Megan Vanneman is a postdoctoral fellow in health services research at the Center for Innovation to Implementation (Ci2i) in the VA Palo Alto Health Care System and at the Center for Health Policy/Primary Care and Outcomes Research (CHP/PCOR) in the Stanford University School of Medicine.

Megan’s primary areas of interest include healthcare value, access, coverage, and disparities. In addition to research, Megan has worked on health policy analysis at the local, state, and federal levels. She is currently working on studies concerning dual users of VA health care and Medicaid, performance measurement, and veterans’ post-deployment linkage to and engagement in health care at VA.

Professional Education

  • Bachelor of Arts, Stanford University, HUMBI-BA (2003)
  • Bachelor of Arts, Stanford University, SPAN-MIN (2003)
  • Master of Public Health, Columbia University (2005)
  • Doctor of Philosophy, University of California Berkeley (2013)

Stanford Advisors


Journal Articles

  • Linking the Legislative Process to the Consequences of Realigning California's Public Mental Health System. Administration and policy in mental health Vanneman, M. E., Snowden, L. R. 2014


    In 1991, California transferred significant responsibility, resources, and accountability for public mental health from the state to its 58 counties. Using purposeful sampling, we conducted in-depth interviews with ten senior state and county leaders to gain insights into the relatively uncharted area of their understanding of this legislation's intent, development, and long-term consequences. While realignment secured funding for the system and provided incentives and flexibility for counties to move toward providing more community-based care, the decision to base realignment allocations on counties' historical spending along with minimal payments to address differences helped to institutionalize spending disparities. Results of this study can inform how we develop and implement decentralization policies.

    View details for DOI 10.1007/s10488-014-0591-z

    View details for PubMedID 25199814

  • Impact of participation in the California Healthcare-Associated Infection Prevention Initiative on adoption and implementation of evidence-based practices for patient safety and health care-associated infection rates in a cohort of acute care general hospitals AMERICAN JOURNAL OF INFECTION CONTROL Halpin, H. A., McMenamin, S. B., Simon, L. P., Jacobsen, D., Vanneman, M., Shortell, S., Milstein, A. 2013; 41 (4): 307-311


    In 2008, hospitals were selected to participate in the California Healthcare-Associated Infection Prevention Initiative (CHAIPI). This research evaluates the impact of CHAIPI on hospital adoption and implementation of evidence-based patient safety practices and reduction of health care-associated infection (HAI) rates.Statewide computer-assisted telephone surveys of California's general acute care hospitals were conducted in 2008 and 2010 (response rates, 80% and 76%, respectively). Difference-in-difference analyses were used to compare changes in process and HAI rate outcomes in CHAIPI hospitals (n = 34) and non-CHAIPI hospitals (n = 149) that responded to both waves of the survey.Compared with non-CHAIPI hospitals, CHAIPI hospitals demonstrated greater improvements between 2008 and 2010 in adoption (P = .021) and implementation (P = .012) of written evidence-based practices for overall patient safety and prevention of HAIs and in assessing their compliance (P = .033) with these practices. However, there were no significant differences in the changes in HAI rates between CHAIPI and non-CHAIPI hospitals over this time period.Participation in the CHAIPI collaborative was associated with significant improvements in evidence-based patient safety practices in hospitals. However, determining how evidence-based practices translate into changes in HAI rates may take more time. Our results suggest that all hospitals be offered the opportunity to participate in an active learning collaborative to improve patient safety.

    View details for DOI 10.1016/j.ajic.2012.04.322

    View details for Web of Science ID 000317416000005

  • Hospital adoption of automated surveillance technology and the implementation of infection prevention and control programs AMERICAN JOURNAL OF INFECTION CONTROL Halpin, H., Shortell, S. M., Milstein, A., Vanneman, M. 2011; 39 (4): 270-276


    This research analyzes the relationship between hospital use of automated surveillance technology (AST) for identification and control of hospital-acquired infections (HAI) and implementation of evidence-based infection control practices. Our hypothesis is that hospitals that use AST have made more progress implementing infection control practices than hospitals that rely on manual surveillance.A survey of all acute general care hospitals in California was conducted from October 2008 through January 2009. A structured computer-assisted telephone interview was conducted with the quality director of each hospital. The final sample includes 241 general acute care hospitals (response rate, 83%).Approximately one third (32.4%) of California's hospitals use AST for monitoring HAI. Adoption of AST is statistically significant and positively associated with the depth of implementation of evidence-based practices for methicillin-resistant Staphylococcus aureus and ventilator-associated pneumonia and adoption of contact precautions and surgical care infection practices. Use of AST is also statistically significantly associated with the breadth of hospital implementation of evidence-based practices across all 5 targeted HAI.Our findings suggest that hospitals using AST can achieve greater depth and breadth in implementing evidenced-based infection control practices.

    View details for DOI 10.1016/j.ajic.2010.10.037

    View details for Web of Science ID 000290019000004

    View details for PubMedID 21531272

  • Mandatory Public Reporting Of Hospital-Acquired Infection Rates: A Report From California HEALTH AFFAIRS Halpin, H. A., Milstein, A., Shortell, S. M., Vanneman, M., Rosenberg, J. 2011; 30 (4): 723-729


    One way to motivate hospitals to improve patient safety is to publicly report their rates of hospital-acquired infections, as California is starting to do this year. We conducted a baseline study of California's acute care hospitals just before mandatory reporting of hospital-acquired infection rates to the state began, in 2008. We found variability in many areas: For example, 70.1 percent of hospitals said that they were fully implementing evidence-based guidelines to fight infection by methicillin-resistant Staphylococcus aureus, but 22.8 percent of hospitals had not adopted any. Our analysis showed that rural hospitals, many of which lack resources to implement needed procedures, faced the greatest challenges in reporting and improving infection rates. Our findings should be of interest to Medicare policy makers who will implement the hospital-acquired infection performance measures in the Affordable Care Act, and to leaders in the thirty-eight states that have enacted legislation requiring reports of hospital-acquired infection rates. California's baseline data also present a unique opportunity to assess the impact of mandatory and public reporting laws.

    View details for DOI 10.1377/hlthaff.2009.0990

    View details for Web of Science ID 000289233400025

    View details for PubMedID 21471494

  • Patient safety climate: variation in perceptions by infection preventionists and quality directors. Interdisciplinary perspectives on infectious diseases Nelson, S., Stone, P. W., Jordan, S., Pogorzelska, M., Halpin, H., Vanneman, M., Larson, E. 2011; 2011: 357121-?


    Background. Healthcare-associated infections (HAIs) are an important patient safety issue, and safety climate is an important organizational factor. This study explores perceptions of infection preventionists (IPs) and quality directors (QDs) regarding two safety microclimates, Senior Management Engagement (SME) and Leadership on Patient Safety (LOPS), across California hospitals. Methods. This was an analysis of two cross-sectional surveys. We conducted Wilcoxon signed-rank test, univariate analyses, and a multivariate ordinary least square regression. Results. There were 322 eligible hospitals; 149 hospitals (46.3%) responded to both surveys. The IP response rate was 59%, and the QD response rate was 79.5%. We found IPs perceived SME more positively than did QDs (21.4 vs. 20.4, P < 0.01). No setting characteristics predicted variation in perceptions. Presence of an independent budget predicted more positive perceptions of microclimates across personnel types (P < 0.01). Conclusions. Differences in perceptions continue to exist between essential leaders in acute health care settings which could have critical effects on outcomes such as HAIs. Having an independent budget for the infection prevention and control department may enhance the overall safety climate and in turn patient care.

    View details for DOI 10.1155/2011/357121

    View details for PubMedID 21826140

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