Systematic effort helps hospital raise employee flu vaccination rates

(Press-News.org) A systematic effort to improve flu vaccination rates for healthcare workers has increased flu vaccinations rates from 59 percent to 77 percent at the University Health System (UHS) in San Antonio. A report detailing their interventions to increase vaccination was published in the June issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.

UHS raised its healthcare worker vaccination rate from 59 percent in 2009 to 77 percent in 2010 through quality improvement tools including vaccine kits to individual units, Grand Round presentations, enhanced staff awareness and a dashboard of vaccination rates of each program was promoted on the staff intranet. The increase places the UHS well above national average for healthcare worker vaccination, which tends to hover below 50 percent.

The vaccination push was spearheaded by a quality improvement team with a goal of reaching a vaccination rate of 80 percent. The team developed a list of possible reasons for low immunization rates, and created a set of interventions to combat them.

Under the improvement program, a vaccination kit was provided to each hospital unit so workers could take it without leaving their work area. Multiple educational conferences on the importance of vaccination were held, and a flu information website and blog were added to the health system's website. Hospital newsletters featured articles about immunization, including photographs of hospital leaders being vaccinated. The vaccination campaign was also promoted on telephone hold messages and computer screen savers. To monitor progress, vaccination rates by unit were sent to unit directors weekly and were available to all employees on the website.

"The quality improvement tools and techniques the team used led to a significant improvement of the vaccination rate," said Dr. Jose Cadena, a member of the team and an author of the journal report. "Our methodology allowed us to adapt and modify interventions over time, adjusting to challenges and opportunities for improvement that emerged."

Making sure healthcare workers are vaccinated is a major public health initiative. Vaccination of healthcare workers helps save patients' lives and reduces the spread of influenza in healthcare settings. It also protects the individual worker from falling ill during influenza outbreaks and from missing work, which further impacts patient care.

"Mathematical models have shown that [healthcare worker] influenza vaccination could lead to a 40 percent decreased risk of patients acquiring influenza in the healthcare setting, which makes influenza vaccination a patient safety issue," Dr. Cadena and his colleagues write.

While the vaccination effort was successful in raising immunization rates substantially, it still fell short of its 80 percent goal. Making vaccination a condition of employment, as recommended recently by several professional societies including the Society for Healthcare Epidemiology of America, may be required to achieve higher rates of vaccination, Dr. Cadena said.

### Jose Cadena, Teresa Prigmore, Jason Bowling, Beth Ann Ayala, Leni Kirkman, Amruta Parekh, Theresa Scepanski, and Jan E. Patterson, "Improving Healthcare Workers' Influenza Vaccination Using Quality Improvement Tools." Infection Control and Hospital Epidemiology 32:6 (June 2011).