Factorial Design for Improving Influenza Vaccination Among Employees of a Large Health System

2009 ◽  
Vol 30 (7) ◽  
pp. 691-697 ◽  
Author(s):  
Richard Kent Zimmerman ◽  
Mary Patricia Nowalk ◽  
Chyongchiou J. Lin ◽  
Mahlon Raymund ◽  
Dwight E. Fox ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Health System ◽  
Factorial Design ◽  
Healthcare Personnel ◽  
Patient Contact ◽  
Administrative Positions ◽  
Healthcare Facilities ◽  
Vaccination Rates ◽  
Contact Rates ◽  
Acute Care Facilities

Objective.As healthcare personnel (HCP) influenza vaccination becomes a quality indicator for healthcare facilities, effective inter¬ventions are needed. This study was designed to test a factorial design to improve HCP vaccination rates.Design.A before-after trial with education, publicity, and free and easily accessible influenza vaccines used a factorial design to determine the effect of mobile vaccination carts and incentives on vaccination rates of HCP, who were divided into groups on the basis of their level of patient contact (ie, business and/or administrative role, indirect patient contact, and direct patient contact).Setting.Eleven acute care facilities in a large health system.Participants.More than 26,000 nonphysician employees.Results.Influenza vaccination rates increased significantly in most facilities and increased system-wide from 32.4% to 39.6% (P < .001). In the baseline year, business unit employee vaccination rates were significantly higher than among HCP with patient contact; rates did not differ significantly across groups in the intervention year. In logistic regression that accounted for demographic characteristics, intervention year, and other factors, the use of incentives and/or mobile carts that provided access to vaccine at the work unit significantly increased the likelihood of vaccination among HCP with direct and indirect patient contact, compared with control sites.Conclusions.Interventions to improve vaccination rates are differentially effective among HCP with varying levels of patient contact. Mobile carts appear to remove access barriers, whereas incentives may motivate HCP to be vaccinated. Education and publicity may be sufficient for workers in business or administrative positions. Interventions tailored by worker type are likely to be most successful for improving HCP vaccination rates.

Correlates of Improved Influenza Vaccination of Healthcare Personnel: A Survey of Hospitals in Louisiana

2013 ◽  
Vol 34 (7) ◽  
pp. 723-729 ◽  
Author(s):  
Kayla L. Fricke ◽  
Mariella M. Gastañaduy ◽  
Renee Klos ◽  
Rodolfo E. Bégué
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Influenza Vaccination ◽  
Vaccination Campaign ◽  
Vaccination Rate ◽  
Healthcare Personnel ◽  
Patient Contact ◽  
Hospital Type ◽  
Vaccination Rates ◽  
Item Questionnaire

Objective.To describe practices for influenza vaccination of healthcare personnel (HCP) with emphasis on correlates of increased vaccination rates.Design.Survey.Participants.Volunteer sample of hospitals in Louisiana.Methods.All hospitals in Louisiana were invited to participate. A 17-item questionnaire inquired about the hospital type, patients served, characteristics of the vaccination campaign, and the resulting vaccination rate.Results.Of 254 hospitals, 153 (60%) participated and were included in the 124 responses that were received. Most programs (64%) required that HCP either receive the vaccine or sign a declination form, and the rest were exclusively voluntary (36%); no program made vaccination a condition of employment. The median vaccination rate was 67%, and the vaccination rate was higher among hospitals that were accredited by the Joint Commission; provided acute care; served children, pregnant women, oncology patients, or intensive care unit patients; required a signed declination form; or imposed consequences for unvaccinated HCP (the most common of which was to require that a mask be worn on patient contact). Hospitals that provided free vaccine, made vaccine widely available, advertised the program extensively, required a declination form, and imposed consequences had the highest vaccination rates (median, 86%; range, 81%–91%).Conclusions.The rate of influenza vaccination of HCP remains low among the hospitals surveyed. Recommended practices may not be enough to reach 90% vaccination rates unless a signed declination requirement and consequences are implemented. Wearing a mask is a strong consequence. Demanding influenza vaccination as a condition of employment was not reported as a practice by the participating hospitals.

