Learning From What We Do, and Doing What We Learn: A Learning Health Care System in Action.

Different models of learning health systems are emerging. At Vanderbilt University Medical Center, the Learning Health Care System (LHS) Platform was established with the goal of creating generalizable knowledge. This differentiates the LHS Platform from other efforts that have adopted a quality improvement paradigm.

A Multicomponent Fall Prevention Strategy Reduces Falls at an Academic Medical Center.

Background: While the reduction in fall rates has not kept pace with the reduction of other hospital-acquired conditions, patient safety research and quality improvement (QI) initiatives at the system and hospital levels have achieved positive results and provide insights into potentially effective risk reduction strategies. An academic medical center developed a QI-based multicomponent strategy for fall prevention and pilot tested it for six months in three high-risk units-the Neuroscience Acute Care Unit, the Myelosuppression/Stem Cell Transplant Unit, and the Acute Care for the Elderly Unit-before implementing and evaluating the strategy hospitalwide.

Methods: The multicomponent fall strategy was evaluated using a pre-post study design.

Transformational Leadership: The Chief Nursing Officer Role in Leading Quality and Patient Safety.

This department column highlights leadership perspectives of quality and patient safety practice. The purpose of this article is to provide strategic direction for transformational quality and safety leadership as the chief nursing officer (CNO) within the academic medical center environment.

Health Care Reform, Care Coordination, and Transformational Leadership.

This article is meant to spur debate on the role of the professional nurse in care coordination as well as the role of nursing leaders for defining and leading to a future state. This work highlights the opportunity and benefits associated with transformation of professional nursing practice in response to the mandates of the Affordable Care Act of 2010. An understanding of core concepts and the work of care coordination are used to propose a model of care coordination based on the population health pyramid.

Acute coronary syndrome pathways: alignment with a bundled care reimbursement model.

Changes in public policy, population demographics, and market dynamics are spurring innovative approaches to value-based care. Annually, hospitalizations for Acute Coronary Syndromes (ACS) account for a substantial proportion of healthcare expenditures in the United States. Vanderbilt University Medical Center has developed a framework to deliver comprehensive care incorporating inpatient and outpatient care teams for patients with ACS under an episode-based, bundled reimbursement model for a term of 6 months.

The Vanderbilt Professional Nursing Practice Program, part 3: managing an advancement process.

Consistency of performance standards across multiple clinical settings is an essential component of a credible advancement system. Our advancement process incorporates a central committee, composed of nurses from all clinical settings within the institution, to ensure consistency of performance in inpatient, outpatient, and procedural settings. An analysis of nurses advanced during the first 18 months of the program indicates that performance standards are applicable to nurses in all clinical settings.