Vanderbilt Health System Improvement and Implementation Initiative

The Vanderbilt Health System Improvement and Implementation Initiative is an enterprise-wide initiative to advance organizational capacity for improvement and the uptake of research results in diverse care delivery settings. We are grateful for the initial support provided by the Patient Centered Outcomes Research Institute (PCORI) though the Health Systems Implementation Initiative (HSII), a new national program to speed translation of evidence into practice. Through a competitive application process, the HSII selected Vanderbilt and 41 other institutions to participate in a national Learning Collaborative and undertake funded Implementation Projects to actively advance the adoption of specific PCORI-funded evidence in practice. HSII is intended to facilitate lasting change within participating systems and lay groundwork for broader adoption of evidence-based practices. For more information on PCORI HSII, click here.

In the first phase of work, PCORI awarded funding to the Vanderbilt Health System to launch the following three Capacity Building Projects:

  1. Implementation Strategies Toolkits
  2. VUMC Enterprise Reporting and Analytics (VERA) Data Literacy Training and Integration
  3. Essentials in Quality Improvement Certificate (EQIC)

We intend for these Capacity Building Projects to also strengthen Vanderbilt Health’s ability to undertake improvement and implementation work on a broad scale outside of HSII activities. 

In the second phase of the work, PCORI awarded funding to the Vanderbilt Health System to launch an implementation project focused on antibiotic prescribing for children with acute respiratory tract infections. 

Please see below for more information regarding each of our Capacity Building Projects and Implementation Project.

Capacity Building Projects

1. Implementation Strategies Toolkits
To enable the support of future HSII Implementation Projects, we have developed centralized approaches that provide technical assistance for common implementation strategies. The goal is to inform, educate, and advise future HSII project teams on effective and accessible strategies for implementation of evidence-based practices. Toolkits cover the following implementation strategies: implementation blueprints, practice facilitation, audit and feedback, and rapid qualitative analysis. These approaches have all demonstrated effectiveness in the healthcare delivery system and are applicable to implementing or evaluating projects across a broad range of topics. We offer training and consultation on the use of each toolkit.

2. VUMC Enterprise Reporting and Analytics Data Literacy Training and Integration
To further develop health IT systems and personnel to facilitate program evaluation of future HSII Implementation Projects and other enterprise-wide initiatives, Vanderbilt Health is focusing on two areas:

  1. Integrating additional data sources into the Enterprise Data Warehouse (EDW): We are developing a centralized data source used across all analytics teams needing to report on Social Drivers of Health (SDoH).
  2. Institutional data literacy among the data analytic and reporting teams: To promote high quality analytics and reporting for the Medical Center, we have developed and implemented the VUMC Enterprise Reporting and Analytics (VERA) Data Literacy Training program for the analytic and reporting community. These trainings include an overview of VERA Steering, data literacy at VUMC, VUMC analytic and reporting teams, and the main applications, platforms, and tools. Skill-building trainings are developed on an ongoing basis. In addition, development of an online resource library offers a centralized location for the analytic and reporting community to access additional resources and external trainings.

3. Essentials in Quality Improvement Certificate Program
To expand Vanderbilt Health's organizational capacity for conducting and evaluating evidence-based practice change initiatives, we have developed a training program for front-line leaders focused on improvement and implementation methods skill building. Utilizing the Institute for Healthcare Improvement's (IHI) Model for Improvement, the Essentials in Quality Improvement Certificate (EQIC) program introduces our front-line leaders to the IHI's methodology and supports front-line leaders in completing a small, workplace-based quality improvement project. Over the course of 9 weeks, participants are engaged in weekly self-directed learning and 1-hour virtual didactic sessions. 

Implementation Project

Implementation Project: Implementation of Pediatric Outpatient Stewardship Interventions to Improve Appropriate Antibiotic Prescribing

To promote antimicrobial stewardship, Dr. Sophie Katz and Dr. Jenny Slayton will lead the Vanderbilt Health System in implementing pediatric outpatient stewardship interventions to improve appropriate antibiotic prescribing across 52 care delivery sites including 16 rural care delivery sites. This project will expand upon current pediatric outpatient antimicrobial stewardship work and develop a user-centered format for feedback reports about antibiotic prescribing, encourage providers to use the best antibiotics possible for children with acute respiratory tract infections (ARTIs), and expand the antimicrobial stewardship program to include a community primary care practice. This project seeks to improve appropriate antibiotic prescribing for children with ARTIs and to:  

  1. Reduce overall antibiotic prescribing for viral and bacterial ARTIs by five percent.
  2. Increase use of narrow-spectrum antibiotics for acute otitis media (AOM), sinusitis, streptococcal pharyngitis and community-acquired pneumonia (CAP) by 10 percent.
  3. Increase prescription of a five-day course (as opposed to longer seven- or 10-day courses) of antibiotics for AOM, sinusitis and CAP by 10 percent.
  4. Decrease the percentage of encounters with a rapid group A streptococcal test ordered by five percent.