PADOH_HCW Flu Vax Program_Case Study Modules_MainLineHealth_June 2011

							Pennsylvania Health Care Worker Flu
     Immunization Campaign
    A Patient Safety & Employee Health Initiative

                Training Resources:
        Cast Study Module: Main Line Health
                       Version 1.1
                       June 2011
                 Case Study Modules
   Based on interviews with leaders at institutions
    representing best and promising practices

   Focus on common elements of strategy, decision to
    implement programs, internal support and barriers

   Focus on mandatory programs given policy and
    ethics foundations

   Recognition that each institution is unique, but
    overall goal (90%+ uptake) is patient safety/
    employee safety imperative is same everywhere!
                          Case Study Snapshot
                             Main Line Health

Main Line Health is suburban Philadelphia's most comprehensive healthcare
resource, offering a full range of medical, surgical, obstetric, pediatric,
psychiatric and emergency services. Forming the core of Main Line Health
are four of the region's most respected acute care hospitals—Lankenau,
Bryn Mawr, Paoli and Riddle—as well as one of the nation's premier facilities
for rehabilitative medicine, Bryn Mawr Rehab Hospital. We're especially
recognized for our cardiac, orthopedic, oncology, rehabilitation and women's
clinical services. [10,000 employees, 2,750 physicians]
http://www.mainlinehealth.org/oth/Page.asp?PageID=OTH000030

Contacts:
- Constance Cutler, RN, MS, CIC, FSHEA; Director, Infection Prevention and
   Control, Main Line Health, CutlerC@MLHS.ORG; (484) 476-3906

- Patty McBride, RN, MSN, CIC; Infection Preventionist, Bryn Mawr
   Hospital, McBrideP@MLHS.ORG; (484) 337-3470
                         Case Study Snapshot
                           Main Line Health
Overview
After averaging seasonal vaccine uptake among its HCWs of about 60% for
several years despite active annual campaigns, Main Line Health adopted a
mandated program for the 2010-11 flu season, achieving a 99.99% uptake.


                 Seasonal Influenza Vaccine Uptake
              Pre-mandate               Post-mandate
             ≈ 60%                            99.99%
                           Case Study Snapshot
                             Main Line Health

Program Justification
Positioned as a patient safety initiative which involves entire Main Line
Health community including physicians.

Program Details
- establishes seasonal flu vaccination as a condition of employment
- impacts all employees, employed physicians, volunteers, students, vendors
    with patient contact (consent form)
- impacts non-employee professional staff credentialed by medical staff
    (privilege suspension)
- integrates medical exemptions (physician letter; no allergy testing) and
    religious exemptions (letter from clergy reviewed by outside
    independent party (retired judge)): very low incidence rate
                           Case Study Snapshot
                              Main Line Health
Key Champion(s)
- Main Line Health CEO John Lynch
   - drove the initial decision based, in part, on his experience in Houston
     with a hospital flood event: act where you can to avoid disaster
- Infection Preventionists/Occupational health
- HR Directors (data sharing with managers on unit uptake)

Best sound bite(s)
During formal campaign and rounding visits to key units, the VP of Nursing
from one hospital encountered “senior” maternity nurses:

Question: “Are you really going to fire all of us if we don’t get vaccinated?”
Answer: “Yes ladies, we are.”
Result: They accepted influenza vaccinations towards the deadline.
                           Case Study Snapshot
                               Main Line Health
Timeline
April-August 2009:
- Initial consideration of a mandate program…HR Directors meeting…H1N1
pandemic and vaccine supply pushes decision off to next cycle

Jan-Feb 2010:
- Groundwork laid with legal, HR
- Steering Group formed/mandate decision affirmed: CMO, HR, Legal, Patient
Safety, Occupational Health, Nursing, Infectious Disease++)

May-June 2010:
- Review and approvals by Medical Executive Committee and Board of Directors
- Launch letter to employees from CEO/CMO

Late Dec 2010/early Jan 2011
- Formal campaign window
                          Case Study Snapshot
                            Main Line Health

Key Strategies/Success Factors
- Use of own employees (community health nurses) to “deliver”
    immunizations in the mandate context
-Use of employee intranet to post key program content ands help assure
   continuity of messaging across stakeholder groups
- Posted base set of 10 Frequently Asked Questions (FAQs) which built to
    twenty; employees could post new questions and get direct response
- Emphasis on physician inclusion in requirement: increased safety
   perception, etc.
- Moving from paper-based form to badge reader to track
                          Case Study Snapshot
                            Main Line Health


Leadership Team (functions that made it happen)
The Steering Group pared down to a handful of key players who held
weekly status phone calls, then almost daily calls during the last week. Key
players included:
- Infection Prevention
- Infectious Diseases
- Occupational Health
- Chief Medical Officer
- Human Resources Director
- others as necessary…
Case Study Snapshot
 Main Line Health
                         Case Study Snapshot
                           Main Line Health

Key Resources on website
- MLH CEO/CMO Campaign Letter 2010:      MainLineHealth_CEO-CMO Campaign Letter

- MLH Employee Flu Vaccination Admin Policy:    MLH_Flu Vaccination Policy 2010

-MLH Intranet Frequently Asked Questions:   MLH_Flu vaccine – Frequently Asked
Questions 2010

-MLH Medical Exemption Form 2010:    MLH_Flu Vax Medical Exemption Form – 2010

-MLH Campaign Poster (above):   MLH_FluFlyer-8 5×11
                      Group Exercise

   What strategies from the Main Line case study
    might work well in your institution? Why?
   What parts of the Main Line experience would
    NOT work for your institution? Why?
   What barriers do you see within your institution
    moving towards a mandatory program?
   Which barriers are not addressed in the Main
    Line experience?

    We will use observations and answers to build a collection of
          “frequently-asked-questions” (FAQs) for the website