The Employee Influenza Vaccine Program at The Children’s Hospital - PowerPoint by elizabethberkley

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									The Employee Influenza Vaccine Program
                   at
The Children’s Hospital of Philadelphia

    Mary G. Cooney, RN, BSN, COHN-S
   Keith H. St. John, MT(ASCP), MS, CIC
            CHOP Structure
420 bed pediatric teaching hospital
     • Level 4 NICU, PICU, CICU, oncology & BMT
Extensive out-patient Center

 Ambulatory Network ~ 1 million outpatients/year
            »   Primary Care
            »   Specialty Care
            »   Surgical Centers
            »   Kids First Physician Practices
        PROGRAM GOALS
Globally…
• Increase the number of patient care
  providers receiving annual influenza
  vaccine

• Change the culture of accountability
          PROGRAM GOALS
Specifically
•   Vaccinate 80% of patient care
    providers in each individual clinical site
    and clinical group within the network



•    Achieve 100% participation in the program
 What your staff really thinks…
***CDC high alert***

 The CDC reports there will be no flu this
 year. Please cease any preparation your
 hospital is currently involved in and offer
 all staff involved in your local influenza
 program paid time off.
     PARTICIPATION DEFINED




All eligible employees identified as having
patient contact required to:

• Receive an influenza vaccine or
• Complete a declination form
      CHOP Participants
• 4225 Employees
     Main Campus
     Hospital - Out-patient clinic – Rehab
     Satellite Sites
            » Specialty Care
            » Primary Care
            » Physician Practices

• 735 Surgical and Anesthesia Affiliates
    KEY PROGRAM ELEMENTS
•   ASSESSMENT OF PREVIOUS SEASON
•   PLANNING
•   PROGRAM DESIGN
•   IMPLEMENTATION
•   TRACKING PROGRESS/REPORTS
•   OUTCOME ASSESSMENT
    Assessing the previous season
•   What were our outcomes?
•   Did we achieve our goals?
•   What were our successes?
•   What challenges remain?
•   Who did What Well?
•   Did we achieve “herd” immunity?
                          Planning
Key Elements
 Getting started:
•   Engaged support from the very top of the organization
•   Employee flu vaccine program identified as a Patient Safety goal
•   Budget developed and approved
•   Identify key players and responsibilities

               Someone has to own the program (OH, IPC)


                        START EARLY!
                Planning
• Multidisciplinary committee meets in the
  planning and evaluation phases
• Includes managers and front line care
  providers
• We asked for advice on how to
  communicate with nursing
• Smaller working team/committee
          Program Design
Focus:
• Include employees with patient contact
• Establish and refine tracking mechanisms
• Commit to communicating progress on a
  regular schedule
• Have a defined, clear message
Get Your Vaccine: Lead by
     Example Logo
         Program Design
Communicating our message
• Public Relations
    flu posters
        cling ads
            CHOP intranet
               OHD website
          Program Design
• Flu captains and teams
    *** leadership and team work key***
• Hold managers accountable
• Kickoff weeks – only goal is vaccinate,
  vaccinate, vaccinate
• Set up methods for data entry and reports
              Screening Form
• TRIVALENT INACTIVATED INFLUENZA VACCINE
  (INJECTABLE)
• 2008-2009 CHOP OCCUPATIONAL HEALTH
  INFLUENZA VACCINATION PROGRAM
• SCREENING FORM AND ACKNOWLEDGEMENT
• All employees who work closely with patients are
  expected to receive influenza vaccine annually. The
  vaccine is available as an injection or as FluMist (a
  brand name for live attenuated influenza vaccine
  administered nasally) Employees who have a
  medical contraindication or a religious prohibition
  should complete this form and check the applicable
  box(s). Please read and complete the entire form in
  clear print before receiving the vaccine.
    Screening Form, Continued
I have one or more of the following contra indications as checked:
 1.Documented allergy to eggs or egg products
 2. Personal history of Guillian-Barre Syndrome within 6 weeks of receiving flu
     shot
 3. Severe allergic reaction to previous influenza vaccine
  4. Latex allergy (avoid single dose preparation of vaccine – can receive FluMist
     or multi dose injectable)
  5. Other (please explain- most medical conditions are not contra indications for
     influenza vaccine)____________
_______________________________________________________________
     _________________________
If receiving influenza vaccine is expected in your job category please
     check the below box if it applies to you:
     I believe my religion prohibits me from receiving influenza vaccine (please
     submit documentation from your clergy person supporting your religious
     prohibition directly to Chas Senior in Human Resources).
If you received vaccine elsewhere please complete this section:
     I have already received either influenza vaccine or FluMist this year (provide
     date of vaccination/administration and provider name)
     Date: ____________ Provider Name: _____________________________
            Implementation
• September - start advertising
    Shuttle buses
      Cafeteria
         Public hallways
            Posters for all sites
              Clinic Schedules
           Implementation
Late September – October
• Vaccinate non-nursing clinical groups
   PT/OT – Residents – Attendings
      Social Work - Child Life
• Distribute Vaccine to nursing units
• Walk-in clinics for all employees
• Vaccine available 24/7
         Tracking Progress
• Essential that flu forms sent to OH daily
• Used Lawson HR system and Business
  Objects
      Collaboration with HRIS
• Individual reports for each unit/site
• Cumulative Report comparing units/sites
          Tracking Progress
• Cumbersome tracking for physicians
    Excel spreadsheet, labor intensive

• Reports distributed via email bi-weekly to
  flu captains, managers and directors

• Track where vaccine is being used
               Obstacles
• Overcoming myths
    side effects
      getting the flu
        pregnancy/thimerosol

• Persistent resistance
                Tactics
• One on one conversations with manager
  or OH nurse
• Letters to OB physicians
• Peer pressure
• Personal responses to emails
• CDC educational material
• Appeal to sense of professionalism
                  Accomplishments


                  %Vaccinated         %Declined         %Non-participation


MAIN              89% (2741/3085)     4.8%(151/3085)    6.2%(193/3085)



Ambulatory        91% (1048/1151)     6%(74/1151)       3% (29/1151)


Attending         90%* (665/735)      not determined     10 % (70/735)
Physicians

*percentage based upon participation in the program: which included those
   vaccinated, as well as those who had a medical or religious contraindication
          Accomplishments
• 93% of in-patient units and 88% of
  ambulatory sites >80%

• 95% participation in program

• Over 8000 doses vaccine administered to
  employees, affiliates, students, volunteers
      What we think worked…
• Culture of organization – strong endorsement for
  employee flu vaccine
• Multi-disciplinary approach
• Accountability
• Strong media campaign
• Efforts focused on vaccination- no option to
  decline - during the initial campaign
• Constant communication
• And…………….
  A Terrific Occupational Health
               Team
Sue Price – OHD RN
Barbara Spiotto – OHD RN
Karla Abdullah – Outpatient clinic coordinator
Sandy Kittell – OHN LPN
Kadya Hester-Bey – Clinic Coordinator
Sharon Burt – OHD Nurse Practitioner
Michelle Ashmore – NICU flu captain
Reasons for not getting vaccine
• 37% - concern with side effects
• 20% - concern about getting flu from the
        vaccine
• 15% - concern about injections
• 22% - don’t want/not interested

								
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