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Published on: February 23, 2014
Improving Pneumococcal Vaccination Rates in High-risk Children in Specialty Clinics
Julia G Harris1,2, Luke A Harris1,3, Liset Olarte1,2
1Children's Mercy Kansas City, Kansas City, Missouri.
Insights
This study enhanced pneumococcal polysaccharide vaccine (PPSV23) vaccination rates in high-risk pediatric patients. Quality improvement initiatives successfully increased PPSV23 coverage from 20% to 60% in three specialty clinics.
Area of Science:
- Pediatric Infectious Diseases
- Vaccinology
- Quality Improvement in Healthcare
Background:
- Pediatric patients with immunocompromising or chronic conditions face a higher risk of invasive pneumococcal disease (IPD).
- The 23-valent pneumococcal polysaccharide vaccine (PPSV23) is recommended for high-risk children aged two years and older to prevent IPD.
- Current vaccination rates for eligible high-risk pediatric patients were suboptimal, necessitating targeted interventions.
Purpose of the Study:
- To significantly improve the vaccination rates of the 23-valent pneumococcal polysaccharide vaccine (PPSV23) among high-risk pediatric patients.
- To increase PPSV23 vaccination coverage from approximately 20% to 50% within a 12-month period in three specialized pediatric clinics.
- To implement and evaluate quality improvement strategies for enhancing vaccine uptake in vulnerable pediatric populations.
Main Methods:
- A multidisciplinary project team, including quality improvement champions and population health leaders, was assembled.
- Key initiatives included refining patient eligibility criteria, developing an automated weekly previsit planning report, and optimizing vaccine stock management.
- Best practices were shared across divisions, and progress was monitored using time series and run charts to track PPSV23 vaccination rates.
Main Results:
- The baseline PPSV23 vaccination rate for eligible high-risk pediatric patients was approximately 20%.
- Following the implementation of quality improvement initiatives, the vaccination rate increased to approximately 60%.
- All three participating specialty divisions demonstrated measurable improvements in their respective PPSV23 vaccination rates.
Conclusions:
- Quality improvement methodologies effectively increased and sustained PPSV23 vaccination rates in three pediatric specialty clinics.
- The project demonstrated a successful strategy for enhancing vaccine uptake in high-risk pediatric populations.
- Future efforts will focus on refining best practices and expanding the program to reach over 9000 additional high-risk pediatric patients.
Background And Objectives:
Pediatric patients with immunocompromising or certain chronic medical conditions have an increased risk of acquiring invasive pneumococcal disease (IPD). The 23-valent pneumococcal polysaccharide vaccine (PPSV23) is recommended for patients ≥2 years at high risk for IPDs. The aim of this project was to improve PPSV23 vaccination rates for children at high risk for IPD who were seen in 3 specialty clinics from ∼20% to 50% over a 12-month period.
Methods:
The project team included quality improvement champions from the divisions of rheumatology, infectious diseases, and pulmonology in addition to leaders from our population health management subsidiary. Several initiatives were implemented, starting with review of patient inclusion criteria per the vaccination recommendations, that led to the design and deployment of an automated weekly previsit planning report. Additionally, we implemented a process to stock pneumococcal vaccines and shared best practices among the divisions. We monitored improvement through times series and run charts of PPSV23 vaccination rates.
Results:
The initial PPSV23 vaccination rate for applicable high-risk patients was ∼20%. There was an increase in vaccination rate to ∼60%. All 3 divisions showed improvements in their individual PPSV23 vaccination rates.
Conclusions:
Using quality improvement methodology, we increased PPSV23 vaccination rates in 3 pediatric specialty clinics, and this improvement was sustained. We will continue to identify best practices and actively recruit additional divisions because we have the opportunity to reach >9000 high-risk patients.
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