# Presentation: 028009

## Strategies for Vaccinating Health Care Personnel

- Amy Groom, MPH
- Cheyenne Jim, MS
- IHS Immunization Program

## Strategies for Improving HCP Vaccination Rates

- Successful HCP vaccination programs are multifaceted and combine:
- Support from top management and administration
- Buy in from HCP
- Education campaigns
- Improved access to influenza vaccine
- Measurement and feedback

## Models that Work

- VA - Agency Level Performance Goal
- 60% in FY 2007
- 80% by 2011
- FY 2007 all sites required to
- Identify how they will collect data, implement mobile vaccination carts
- Report on the number of employees vaccinated
- Developed report with coverage data by facility
- Strategies in successful sites:
- Inclusion of goal in facility improvement plan
- Dedicated leadership support, resource allocation
- Education, improved vaccine access, tracking and display of rates, incentives

## Models that work

- Top Management Involvement
- St. Jude Children’s Research Hospital in Memphis, TN
- Gained support from top members of administration and central authority figures within each department
- Some techniques used include:
- Education campaign
- Making vaccine more accessible
- “Feedback & follow-up”
- On a weekly basis, staff reviewed the list of workers not vaccinated and sent reminders to their supervisors
- In the third year, **96%** of staff was immunized

- Source: National Foundation for Infectious Diseases. Immunizing Healthcare Personnel Against Influenza: A report on best practices. Bethesda, MD, 2008. http://www.nfid.org/HCWtoolkit/report.html

## Models that work

- Leveraging Technology
- Cleveland Clinic in Cleveland, OH
- Implemented mandatory intranet participation
- All employees are required to go to the Influenza homepage and complete an online immunization form by December 1st of each year
- Intranet education include:
- Information about influenza
- Frequently Asked Questions
- Clinic locations and hours
- Hospital policy regarding influenza immunizations
- Dashboard report of coverage rates
- In the first year of implementation system wide, **81%** of staff was immunized

- Source: National Foundation for Infectious Diseases. Immunizing Healthcare Personnel Against Influenza: A report on best practices. Bethesda, MD, 2008. http://www.nfid.org/HCWtoolkit/report.html

## Models that work

- Mandating Immunization
- Virginia Mason Medical Center in Seattle, WA
- Anyone who failed to get vaccinated by the hospital’s deadline was subject to termination
- 7 people terminated in the first year, none in the years since
- Those refusing based on medical or religious needs were required to wear a surgical mask for the duration of flu season
- In the first year, **98%** of staff was immunized
- Some of the techniques utilized include:
- Informational kiosks	• Internal Web site
- Slogan contest	• Tailgate kickoff party
- Downside: Nursing union rejected mandatory flu vaccination; court sided with the union

- Source: National Foundation for Infectious Diseases. Immunizing Healthcare Personnel Against Influenza: A report on best practices. Bethesda, MD, 2008. _[http://](http://www.nfid.org/HCWtoolkit/report.html)__[www.nfid.org/HCWtoolkit/report.html](http://www.nfid.org/HCWtoolkit/report.html)_

## What facilities can do

- Involve top management
- Identify an influenza vaccination coordinator
- Someone needs to own the program
- Educate HCP in your facility about the importance of influenza vaccination
- HCP Influenza vaccination is a PATIENT SAFETY issue
- Many refuse vaccination because of incorrect information/beliefs
- Provide information during staff trainings, new employee orientations, through email, posters in the facility, etc.
- Identify peer “flu champions”

**Notes:**
Some ideas of what you/your sites can do

## What facilities can do, cont. 

- Ensure access to vaccine for all HCP
- Free of charge
- Convenient (multiple locations/times, mobile vaccination cart)
- Standing Orders
- Peer vaccination program
- Declination Forms
- Consider having employees who refuse the vaccine sign a declination form
- One study found that declination forms increased HCP vaccination by a mean of 11% 1

- 1. Polgreen P et al. Relationship of influenza vaccination declination statements and influenza vaccination rates for healthcare workers in 22 US hospitals. Infect Control Hosp Epidemiol 2008; 29(&): 675-7.

## What facilities can do, cont. 

- Monitor coverage of your employees
- Set up a system to track coverage
- Display vaccination status by department
- Provide Incentives
- Drawings for movie tickets, books, etc.
- Pizza Party for department with highest coverage
- 59 minutes off (VA)

## Resources

- For more information:
- 	Department of Health and Human Services Toolkit:
- 	http://www.hhs.gov/ophs/programs/initiatives/vacctoolkit/index.html
- 	National Foundation for Infectious Diseases. Immunizing Healthcare Personnel Against Influenza: A report on best practices. Bethesda, MD, 2008. http://www.nfid.org/HCWtoolkit/report.html
- 	IHS HCP Influenza Website: _http://www.ihs.gov/PublicAffairs/NewsReleases/index.cfm_