In February 2015, Banner entered into a 30-year academic affiliation agreement with the UArizona to form the UArizona-Banner partnership. This health system includes 21 clinical consensus groups and 27 hospitals in Arizona, Wyoming, Colorado, Nebraska, Nevada, and California.
The race/ethnicity breakdown is:
41.9% Non-Hispanic Whites
40.9% Hispanic
7.1% Native American
5.8% African Americans
4.3% of other race/ethnicities
QI Project Team Members and Roles:
Sairam Parthasarathy, MD
Principal Investigator
Professor, Medicine
Chief, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine
Director, Center for Sleep, Circadian and Neuroscience Research, UA Health Sciences
Medical Director, Center for Sleep Disorders, Banner – University Medical Center Tucson
Andrea Morton
Project Coordination Manager
Adam Dean
Data Analyst
What is one strategy you have tested that has made a difference in improving vaccination rates in your clinic(s)?
The triad of (a) Data scientist: The data scientist identifies potentially eligible patients for vaccination before their clinic visit by interrogating the IIS records for Arizona and alerting the quality improvement specialist within the clinic. (b) Clinic champion: An expert pulmonary provider who has been educated about the importance of vaccination and how to discuss vaccination with their patient in a culturally sensitive manner. (c) Quality improvement specialist: Quality improvement specialist works with the clinic champion with awareness of potentially eligible patients and identifies clinic champions during rollout of the stepped wedge design intervention.
Based on what you’ve learned, what new strategy will you try for the in the coming year?
During the first 6 months of our stepped wedge design, our strategy involved having a project specialist pull the vaccination status of patients seen each day in the clinic and provide this information to the Medical Assistant (MA) lead. The project specialist also set up a table in the clinic waiting room with patient vaccination resources.
After this initial 6-month period (which followed a 6-month baseline phase), we adapted our strategy by incorporating a team approach, which included a Data Scientist, Clinic Champion, and Quality Improvement (QI) Project Specialist, as described earlier. Since then, our intervention has remained unchanged in terms of its structure and effectiveness. We believe that our current strategy is effective and has been refined over the past year as part of the ongoing quality improvement initiative.
Can you provide statistics on vaccination rates or interventions, and how they changed before and after the initiative?
In our stepped wedge design across various clinics the ratio of number of patients receiving a vaccination in clinic /Number of in-person visits by patients who were eligible for vaccinations (by criteria and time-window of eligibility. These data are from May 2024 and a more recent analysis is not available for reporting at this time but will become available in February 2025.
- In clinic #1 the vaccinations increased from 1% to 24% (a 24-fold increase);
- In clinic #2 the vaccinations increased from 1% to 11% (a 11-fold increase);
- In clinic #3 the vaccinations increased from 0.8% to 31% (a 38-fold increase);
Please share a key insight gained from your work to improve vaccination rates.
It is important to get the clinic pulmonary healthcare providers’ support.