Get documents about "phc presentation 05 09 12
Document Sample
Slide 1
2011-2012 Massachusetts Acute Care Hospital Healthcare Employees Influenza
Vaccination Update
Public Health Council
May 9, 2012
Iyah Romm
Director of Policy, Health Planning, and Strategic Development
Bureau of Health Care Safety and Quality
Slide 2
Presentation Overview
• Reporting: Background and Context
• Acute Care Hospital 2011-2012 Employee Vaccination
• Next Steps
Slide 3
Why Healthcare Personnel Vaccination?
• Healthcare personnel (HCP) may be an important source of transmission of the
influenza virus.
• The most effective method of preventing influenza and its potentially serious
complications is annual immunization.
• As well as protecting patients, vaccination of HCP has been shown to reduce
absenteeism among healthy workers, resulting in financial savings to healthcare
facilities.
• Despite the strong recommendation of major public health agencies, professional
societies and healthcare organizations for annual, universal immunization of
healthcare workers against influenza, overall rates of immunization among
healthcare workers has remained low.
• Identified as a measure of patient safety and is the right thing to do!
Slide 4
Regulatory Background
Hospital licensure regulations acute care hospital reporting healthcare
vaccination reported to BLC
Flu vaccination a condition of licensure
condition of licensure in all facilities
MDPH sets performance goals
Slide 5
2011-2012 MDPH Established Acute Care Hospital Performance Goal
Overall goal is for acute care hospital healthcare employee vaccination rates to be
greater than 90%
No hospital will report a rate less than 73%, which is 2 percentage points above
the Massachusetts average rate in 2010-2011
Slide 6
Influenza Reporting Requirements 2011-2012
Acute care hospitals must report:
the total # of employees at the facility as of December 31, 2011.
the # of employees vaccinated between 8/1/2011 and 3/31/2012.
the # of employees vaccinated by the hospital between 8/1/2011 and 3/31/2012.
the # of employees vaccinated outside the hospital between 8/1/2011 and
3/31/2012.
the # of employees who declined influenza vaccination during the 2011-2012 flu
season.
Slide 7
Definition of an Employee
• Employees are defined as part and full time individuals who are on the facility
payroll as of December 31, 2011.
• Employees with no direct patient contact need to be included in both the total
number of employees and the number of employees vaccinated.
Slide 8
Calculation of Percent of Healthcare Employees Vaccinated
# employees immunized with flu vaccine from August 1, 2011 thru March 31, 2012*
______________________________________ X 100
# employees on the payroll as of December 31, 2011
*includes vaccination administered both inside and outside the health facility
Slide 9
2011-2012 Statewide aggregate Percentage among all acute care hospital HCWs
Vaccinated and Declining Vaccination
N Total Employees Percentage
Total Vaccinated 151010 180410 83.7%
Total Declined 29907 180410 16.6%
Slide 10
2011-2012 Massachusetts Mean Percentage Vaccinated and Declining Vaccination at all
Acute Care Hospitals
Mean % Vaccinated Range
Total Vaccinated 81.4 (51.4 - 101.8)
Vaccination Declination Rate 18.4 (1.7 - 38.8)
Location Vaccinated
At Hospital of Employment 70.0 (46.4 - 94.7)
Outside Hospital of
Employment 11.4 (0.3-27.1)
Slide 11
2010-2011 and 2011-2012 Comparison
Mean percentage of HCWs vaccinated and declining vaccine at acute
care hospitals in Massachusetts
100.0
81.4
Percentage of HCWs
80.0 70.8
60.0
40.0
18.4 20.1
20.0
0.0
2011-2012 Influenza Season 2010-2011 Influenza Season
Mean Percent Vaccinated Mean Percent Declined
Slide 12
2011-2012 Mean percentage Healthcare Employee Influenza Vaccination by Teaching
Status and Bed Size
Mean % Vaccinated Range
Hospital Teaching Status*
Major Teaching Hospital 84.9 (53.8 - 101.8)
Non-Teaching Hospital 79.8 (51.4 - 99.6)
Hospital Bed Size
Small (<=100 beds) 81.4 (64.4 - 98.7)
Medium (101-300 beds) 80.4 (51.4 - 101.8)
Large (>300 beds) 84.4 (60.6 - 98.1)
Vaccine coverage did not differ greatly by hospital teaching status or bed size.
*Teaching status was determined by hospital’s most recent National Healthcare Safety
Network annual hospital survey. Major teaching status is defined as a hospital that is an
important part of a medical school teaching program in which the majority of medical
students rotate through multiple clinical services.
