How Denver Health Spectacularly Improved Their Operations

Patricia A. Gabow, M.D., CEO of Denver Health and Hospital Authority, has spectacularly improved Denver’s public hospital and busiest trauma center by asking the right questions and implementing Lean.

In a blog post by Matthew Weinstock at Hospitals and Health Network Gabow says, “I was really becoming frustrated that we were doing things pretty much the same way as when I was an intern 40 years earlier,” Gabow says. “I started to ask myself, ‘Is there any other industry that has been so stuck in time and been successful?’ I talked to a service line director about it and he suggested that we did things the same way because it worked. ‘Give me a break. We can do better.’ I told him.”

So, around 2004, Denver Health applied for and got a grant to see if there was indeed a better way. They built an advisory panel and brought in experts from other leading industries — Microsoft, Siemens, and FedEx. Gabow held upwards of 60 focus groups with Denver Health employees, asking two key questions:

“What are the things that keep you from being efficient?”


“what do you see happening to patients that you think is wrong?”

After a year of studying operations, leadership determined that there wasn’t “one magic bullet,” Gabow says. Instead, they realized that they needed a series of “linked endeavors.” That’s when they turned to Lean management. Gabow says Lean is appealing because it is based on respect and innovation. Secondly, the tools used in Lean are intuitive and relatively easy to teach and learn. Implementing Lean management in 2005, has resulted in the following achievements:

  • Trained more than 250 employees as black belts in Lean
  • Completed more than 400 rapid-improvement projects, resulting in that $135 million financial benefit due to performance improvements
  • Last year alone, the hospital saw $46 million in financial benefits from Lean projects.
  • Impressively, Denver Health has achieved the high quality marks and boost to the bottom line without reducing the workforce.
  • #1 — ranking in patient survival among the nation’s academic medical centers
  • 100 percent — number of patients receiving antibiotics in pre-op
  • 80 percent and $1.75 million — drop in blood clots among hospitalized patients and the savings as a result of reduced complications
  • An impressive 60 percent drop in Denver Health’s observed to expected mortality. “That meant that last year, 250 people walked out of our hospital alive who would have been expected to die at another academic health center.” stated Galbow.

As CEO of Denver Health, Gabow’s leadership and willingness to ask questions has had a huge impact at the hospital. What do you think of the approach utilized by Gabow at Denver Health?

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