The goal of this project is to improve the influenza immunization rate of eligible asthmatics admitted to the Pediatric Hospital Medicine (PHM) service to 80% by February 2015.
Asthma patients were identified via ICD-9 codes, and charts were manually reviewed to determine influenza immunization status.
○ Outcome: vaccination rate of eligible asthmatics
○ Process: Asthma History & Physical (H&P) template and Order Set usage
○ Balance: Adverse vaccine reaction
2013-2014: addition of vaccine consent to Asthma H&P template, addition of influenza immunization order in Asthma Order set, adding review of vaccine status during multidisciplinary rounds, CDC posters displayed on PHM units, written and verbal education and reminders to physicians
2014-2015: continuation of all 2013-2014 interventions, addition of dropdown vaccination status menu to Asthma H&P, addition of flu vaccine information sheet to patient welcome packets, addition of flu vaccine status review during asthma education, housestaff perception survey to assess perceived barriers to inpatient administration of the flu vaccination
During the current flu season, the median influenza immunization rate was 65%. Asthma Order Set Usage was 80% and H&P usage was 60%. No adverse vaccine reactions were noted. For eligible patients who were not vaccinated during hospitalization, reasons were largely undocumented, although family refusal was documented in 20% of those patients.
Our additional interventions improved the PHM influenza immunization rate to 65% without an increase in adverse vaccine reactions. Family hesitancy remains a significant barrier to inpatient vaccination and represents a target area for intervention. Future directions for this project include transition of the initiative to the hospital-wide acute asthma care team. Several proposed interventions in the upcoming year include hospital-wide flu immunization tracking and ordering, development of a new inpatient Asthma Navigator in the EMR, and dissemination of the asthma H&P template to other sections within the hospital.
- Copyright © 2017 by the American Academy of Pediatrics