Best Healthcare Leaders Know When to Exit

One of Lean's overriding principles is that front line workers are best able to determine the most efficient ways to do their jobs. It's up to senior management to support the changes they feel need to be made to cut waste and improve quality. She stresses that much of the success that Denver Health has achieved is "really about the will to do it."

4 success factors
But she will name some of the specific actions that brought Denver Health so much success while other safety nets were failing spectacularly. All the points below are direct quotes, except bracketed material:

1. Employing our physicians [who are] also high-quality academics. 
2. Being an independent governmental entity. All of what we make in profit goes back into what we're doing [not to general city or regional governmental entities]. I'm convinced that you can't run healthcare within the confines of city, county, or state government and that's a core issue with many safety nets.
3. We're very sophisticated users of IT. We've been one of the 100 most wired 6 years in a row.
4. We never want to stay where we are, ever.

Gabow's not sure what the next phase of her life will consist of, but she's excited to begin with a trip to Italy with her husband of 40 years. After that, she may return to Denver Health in another capacity (there's a mandatory 90-day period of disassociation for all employees who leave the health system) or she may write a book about Lean. Or both. One thing she's not concerned about is her legacy. "The best tax break in America"
"I don't care if people remember anything about my tenure," she says. "I want people to realize that Denver Health is a model that says to this country that you can treat everyone—including the most vulnerable—at an affordable cost and at very high quality. No one person made us successful. We have an unbelievable team of people and it takes that team."

She wants America to use Denver Health as an example of what can be accomplished.

"We are a model—a solid example. This isn't theoretical," she insists. "We've done $4.6 billion in care to the uninsured since 1991 and we've been in the black every year with a very low annual city/county subsidy of roughly $27 million. We are the best tax break in America."

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