Slide 13
2011-2012 Mean Percentage Healthcare Employee Influenza Vaccination by Region
Mean % Vaccinated Range
Region
Western 76.1 (64.1 - 92.9)
Central 77.7 (51.4 - 90.4)
Northeast 79.9 (61.2 - 99.0)
Metro 86.9 (75.1 - 101.8)
Boston 86.8 (70.9 - 98.3)
Southeast 78.3 (53.8 - 99.6)
Slide 14
2011-2012 MDPH Influenza Vaccination Benchmarks
• Seventy-four acute care hospitals submitted healthcare worker vaccination data.
Data from the 2010-2011 Influenza season was not available from one facility.
• Sixty-two (83.8%) facilities met the benchmark of vaccinating 73% or more of
their healthcare workers.
• Thirty-five facilities (47.3%) had a declination rate for influenza vaccine by their
healthcare workers of 20% or greater.
Slide 15
Change in Vaccination Rates by Hospital between the 2010-2011 and 2011-2012
Influenza Seasons
Percent Change in Vaccination Rate by Hospital
40.0%
National Comparison
30.0%
Percent Change
20.0%
10.0%
0.0%
-10.0%
Increase in Vaccination Rate and met Benchmark Increase in Vaccination but did not meet Benchmark
Decrease in Vaccination and did not meet Benchmark Decrease in Vaccination but met Benchmark
• Sixty-four facilities had an increase in vaccination, though six of these still did not
meet the 73% benchmark
• Ten facilities had a decrease in vaccine coverage, however five of these facilities
were over the 73% benchmark.
Slide 16
National Comparison
Table 1: Health care personnel influenza vaccination coverage by mid-
November 2011, United States
Unweighted Coverage % (95%
Population sample size Weighted n CI)
Overall 2,442 13,337,764 63.4 (60.7,66.1)
CDC Internet Panel Survey, United States, November 2011
Authors: Megan C. Lindley, MPH; Jun Zhang, MD; Gary L. Euler, DrPH.
Immunization Services Division, NCIRD
Slide 17
Best Practices for increasing influenza vaccination rates among healthcare workers
• MDPH contacted hospitals that have been particularly effective in increasing
influenza vaccination rates among healthcare workers
• Outreach to high performers reporting greater than 90% influenza vaccination
coverage
• Effective sharing of best practices can help organizations to design and implement
successful programs
• Key lessons from successful programs can help others replicate success
Slide 18
Top Performers
2010-
2011-2012 2011
Newton Wellesley
Hospital 101.8% 83.0%
Sturdy Memorial
Hospital 99.6% 79.7%
Lawrence General
Hospital 99.0% 76.1%
Dana-Farber
Cancer Institute 98.3% 82.7%
Beth Israel
Deaconess - Milton 98.2% 76.1%
Children's
Hospital Boston 98.1% 91.3%
Falmouth Hospital 98.7% 61.6%
Lahey Clinic 97.6% 96.1%
Nantucket Cottage
Hospital 95.7% 74.0%
Tufts Medical
Center 95.5% 63.3%
Mount Auburn
Hospital 94.7% 70.8%
Beth Israel
Deaconess - Boston 93.7% 80.4%
Fairview Hospital 92.9% 88.4%
St. Elizabeth's
Medical Center 92.4% 60.7%
Winchester 92.8% 81.5%
Hospital
Faulkner Hospital 92.0% 73.1%
Massachusetts
General 91.1% 82.8%
Metro West
Medical Center 90.6% 73.7%
Harrington
Memorial Hospital 90.4% 65.2%
Slide 19
Best Practices to Promote Maximal Coverage – Common Themes
• Support and buy in from senior leadership
• Established performance goals with timely data feed back to hospital
leadership
• Made vaccination accessible
• Developed communication strategies
• Implemented Mandatory Influenza Vaccination Program
• Required employees who declined vaccination or did not provide evidence
of vaccination to wear a mask in public spaces within the facility
• Those with egg allergies or history of Guillain-Barré syndrome offered a
reimbursed visit to consult an allergist or neurologist
• Provided resources to implement and manage program,
• Culture shift where influenza vaccination is valued
Slide 20
Next Steps
• MDPH will contact Chief Quality Officers (or Chief Medical Officers) in
underperforming hospitals to offer technical support
• Letters of commendation will be sent to hospitals reporting greater than 90%
influenza vaccination coverage and to the top 10% of hospitals reporting the
greatest improvement when compared to data collected during 2010-2011
• Letters will be sent to all hospitals that failed to meet the established MDPH
performance goal
• Complete follow-up and data analysis in additional licensed healthcare facilities
(ambulatory surgical centers, clinics, dialysis long term care facilities and
nonacute hospitals)
Slide 21
Thank you
Massachusetts Department of Public Health
Bureau of Health Care Safety & Quality
99 Chauncy Street, 11th Floor
Boston, MA 02111
617.753.8000
For Further Information, Please Contact
Iyah Romm
Director of Policy, Health Planning and Strategic Development
(iyah.romm@state.ma.us)