A Qualitative Assessment of a Performance Measure for Reporting Influenza Vaccination Rates among Healthcare Personnel

2012 ◽  
Vol 33 (9) ◽  
pp. 945-948 ◽  
Author(s):  
Taranisia MacCannell ◽  
Alicia Shugart ◽  
Amy K. Schneider ◽  
Megan C. Lindley ◽  
Suchita A. Lorick ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Performance Measure ◽  
Qualitative Assessment ◽  
Healthcare Personnel ◽  
Healthcare Facilities ◽  
Key Informants ◽  
Vaccination Rates ◽  
Semistructured Interviews ◽  
A Performance

To understand the feasibility of implementing a standardized performance measure for collecting and reporting influenza vaccination rates among healthcare personnel, qualitative, semistructured interviews were conducted with key informants in 32 healthcare facilities. Despite practical and logistical challenges to implementing the measure, respondents perceived clear benefits to its use.

A Successful Mandatory Influenza Vaccination Campaign Using an Innovative Electronic Tracking System

2009 ◽  
Vol 30 (12) ◽  
pp. 1137-1142 ◽  
Author(s):  
Tara N. Palmore ◽  
J. Patrick Vandersluis ◽  
Joan Morris ◽  
Angela Michelin ◽  
Lisa M. Ruprecht ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Tracking System ◽  
Vaccination Campaign ◽  
Healthcare Providers ◽  
Data Entry ◽  
Dramatic Improvement ◽  
Patient Contact ◽  
Hospital Policy ◽  
Vaccination Rates ◽  
Clinical Center

Background.Although influenza vaccination of healthcare workers reduces influenza-like illness and overall mortality among patients, national rates of vaccination for healthcare providers are unacceptably low. We report the implementation of a new mandatory vaccination policy by means of a streamlined electronic enrollment and vaccination tracking system at the National Institutes of Health (NIH) Clinical Center.Objective.To evaluate the outcome of a new mandatory staff influenza vaccination program.Methods.A new hospital policy endorsed by all the component NIH institutes and the Clinical Center departments mandated that employees who have patient contact either be vaccinated annually against influenza or sign a declination specifying the reason(s) for refusal. Those who fail to comply would be required to appear before the Medical Executive Committee to explain their rationale. We collected in a database the names of all physician and nonphysician staff who had patient contact. When a staff member either was vaccinated or declined vaccination, a simple system of badge scanning and bar-coded data entry captured essential data. The database was continuously updated, and it provided a list of noncompliant employees with whom to follow up.Results.By February 12, 2009, all 2,754 identified patient-care employees either were vaccinated or formally declined vaccination. Among those, 2,424 (88%) were vaccinated either at the NIH or elsewhere, 36 (1.3%) reported medical contraindications, and 294 (10.7%) declined vaccination for other reasons. Among the 294 employees without medical contraindications who declined, the most frequent reason given for declination was concern about side effects.Conclusions.Implementation of a novel vaccination tracking process and a hospital policy requiring influenza vaccination or declination yielded dramatic improvement in healthcare worker vaccination rates and likely will result in increased patient safety in our hospital.

scholarly journals Impact of an influenza vaccine educational programme on healthcare personnel

2016 ◽  
Vol 144 (11) ◽  
pp. 2290-2294 ◽  
Author(s):  
R. RODRÍGUEZ-FERNÁNDEZ ◽  
A. B. MARTÍNEZ-LÓPEZ ◽  
J. PÉREZ-MORENO ◽  
M. I. GONZÁLEZ-SÁNCHEZ ◽  
F. GONZÁLEZ-MARTÍNEZ ◽  
...  
Keyword(s):  
High Risk ◽  
Influenza Vaccination ◽  
Risk Groups ◽  
Educational Programme ◽  
Healthcare Personnel ◽  
Preventive Strategy ◽  
Paediatric Hospital ◽  
Vaccination Rates ◽  
Question Survey ◽  
Effective Preventive Strategy

SUMMARYInfluenza vaccination has been shown to be the most effective preventive strategy to reduce influenza-related morbidity and mortality in high-risk groups. Despite healthcare personnel (HCP) being considered part of such high-risk groups, their vaccination coverage is low in Europe. In January 2012, we distributed an 18-question survey regarding influenza vaccination to HCP at Gregorio Marañon Paediatric Hospital, in Madrid, Spain. After we documented that only ~30% of HCP were vaccinated an educational programme was implemented in October 2012 before the next influenza season. In January 2013, the same survey delivered again to all HCP documented a significant increase in vaccination rates (from 30% to 40%, P = 0·007) mainly among physicians and for patients' protection. In summary we found that a simple and inexpensive educational programme significantly improved the uptake of influenza vaccination in HCP in our centre. Nevertheless, vaccination rates remained low, and broader and updated campaigns are needed to overcome perception barriers.

