Use DRIVE to improve flu vaccination rates in your healthcare system


Flu season fills health care leaders with dread. Asking our healthcare workers to do more during flu season is a big ask for an already overstretched workforce. Until June 2021, I held this position as outpatient chief medical officer for Prisma Health, South Carolina’s largest health system, serving 1.2 million people. people. Prisma Health needed a strategic plan that would best respond to our diverse populations, but also recognized the practical realities of our practices.

We identified early on that the success of Prisma Health was not going to be the status quo. We needed a strategic process that addresses key barriers, is agile and can be adapted to meet local needs. We found this solution in TO DRIVEthe Center for Sustainable Health Care Quality and Equity’s toolkit for improving the value and equity of health care.

Recognizing that blanket flu shot reminders were only going to get us so far, the DRIVE process helped us do two key things that were instrumental in our success: building valuable partnerships and developing solutions based on proofs. The DRIVE flu toolkit and processes helped us identify what worked best and how best to implement it.

One of the cornerstones of DRIVE is partnership. DRIVE helped us determine who should be part of our vaccination processes, not only against the flu, but also against COVID-19. Our partners obviously understood our practices, but also our communications team and our community actors, from elected officials to non-profit and faith-based community organizations. I realize this sounds like a lot of work and very heavy lifting, but something completely different happened. We were able to tailor our solutions to really meet local needs and overcome specific barriers. Our practices shared successes and lessons learned to create an effective iterative process where our practices were able to capitalize on what worked. And, more importantly, our various partners have actually lightened our load. Here is the reality: we are stronger together. We cannot work independently and expect to create healthier populations. We brought in partners who were experts in their field – whether that expertise was in health or community. We invested in our partners so they knew they were valued and appreciated. As a result, they invested in our shared vision of a healthier South Carolina.

The second key element of DRIVE that contributed so much to our success was the process. Improving processes can add time to implementation, but the process can improve effectiveness and efficiency. And that’s what happened when we adopted DRIVE. We were able to focus on the main obstacles and offer tailor-made solutions. For example, DRIVE helped us understand that communication was a major challenge. Our people didn’t want emails let alone robocalls. We replaced automated reminders with text messages that allowed individuals to book flu shot appointments with just one click. In a busy world, these efficiencies are the key to better adoption. Improving our processes didn’t stop at logistics, we also focused on improving interpersonal communication. Using DRIVE’s training tools, we were able to easily train our healthcare workers to be effective flu vaccine advocates. We taught them to be presumptive positive when talking about getting vaccinated, how to use motivational interviewing techniques, and armed them with understandable and compelling messages to counter misinformation. The impact of a better educated and more confident workforce was that 90% of our patient base was aware of their vaccination status and received empowerment messages regarding vaccination.

The final element of our DRIVE success story was the power of a champion. Prisma had a DRIVE “coordinator” who supported our practices. She reached out to them monthly to help them understand their performance data and brainstorm solutions to improve performance. We recognized early on that we needed to provide incentives for our practices that were already in such high demand. DRIVE’s data-driven and solution-driven approach has helped drive the success of our practices.

We recognize that every practice is a little different, just as every patient is a little different. The value of DRIVE is that it recognizes it too. Through these partnerships and processes, we have been able to refine our approach to addressing the needs and concerns of individuals in a scalable way that has not buried our practices in a high-contact approach. This model has been so successful that it has not only enhanced our flu vaccination initiatives, but it has also inspired our vaccination strategies and partnerships for COVID-19.

The last thought I would leave for my peers is about passion. Don’t be afraid to bring it to the table. Our passion and compassion have built trust with our community partners and helped reinvigorate our practices. Our patients needed to see that we were passionate about protecting them. Our patients, our partners and the community were watching and listening. When they believed we were deeply invested in their health, their confidence in us increased.

Saria Carter Saccocio is the current President of Proactive MD, a leader in advanced primary care. Prior to his role at Proactive MD, Dr. Saccocio served as Prisma Health’s Ambulatory Chief Medical Officer. His career includes a wide range of medical leadership roles, from operating a primary care practice to serving as CMO at Bon Secours St. Francis. She received her MD with honors from the University of Florida, completed her residency at the University of Miami, and earned her Masters in Health Administration from UNC-Chapel Hill. She also volunteered at the Greenville Free Clinic for six years.

By Saria Saccocio MD MHA FAAFP
President, Proactive MD
Former Ambulatory Chief Medical Officer, Prisma Health

You can find more information about the DRIVE approach and tools at


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