Inadequate vaccination of eligible inpatients against influenza and pneumococcal infections is a gap in quality care that contributes to the spread of disease in the community. Rates of vaccination at Emory University hospitals were noted to be 40% with a desired rate > 90%. The objective of this study was to evaluate the reasons for the failure to vaccinate all eligible inpatients in the hospital system against influenza and pneumococcal infections and to develop interventions to improve vaccination rates.
An interdisciplinary team including administration, nursing staff, physicians, pharmacists, information technologists, and secretarial staff performed a qualitative and quantitative review of the vaccine process. Quality improvement tools used included a conceptual model, a process flow diagram, and behavior determinate intervention logic models for all stakeholders. Barriers to vaccine administration were placed on a fishbone diagram. The percentage of patients screened for vaccination on admission, percentage of patients receiving the vaccination, and percentage core measures compliance were identified as key process measures and used to determine the effect of the interventions. The interventions identified and agreed on by the interdisciplinary team were: an educational intervention targeting nurses, a redesign of the vaccine screening tool incorporating qualitative feedback, employment of a real‐time nursing dashboard on each hospital unit that noted which patients needed screening and vaccination, modification of vaccine administration from the day of discharge to 900 AM the second day of admission, and use of a social work consult to trigger vaccine screening in the intensive care unit.
Before introduction of the interventions, the vaccine administration compliance rates was 40%. Introduction of an educational intervention did not result in an increase in vaccination rates. Rapid implementation of a user‐friendly vaccine screening tool, a real‐time nursing dashboard, and modification of the time of vaccine administration were key initiatives that resulted in the percentage of patients who received “perfect vaccine care” to increase to 95.4% for the entire system.
The use of a multidisciplinary team and appropriate quality improvement tools to identify interventions resulted in a marked improvement in vaccination rates.
D. S. VanderEnde ‐ none; N. Spell ‐ none; K. Graham ‐ none; T. Wilds ‐ none; B. McKee‐Waddle ‐ none; L. Hurt ‐ none; J. Gibbons ‐ none; D. Bowen ‐ none; C. Batchelder ‐ none; R. Gitomer ‐ none
To cite this abstract:VanderEnde D, Spell N, Graham K, Wilds T, McKee‐Waddle B, Hurt L, Gibbons J, Bowen D, Batchelder C, Askew D, Margolis M, Sapp P, Wheeler C, Caesar L, Wannamaker C, Comer R, Stroud B, Gitomer R. A Systematic Approach to Increasing Pneumococcal and Influenza Vaccination Rates Among Hospitalized Patients. Abstract published at Hospital Medicine 2011, May 10-13, Dallas, Texas. Abstract 133. Journal of Hospital Medicine. 2011; 6 (suppl 2). https://www.shmabstracts.com/abstract/a-systematic-approach-to-increasing-pneumococcal-and-influenza-vaccination-rates-among-hospitalized-patients/. Accessed March 31, 2020.