Influenza Vaccination Campaign 2003 Dr. Michael Koller QI Director for Primary Care

Opportunity Statement and Desired Outcome Infection with influenza causes significant morbidity and mortality every “flu season.” Influenza vaccination can prevent infection with the flu virus and can minimize the illness. s Healthy People 2010 goal is that 90% of patients age 65 and older are vaccinated against influenza and 60% for high risk patients (adults age with chronic diseases like diabetes and asthma). s LUHS set a goal of 90% immunization rate or documented refusal for all our targeted patient groups.

Most Likely Causes for Current Opportunity  Lack of a system-wide approach led to inconsistent vaccination of eligible patients across departments  Reliance on memory failed to identify high risk patients in all ambulatory specialties (i.e. OB, pediatrics, primary care, cancer center, and medical specialties)  Minimal efforts to publicize influenza vaccinations across departments  Lack of use or inadequate use of flu shot clinics and standing orders  Inadequate use of reminders to patients and prompts to clinical staff  Inconsistent supply and timeliness in delivery of flu shots in past years

Solutions Implemented  Dr. Koller becomes system champion: attends multiple department and resident meetings to promote flu shots  Expanded use of flu clinics with standing orders  Utilized Marketing Department to develop multi-faceted approach to publicity  Information Technology creates IDX prompts to assist clinical staff to encourage vaccination at outpatient visits of high risk patients  LUHS ambulatory promotes vaccinations for all identified high risk pts  Free postcards mailed to over 5,000 high risk patients in primary care  List of high risk patients generated for each PCP

Progress to Date Implementation of an ambulatory system campaign for influenza vaccination There was greater than 40% increase in flu shots given in 2003!

Results

Results – “star PC site”

Results

Conclusions Next Steps It Worked!  The sites that made the most use of flu clinics were the most successful  The “culture” can be changed –Everyone in contact with the patient can facilitate vaccinations, it is not just primary care’s job to vaccinate  The campaign was a success and should be repeated annually Take advantage of every capability in EPIC to promote influenza vaccination –Prompts to staff –Identify high risk patients Vaccinate high risk patients on discharge from hospitalization next flu season