scholarly journals Revised SHEA Position Paper: Influenza Vaccination of Healthcare Personnel

2010 ◽  
Vol 31 (10) ◽  
pp. 987-995 ◽  
Author(s):  
Thomas R. Talbot ◽  
Hilary Babcock ◽  
Arthur L. Caplan ◽  
Deborah Cotton ◽  
Lisa L. Maragakis ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Healthcare Workers ◽  
Position Paper ◽  
Healthcare Personnel ◽  
Executive Summary ◽  
Vaccination Rates ◽  
Official Statement ◽  
Healthcare Epidemiology ◽  
Vaccine Shortages ◽  
New Evidence

Executive SummaryThis document serves as an update and companion piece to the 2005 Society for Healthcare Epidemiology of America (SHEA) Position Paper entitled “Influenza Vaccination of Healthcare Workers and Vaccine Allocation for Healthcare Workers During Vaccine Shortages.” In large part, the discussion about the rationale for influenza vaccination of healthcare personnel (HCP), the strategies designed to improve influenza vaccination rates in this population, and the recommendations made in the 2005 paper still stand. This position paper notes new evidence released since publication of the 2005 paper and strengthens SHEA's position on the importance of influenza vaccination of HCP. This document does not discuss vaccine allocation during times of vaccine shortage, because the 2005 SHEA Position Paper still serves as the Society's official statement on that issue.

Self-reported influenza vaccination rates among health care workers in a large health system

2008 ◽  
Vol 36 (8) ◽  
pp. 574-581 ◽  
Author(s):  
Mary Patricia Nowalk ◽  
Chyongchiou J. Lin ◽  
Richard K. Zimmerman ◽  
Dwight E. Fox ◽  
Mahlon Raymund ◽  
...  
Keyword(s):  
Health Care ◽  
Influenza Vaccination ◽  
Health System ◽  
Health Care Workers ◽  
Vaccination Rates ◽  
Care Workers

Voluntary to Mandatory: Evolution of Strategies and Attitudes toward Influenza Vaccination of Healthcare Personnel

2012 ◽  
Vol 33 (1) ◽  
pp. 63-70 ◽  
Author(s):  
Kathleen Quan ◽  
David M. Tehrani ◽  
Linda Dickey ◽  
Eugene Spiritus ◽  
Denise Hizon ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Vaccination Campaign ◽  
Vaccine Uptake ◽  
Healthcare Personnel ◽  
Vaccination Policy ◽  
Vaccination Rates ◽  
Hospital Policies ◽  
Mandatory Vaccination ◽  
Vaccination Campaigns ◽  
The Impact

Background.Assessing the relative success of serial strategies for increasing healthcare personnel (HCP) influenza vaccination rates is important to guide hospital policies to increase vaccine uptake.Objective.To evaluate serial campaigns that include a mandatory HCP vaccination policy and to describe HCP attitudes toward vaccination and reasons for declination.Design.Retrospective cohort study.Methods.We assessed the impact of serial vaccination campaigns on the proportions of HCP who received influenza vaccination during die 2006–2011 influenza seasons. In addition, declination data over these 5 seasons and a 2007 survey of HCP attitudes toward vaccination were collected.Results.HCP influenza vaccination rates increased from 44.0% (2,863 of 6,510 HCP) to 62.9% (4,037 of 6,414 HCP) after institution of mobile carts, mandatory declination, and peer-to-peer vaccination efforts. Despite maximal attempts to improve accessibility and convenience, 27.2% (66 of 243) of die surveyed HCP were unwilling to wait more than 10 minutes for a free influenza vaccination, and 23.3% (55 of 236) would be indifferent if they were unable to be vaccinated. In this context, institution of a mandatory vaccination campaign requiring unvaccinated HCP to mask during the influenza season increased rates of compliance to over 90% and markedly reduced the proportion of HCP who declined vaccination as a result of preference.Conclusions.A mandatory influenza vaccination program for HCP was essential to achieving high vaccination rates, despite years of intensive vaccination campaigns focused on increasing accessibility and convenience. Mandatory vaccination policies appear to successfully capture a large portion of HCP who are not opposed to receipt of die vaccine but who have not made vaccination a priority.Infect Control Hosp Epidemiol 2012;33(1):63-70

scholarly journals Effect of Personalized Messages Sent by a Health System’s Patient Portal on Influenza Vaccination Rates: a Randomized Clinical Trial

