News Update: Use of multiple strategies to increase flu vaccination rates

The 39-practice physician hospital organization (PHO) related to the Cincinnati Children's Hospital Medical Center has increased its influenza immunization rate from 22% to 66% in 5 years, according to Gerry Pandzik, RN, director of the chronic care systems with this PHO. The number of practices with at least 70% immunization has expanded from 2 to 16, but it's still a year-by-year learning process, Pandzik said in her presentation at the recently concluded American Academy of Pediatrics (AAP) 2009 National Conference and Exhibition.

The best-ranked processes

Each year, the PHO puts together a notebook with information regarding what has worked and what has not, trend lines for past results, and literature and resources.

But it's also important that each practice identifies a "flu champion"-a nurse, doctor, or office manager who takes responsibility for organizing the effort, creating strategies, and keeping everyone up-to-date. That also helps with preplanning, including looking at the new challenges for the upcoming season such as supply issues.

The practices also have patient registries that, among other things, help target priority populations.

And the practices have found that it makes a difference to have parents hear from the providers themselves about the vaccine's importance. One practice is testing automated phone calls with the provider's voice this year. And some practices call to ask if the patient may have had the shot elsewhere, just to ensure their population is protected, said Pandzik.

The practices use data to drive decision-making, she stressed, to know whether a change makes a difference. They can pull up a screen showing trends on immunization status in the network and in individual practices. Many providers update those reports weekly and share the results in their practices, Pandzik said.

The PHO has a variety of "work lists" that the flu champions designed. One, for example, lists children to target specifically for vaccination because of asthma severity.

Along those lines, some practices use a poster with a thermometer on it to mark immunization progress with their population. One practice has a T-shirt promoting the vaccine that staff can wear during flu season. Other practices use stickers or waiting room signs. One practice runs flu clinics with a local hospital; another practice sends out an email blast saying it has the vaccine.