Public Safety-Net Hospitals–The Denver Health Model

Abstract

Safety-net hospitals provide a disproportionately large share of the medical care to uninsured and vulnerable patients. For those who use these hospital systems merely as institutions of last resort, there would be little reason to believe that they could indeed be receiving the safest, highest quality health care because safety-net hospitals are a role model of health care reform and the high quality delivery of care. However, there is increasing evidence, albeit not yet conclusive, that these critically important hospitals do indeed provide high quality, safe and low-cost health care. Although America’s health care systems have not achieved the desired level of quality and safety as exhorted by the Institute of Medicine’s seminal writings in the late 1990s, Denver Health, an integrated public safety-net institution, has developed a multifaceted structured approach to patient safety and quality, which has garnered much national recognition for Denver Health during the last decade. Herein is described this safety-net hospital’s structured model for achieving patient safety and quality. The Denver Health experience demonstrates that care quality and patient safety can be advanced within America’s health care institutions, even in safety-net hospitals which, remain challenged by lack of resources and by socially disadvantaged patients.