2021 ◽  
Author(s):  
Peter G. Szilagyi ◽  
Christina S. Albertin ◽  
Alejandra Casillas ◽  
Rebecca Valderrama ◽  
O. Kenrik Duru ◽  
...  
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Health System ◽  
Behavioral Science ◽  
Patient Portal ◽  
Vaccination Rates ◽  
Loss Frame ◽  
Gain Frame

Abstract Background Adult influenza vaccination rates are low. Tailored patient reminders might raise rates. Objective Evaluate impact of a health system’s patient portal reminders: (1) tailored to patient characteristics and (2) incorporating behavioral science strategies, on influenza vaccination rates among adults. Design Pragmatic 6-arm randomized trial across a health system during the 2019–2020 influenza vaccination season. The setting was one large health system—53 adult primary care practices. Participants All adult patients who used the patient portal within 12 months, stratified by the following: young adults (18–64 years, without diabetes), older adults (≥65 years, without diabetes), and those with diabetes (≥18 years). Interventions Patients were randomized within strata to either (1) pre-commitment reminder alone (1 message, mid-October), (2) pre-commitment + loss frame messages, (3) pre-commitment + gain frame messages, (4) loss frame messages alone, (5) gain frame messages alone, or (6) standard of care control. Patients in the pre-commitment group were sent a message in mid-October, asking if they planned on getting an influenza vaccination. Patients in loss or gain frame groups were sent up to 3 portal reminders (late October, November, and December, if no documented influenza vaccination in the EHR) about importance and safety of influenza vaccine. Main Measures Receipt of 1 influenza vaccine from 10/01/2019 to 03/31/2020. Key Results 196,486 patients (145,166 young adults, 29,795 older adults, 21,525 adults with diabetes) were randomized. Influenza vaccination rates were as follows: for young adults 36.8%, for older adults 55.6%, and for diabetics 60.6%. On unadjusted and adjusted (for age, gender, insurance, race, ethnicity, and prior influenza vaccine history) analyses, influenza vaccination rates were not statistically different for any study group versus control. Conclusions Patient reminders sent by a health system’s patient portal that were tailored to patient demographics (young adults, older adults, diabetes) and that incorporated two behavioral economic messaging strategies (pre-commitment and loss/gain framing) were not effective in raising influenza vaccination rates. Trial Registration This trial was registered with ClinicalTrials.gov (NCT04110314).

scholarly journals Improving immunization practices in United States hospitals and health systems

2017 ◽  
Vol 22 (3) ◽  
pp. 199-211
Author(s):  
Wesley D. Kufel ◽  
Dennis M. Williams ◽  
David Jay Weber
Keyword(s):  
Health System ◽  
Health Systems ◽  
Healthcare Services ◽  
Healthcare Personnel ◽  
Fee For Service ◽  
Content Type ◽  
Vaccination Rates ◽  
Immunization Rates ◽  
The Usa ◽  
Mandatory Vaccination

Purpose Payment for healthcare services in the USA has shifted from fee for service to compensation based on value and quality. The indicators used for payments are a variety of clinical measures, including administration of vaccines to patients. The purpose of this paper is to describe the implementation of programs in health systems to improve vaccination rates and patient outcomes. Design/methodology/approach A search of the literature was conducted to find examples of vaccine programs in US health systems, and also to identify policies to improve immunization rates. Findings Successful programs for improving vaccination rates require advocacy and support of leadership, a systematic and multidisciplinary approach, and an evaluation of local resources and capacity. Numerous examples exist of medical, nursing, and pharmacy led programs that improve vaccination rates. The department in charge has relied on the support of other groups to ensure the success. Social implications Mandatory vaccination of healthcare personnel (HCP) in the health system has been a growing trend in the USA. Although there has been some resistance to mandatory vaccinations for HCP, the standards and requirements have resulted in improved rates in health systems, which ultimately improve efficiency and protects patients. Originality/value This review describes considerations for implementing a successful vaccination program in a health system and provides examples of specific strategies. An overview of mandatory vaccinations for HCP is also described.

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