplant candidates. These patients rarely have palliative care involvement or referral to hospice.

Intervention: Integrated early involvement of palliative care team in transplant evaluation and decision.

Outcome: 100% of patients now receive palliative care consult, 80% within first three days of admission, and 40% of patients deemed not transplant candidates are discharged with home hospice.
Opportunity: Scheduling process allowing for schedules to only be open 31 days in advance causing a referral backup of > 500 patients.

Intervention: Set templates, schedule available 90 days in advance and weekly leadership attention to backlog.

Outcome: 45% increase in number of patients seen; 84% reduction in referral backlog.

Opportunity: Most kids with corrective surgery for single cardiac ventricle do not get recommended care, hastening the need for transplant and significantly shortening their lifespan.

Intervention: Developed multi-disciplinary care approach and pathway to increase number of patients receiving guideline concordant care.

Outcome: 13% increase in number of patients receiving guideline concordant care.

Opportunity: Improve safety of central line placement in pediatric oncology patients. 

Intervention: Streamlined ordering process requiring vital information and dual signature by medical and surgical providers.

Outcomes: Occurrence of central line placement near miss or errors reaching the patient dropped from ~4.5/year to 0/year.

Opportunity: Blood stream infections in CTICU associated with 71% mortality rate; 100% if on ECMO.

Intervention: Monitored compliance with bundle; CHG wipes on ECMO cannulas, created leadership rounds to emphasize importance of compliance.

Outcome: 77% reduction in central line associated blood stream infections.


Opportunity: 30% of children with severe abusive head trauma are seen before that visit with potentially identifiable less severe injuries.

Intervention: Implemented nursing screening evaluation for all children < 6 years old. 

Outcome: 83% of patients screened. 3% positive rate with significant referrals to social work and protective services. Minimal impact on provider/staff workflow.

Opportunity: Create telehealth program to provide better access to distant patients. 

Intervention: Implemented clinic-to-home and clinic-to-clinic telehealth program.

Outcome: 469 telehealth patients seen in one year; transfers to inpatient care increased 150% year-over-year.

Opportunity: Patients with late-stage GI cancers spend an inordinate amount of their end-of-life time in the hospital.  

Intervention: Integrated palliative care consultation into care pathway for hospitalized patients.

Outcome: 58% increase in patients referred to ambulatory palliative care; 25% reduction in ED visits at 30 days.Learn more about this project and outcomes here. 

Opportunity: Lack of timely preoperative evaluation leads to frequent cancellations of complex spine surgeries.

Intervention: Creation of risk calculator and lab/imaging protocols; coordinated scheduling of preoperative and spine appointments.

Outcome: 59% fewer cancellations. 4-fold improvement in patients having all labs completed; labs completed 7 days earlier. More than twice as many patients had all imaging completed in timely manner.  

2019 IHQSE Project Outcomes

Opportunity: Improve inefficiency and throughput of cath lab by decreasing the length of stay. 

Intervention: Created a new fast track unit for patients of lower complexity.

Outcome: Reduction in the amount of time a patient spent in the unit by 2 hours and 5 minutes.

Opportunity: Reduce time patients waited to receive medications.  

Intervention: Optimized the process by using a medication delivery system for all early discharges.

Outcome: Nearly a 60% reduction in total amount of time discharging patients had to wait for medications.

Opportunity: Reduce graft failure of patients ages 13-24 yo. 

Intervention: Developed a program to transition these patients to adult care starting at 14 yo & fully transitioned by 22 yo.

Outcome: Improved making of first appointment in the Adult Kidney Transplant Program from 30% to 70%. 
Opportunity: Improve access to care for pediatric patients with autism. 

Intervention: Shifted tasks to trained nurse to complete initial evaluation.

Outcome: Reduced physician time from 155 to 120 minutes, led to a 55% increase in number of patients seen per physician. 
Opportunity: Improve standardization of transfer of bronchiolitis patients from ICU to floor. 

Intervention: Introduced transfer criteria and new process for transfer readiness assessment.

Outcome: Reduced time-to-transfer from PICU from 14.4 hours to 7.8 hours. Overall PICU LOS was reduced by 13%.
Opportunity: Decrease length of stay (LOS).

Intervention: Engaged with staff to change culture and treatment of pulmonary hypertension patients.

Outcome: Decreased hospital LOS from 8.2 days to 6.4 days.

Opportunity: Up to 50% of ambulatory antibiotics are inappropriate or unnecessary.

Intervention: Provider education, patient education, and standardized ambulatory antibiotic ordering pathways for common infections.

Outcome: 50% reduction in median duration of antibiotic use for pharyngitis, otitis and COPD exacerbations.

Opportunity: Improving pre- and post-op risk appropriate venous thromboembolism (VTE) prophylaxis.

Intervention: Providers were given training, data, feedback and a financial incentive to improve VTE prophylaxis.

Outcome: Pre-op VTE prophylaxis improved 30%; post-op VTE prophylaxis improved 20%.

Opportunity: Reduce post-operative liver transplant ICU stay.

Intervention: Created intra-operative and PACU care protocols and ICU triage decision tool.

Outcome: Reduced percent of patients requiring ICU stay from 41% to 23%; Saved over $400,000 per year.

2018 IHQSE Project Outcomes

Opportunity: Improve discharge process.

Intervention: Created discharge nurse to improve discharge planning.

Outcome: Reduced time to discharge by 43 minutes, length of stay by 1 day and doubled rate of patients discharged by 11am.

Spread: Spread to 6 additional hospital units.

Opportunity: Reduce nursing time spent looking for medications.

Intervention: Redesigned Pyxis content and layout.

Outcome: Reduced nursing time to find medication by 21 minutes per nurse per shift. Estimated savings of $76,895 on unit.

