DHMP’s Quality Improvement Program is designed to support the mission of DHMP by promoting the delivery of high quality, accessible healthcare services that will enhance or improve the health status of DHMP members.

The Quality Improvement Program provides a formal process to objectively and systematically monitor and evaluate quality and safety of clinical care and service utilizing a multidimensional approach measured through different performance dimensions. These dimensions include appropriateness, efficiency, effectiveness, availability, timeliness and continuity. This approach enables DHMP to focus on opportunities for improving operational processes, member and provider satisfaction as well as health outcomes.

The quality DHMP seeks to achieve through implementation of the Quality Improvement Program, is to deliver the “right care or service, at the right time, by the right staff” in the most appropriate place and to continuously improve the care, safety and service provided to our members.

The quality improvement process is based on a continuous improvement cycle of measurement, assessment, planning, implementation and evaluation. Data is systematically collected prospectively, concurrently and/or retrospectively on clinical, safety, preventative and service performance. Data is analyzed, summarized and presented as information with recommendations to the Quality Management Committee. Quality Improvement works collaboratively with various DHMP departments to develop and implement initiatives targeted at improving clinical care, outcomes, safety and service.

QI Activities Summary

In 2020, QI activities will focus on diabetes, prenatal/postpartum care, behavioral health, member satisfaction and preventive health measures for both children and adults. QI team members will collaborate with Ambulatory Care (ACS) through various work groups in diabetes, weight management, children’s preventive health, and preventive cancer screening. We will work with school-based health centers in the Denver Health system to improve the delivery of well-child care to our commercial members enrolled in Denver Public Schools. Additionally, QI will continue to make improvements in obtaining real time data from the warehouse and registries, which is helpful in the many interventions conducted throughout the year.

Quality Improvement Work Plans

The QI Department develops a Work Plan annually. The Work Plan covers the scope of the QI Program and includes:

Clinical Practice Guidelines

Denver Health Medical Plan (DMHP) adopts and disseminates clinical practice guidelines to assist providers and members in making decisions about appropriate health care for specific clinical conditions. Our clinical practice guidelines produce care recommendations to support the provision of high-quality, evidence-based care, based on existing clinical guidelines and recognized scientific evidence. We utilize and reference expert professional and clinical sources to ensure our guidelines reflect the highest level of evidence-based content. Clinical practice guidelines are also used to guide efforts to improve the quality of care for our members and facilitate implementation of evidence-based clinical recommendations into practice.