System Methods to Overcome Barriers

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Presentation transcript:

System Methods to Overcome Barriers Margaret Hennessy MD May 2016

Disclosure statement I do not have a relevant financial, professional, or personal relationship with a commercial interest producing health care goods/services related to this educational activity.

How much does HCW recommendation matter? Easy answer—A LOT! Holman,JAMA Peds. 2014; 168(1):76-82 Barriers to HPV vaccine

Barriers to HPV vaccine HCW Parents Parents will not like it Financial/insurance Knowledge gaps Not sure about young teens Not sure about boys Physician did not recommend it Wanted more info Worry about young teens Concern about new vaccine Concern about finding a clinic that had vaccine

Recommendations Immunization Champion Start Early Rooming process-in EMR/WIR Provide scripting for staff Monitor rates Recall/Reminders

Champion Can be a nurse or physician Join listserv from CDC Tune into Immunization Action Coalition Disseminate information to all providers

Educate

Start Early We offer HPV vaccine at age 10 years Improved immune response at early ages

Rooming Process Check WIR on all patients-sick or well Bidirectional transfer of information from WIR and EHR Staff to offer vaccines that are due to patient,VIS Families that refuse, sign AAP refusal form Provider then cued for discussion Vaccinate

How do I bring up HPV vaccination? Screen all teens from age 11 years & above Don’t tip toe around the recommendation. You have to recommend it. “Your daughter is due for meningococcal, Tdap, and HPV vaccines today.” “HPV vaccine is very important since it protects against cancer.” Train staff to know the facts so that they are your allies. Provide scripting for them. Talk about vaccinating your own children. “I believe so strongly in this vaccine that I am giving it to my son..”

Don’t offer it. Recommend it. Screen for vaccine status at every encounter. Don’t wait for well visits.

Check vaccine rates If you don’t measure it then you can’t improve it! WCHQ will be adding HPV to panel in near future.

Reminder system

Next steps Set up system for RECALL and REMINDERS

THE END