Spread: All hospital units: projected benefit of $916,584 per year.

Opportunity: Decrease inappropriate use of IV Levothyroxine among hospitalized adults.

Intervention: Developed an EMR order set that included the appropriate indications for use of IV Levothyroxine.

Outcome: The number of patients receiving inappropriate IV levothyroxine therapy decreased from 79% to 19%.

Opportunity: 90% of Children labeled penicillin-allergic can tolerate penicillin-based drugs.

Intervention: Introduce penicillin pathway and procedures to de-label children at 'no risk'; challenge and de-label those at 'low risk'.

Outcome: 4.2 fold increase in number of children de-labeled from penicillin allergy.

Opportunity: Delays in MRI access result in prolonged length of hospital stay.

Intervention: Streamlined processes for patient screening, transport, and scheduling.

Outcome: 47% reduction in MRI turn-around-time resulting in the equivalent of opening more than 15 available beds per day.  

Opportunity: Poorly coordinated discharge care leads to delays, increased length of stay, and readmissions

Intervention: Creation of multi-disciplinary rounds.

Outcome: 39% increase in patients discharged by noon, 5% reduction in length of stay, and 13% reduction in 30-day readmissions.

2017 IHQSE Project Outcomes

Opportunity: Reduce wait time to be seen in clinic.

Intervention: Optimized the process for referrals, appointing patients and check in.

Outcome: Reduced wait time for an appointment by 24.9%.

Opportunity: Reduce wait time to be seen in clinic.

Intervention: Developed telehealth program, optimized the process for referrals, appointing patients and check in.

Outcome: Reduced wait time for an appointment by 24.1%.

Opportunity: Improve pediatric patients follow up after sleep study showing obstructive sleep apnea.

Intervention: Build and provide scheduler with EMR-derived report and process for follow up visits.

Outcome: Improved time to follow up from 69 to 54 days and follow up appointments from 60% to 87%.

Opportunity: Hemorrhages account for 40% of trauma related deaths.

Intervention: Implemented a resuscitation bundle to improve early treatment of hemorrhagic shock.

Outcome: Appropriate blood product transfusion ratios increased 44%. Trauma mortality improved by 23%.

2016 IHQSE Project Outcomes

Opportunity: Reduce length of stay (LOS) for pancreatic surgery patients.

Intervention: Standardized order set with compliance reporting.

Outcome: LOS reduced by 1.1 days, 35% reduction in complications, 67% reduction in return to ICU, 46% reduction in readmissions.

Opportunity: Reduce length of stay (LOS), improve outcomes in geriatric hip fracture patients.

Intervention: Standardized order set with compliance reporting; cohorted patients on orthopedic unit and service.

Outcome: Reduced LOS by 1 day, decreased readmissions by 16% and reduced 1-year mortality by 48%.

Opportunity: Most children undergoing adenotonsillectomy for obstructive sleep-disordered breathing have an overnight hospital admission for monitoring.

Intervention: Implementation of new perioperative monitoring criteria allowing uncomplicated patients to avoid overnight hospital stay.

Outcome: 31% fewer patients requiring an overnight hospital stay.  No increase in complication rates. Read more here.

2015 IHQSE Project Outcomes

Opportunity: Reduce readmission rate. 

Intervention: Standardized transition process, follow up phone call, focus on medications.

Outcome: Reduced readmissions by 42%: sustained for over 5 years.

Spread: Framework incorporated into hospital care management workflows.

Opportunity: Reduce incidence of rescue care associated with operating room pediatric intensive care unit transfers.

Intervention: Standardized order set with compliance reporting.

Outcome: Reduced incidence of rescue care by 43%; projected savings of $403,000 per year.

Opportunity: Improve adherence with well-child care visits in the first year of life. 

Intervention: Development of tracking system, scheduling redesign, patient education, patient incentive, and marketing program.

Outcome: Increased adherence with first five visits in the first year of life from 25% to 78%. Continuity with the same provider improved from < 10% to 74%. Sustained changes for more than 6 years.

2014 IHQSE Project Outcomes

Opportunity: Improve length of stay (LOS) for palliative care patients.

Intervention: Moved consult earlier in hospital stay.

Outcome: Patients received treatment 14 hours earlier improving pain and symptom scores, reducing LOS by 1.7 days. Total projected savings of $3 million per year.
Opportunity: Reduce length of stay (LOS) for esophageal surgery patients.

Intervention: Standardized order set with compliance reporting.

Outcome: LOS reduced by 1.1 days and composite harm score reduced by 33%.

Opportunity:  Readmissions are suboptimal for patients and increase costs of care.

Intervention: Created a complex transitions score (CTS) and implemented auto-consulting for high-risk patients.

Outcome: Reduced 7-day readmissions by 32% (7.8% to 5.3%) and 30-day readmissions by 30% (22%  to 15.6%).

2013 IHQSE Project Outcomes

Opportunity: Reduce length of stay (LOS) by improving discharge process.

Intervention: Standardized process for earlier discharge education prior to discharge.

Outcome: LOS reduced by 7 days. Total projected savings of $840,000 per year.

Opportunity: Antimicrobial over-utilization results in side effects, excess length of stay (LOS) and avoidable cost.

Intervention: Implemented "handshake stewardship" program.

Outcome: Antibiotic usage reduced by 25%, C. difficile rates by 41%. Reduced LOS for patients on antibiotics by 8% and pharmacy costs by $1-2 million annually.

Institute for Healthcare Quality, Safety and Efficiency (IHQSE)

CU Anschutz

Leprino Building

12401 E. 17th Avenue

Mail Stop L963

Aurora, CO 80045

CMS Login