Denver Health and Hospital Authority, Colorado, USA.
Health Aff (Millwood). 2011 Apr;30(4):612-8. doi: 10.1377/hlthaff.2011.0042.
America's health care systems have not achieved the desired level of quality and safety. This may be due, in part, to the lack of clear and robust approaches for institutions to follow. Denver Health, an integrated, public safety-net institution, developed a multifaceted, structured approach to quality and safety improvement that has produced positive outcomes. For example, in 2010 Denver Health ranked first of 112 US academic medical centers in terms of actual mortality observed relative to the national mortality rate. Given these results, we argue that regulatory bodies should refocus their oversight to consider an institution's overall structured approach to quality improvement and safety, instead of monitoring individual small outcomes, such as a patient's receipt of antibiotics for pneumonia within six hours of arriving in the emergency department.
美国的医疗体系并未达到理想的质量和安全水平。部分原因可能是医疗机构缺乏明确且强有力的方法可循。丹佛健康医疗中心是一家综合性的公共医保定点医疗机构，它制定了一个多方面的、结构化的质量和安全改进方法，取得了积极的成果。例如，2010 年，丹佛健康医疗中心在全美 112 家学术医疗中心中，实际死亡率与全国死亡率相比排名第一。鉴于这些结果，我们认为监管机构应该重新调整其监督工作，以考虑机构在质量改进和安全方面的整体结构化方法，而不是监测个别小的结果，例如患者在抵达急诊部门后六小时内是否接受了肺炎抗生素治疗。
