Designing and implementing a hospital-based vaccine standing orders program

Area of Science:

• Healthcare Management
• Vaccinology
• Public Health Policy

Background:

• Federal regulations changed in 2002, allowing hospitals to use standing orders programs (SOPs) for vaccines.
• Inpatient vaccination rates at UPMC-Presbyterian declined significantly, from 31% in 2000 to 15% in 2003.
• A multidisciplinary team was formed to address the low vaccination rates and redesign the program.

Purpose of the Study:

• To design and implement an effective inpatient pneumococcal polysaccharide vaccine (PPV) vaccination program.
• To meet federal and state regulatory requirements and national vaccination goals.
• To improve low inpatient vaccination rates through a revised program.

Main Methods:

• Evaluation of the existing adult vaccination program and institutional vaccination rates.
• Design of a new vaccine standing orders program (SOP) with a pharmacy-driven approach.
• Development of user-friendly tools and clear instructions for the SOP.

Main Results:

• The implementation of a pharmacy-driven SOP led to a dramatic increase in PPV vaccination rates.
• Average inpatient PPV vaccination rates rose to 69% in 2005.
• The highest vaccination rate achieved was 87% in March 2005.

Conclusions:

• A collaborative, multidisciplinary effort was key to creating a successful inpatient PPV SOP.
• Thorough analysis of the previous program and careful planning were essential for SOP design.
• Defined responsibilities and user-friendly tools were crucial for the program's success.