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Published on: June 25, 2015
Evaluating Interventions to Increase Influenza Vaccination Rates among Pediatric Inpatients
Suchitra Rao1, Victoria Fischman2, David W Kaplan3
1Department of Pediatrics (Infectious Diseases and Hospital Medicine), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colo.
Insights
Provider reminders significantly increased inpatient influenza vaccination rates in children, proving more effective than family education or electronic medical record prompts alone. This strategy enhances public health during hospitalization.
Area of Science:
- Pediatric Healthcare
- Infectious Disease Prevention
- Quality Improvement Initiatives
Background:
- Hospitalization presents a key opportunity for influenza vaccination.
- Electronic medical record (EMR) tools can be enhanced to improve vaccination rates.
- Provider and family-directed interventions can increase influenza vaccination ordering among inpatients.
Purpose of the Study:
- To introduce and evaluate provider and family-directed interventions to increase influenza vaccination ordering among pediatric inpatients.
- To compare the effectiveness of different EMR-integrated strategies for improving influenza vaccination rates.
- To assess the impact of interventions on overall vaccination rates and immunization status.
Main Methods:
- A quality improvement initiative was conducted in a pediatric tertiary care hospital (September 2014 - March 2015).
- Interventions included provider reminders (emails, reports, visual prompts) and family education (handouts).
- A control group used EMR prompts alone; data analyzed using Statistical Process Control Charts and Chi-square tests.
Main Results:
- The provider reminder group had the highest influenza vaccine ordering rate (52%), significantly higher than family education (30%) and control (25%) groups (P < 0.0001).
- Provider reminders also led to higher overall influenza immunization status compared to the control group (61% vs. 53%; P = 0.0017).
- Intervention exposure did not affect patient length of stay or discharge time.
Conclusions:
- Provider reminders, encompassing emails, visual prompts, and vaccination reports, are effective in boosting inpatient influenza vaccination rates.
- These provider-focused strategies are more effective than family education or EMR prompts alone.
- Targeted interventions during hospitalization can significantly improve influenza immunization coverage in pediatric populations.
Introduction:
Hospitalization provides an ideal opportunity for influenza vaccination, and strategies can enhance existing tools within the electronic medical record (EMR). The objectives of the study were to introduce and evaluate the effectiveness of provider and family-directed interventions to increase influenza vaccination ordering among inpatients.
Methods:
We conducted a quality improvement initiative for children aged older than 6 months on medical inpatient teams at a large pediatric tertiary care hospital from September 2014 to March 2015, comprising 2 intervention groups (provider reminders and family education) and 1 control group for comparison, using EMR prompts alone. The provider reminder interventions comprised weekly e-mails indicating inpatient immunization status; vaccination reports; and visual reminders. The family education group intervention consisted of handouts regarding the benefits and safety of influenza vaccination. We measured vaccine ordering rates for each group among eligible children and overall vaccination rates. Data were analyzed using Statistical Process Control Charts and Chi-square tests.
Results:
Among 2,552 patients aged older than 6 months hospitalized during the study period, 1,657 were unimmunized. During the intervention period, the provider group ordered 213/409 (52%) influenza vaccines, the family education group ordered 138/460 (30%) and the control group ordered 71/279 (25%) (P < 0.0001). The provider group had higher influenza immunization status than the control group (61% versus 53%; P = 0.0017). Exposure to the intervention did not impact the length of stay/discharge time.
Conclusions:
Provider reminders including e-mails, visual reminders, and vaccination reports are effective ways of increasing inpatient influenza vaccination rates and are more effective than family education, or EMR prompts alone.
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