The flu season fills health system leaders with dread. Asking our healthcare workers to do more during flu season is a big ask for an already overburdened workforce.Until June of 2021, I was in this position as Ambulatory Chief Medical Officer for Prisma Health –the largest health system in South Carolina, serving 1.2 million people. Prisma Health needed a strategic plan that would best address our diverse populations but also recognized the practical realities in our practices.
We identified early on that success for Prisma Health was not going to be status quo. We needed a strategic process that addressed key barriers, that was nimble, and could be tailored to address local needs. We found that solution in DRIVE, the Center for Sustainable Health Care Quality and Equity’s toolkit for improving health care value and equity.
Recognizing that blanket flu vaccination reminders were only going to take us so far, the DRIVE process helped us do two key things that were instrumental in our success: create valuable partnerships and develop evidence-based solutions. The DRIVE flu toolkit and processes helped us identify what worked best and how to best implement it.
One of the cornerstones of DRIVE is partnership. DRIVE helped us think through who needed to be part of our vaccination processes, not only for flu, but also for COVID-19. Our partners obviously included our practices but also included our communication team, and our community stakeholders from elected officials to community nonprofits and faith-based organizations. I realize it sounds like a lot of work and a very heavy lift but something entirely different happened. We were able to tailor our solutions to truly meet the needs and address the specific barriers at a local level. Our practices shared successes and lessons learned to create an effective, iterative process where our practices were able to capitalize on what worked. And, most importantly, our diverse partners actually lightened our load. Here is the reality: we are stronger together. We cannot work independently and expect to create healthier populations. We brought partners who were experts in their space – whether that expertise was health or community. We invested in our partners so they knew they were valuable and valued. As a result, they invested in our shared vision of a healthier South Carolina.
The second key component of DRIVE that factored so heavily in our success was the process. Process improvement can add time to implementation, but process can improve effectiveness and efficiency. And that’s what happened when we adopted DRIVE. We were able to hone in on the key barriers and tailor solutions. For instance, DRIVE helped us understand that communication was a key challenge. Our populations did not want emails and they wanted robocalls even less. We transitioned automated reminders to texts that allowed individuals to book flu vaccination appointments with one click. In a busy world, those efficiencies are keys to improved uptake. Our process improvement didn’t stop with logistics, we also focused on improved interpersonal communication. Using DRIVE’s training tools, we were able to easily train our healthcare workers how to be effective flu vaccine advocates. We taught them to be presumptive positive when speaking about getting the vaccine, how to use motivation interviewing techniques, and armed them with understandable, compelling messages to address misinformation. The impact of a better trained and more confident workforce was that 90% of our patient-base was aware of their vaccination status and received empowering messages around vaccination.
The final piece of our DRIVE success story was the power of a champion. Prisma had a DRIVE “coordinator” who supported our practices. She connected with them monthly to help them understand their performance data and brainstorm on solutions to improve performance. We recognized early on that we needed to provide incentives for our practices that were already stretched so thin. DRIVE’s data-driven and solutions focused approach helped her ensure our practices would be successful.
We recognize that every practice is a little different, just like every patient is a little different. The value in DRIVE is that it recognizes that too. Through these partnerships and processes, we were able to fine tune our approach to speak to individuals’ needs and concerns in a scalable way that didn’t bury our practices in a high-touch approach. This model was so successful that it not only enhanced our flu vaccination initiatives, but it inspired our vaccination strategies and partnerships for COVID-19.
The final thought I would leave my peers with is about passion. Don’t be afraid to bring it to the table. Our passion, and compassion, built trust with our community partners and helped re-energize our practices. Our patients needed to see that we were passionate about protecting them. Our patients, partners, and community were watching and listening. When they believed we were deeply invested in their health, their trust in us increased.
Saria Carter Saccocio is the current President of Proactive MD, a leader in advanced primary care. Prior to her role at Proactive MD, Dr. Saccocio served as ambulatory chief medical officer of Prisma Health. Her career includes a wide range of medical leadership roles, from operating a primary care practice to serving as the CMO at Bon Secours St. Francis. She received her doctor of medicine with honors from the University of Florida, completed her residency at the University of Miami and earned her master's in health administration at UNC-Chapel Hill. She has also been a volunteer at the Greenville Free Clinic for six years.
By Saria Saccocio MD MHA FAAFP President, Proactive MD Former Ambulatory Chief Medical Officer, Prisma Health________________More information about the DRIVE approach and tools can be found at SHCDrive.org.