Pamela Hirsch1, Michael Hodgson, Victoria Davey. 1. Office of Public Health and Environmental Hazards, Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420, USA. pamela.hirsch@va.gov
Abstract
OBJECTIVE: To document successful substantial increases in healthcare worker influenza vaccination rates and to identify reasons for success and failure. DESIGN: (1) Four-year longitudinal characterization of facility vaccination rates, (2) Web-based facility-level questionnaire for influenza coordinators to identify success factors in year 3, and (3) semistructured telephone interviews of influenza coordinators at facilities with substantial increases or declines in year 4. SETTING: National single-payer hospital (healthcare) system with 153 hospitals in 5 levels of complexity. PATIENTS: Facility leadership staff. METHODS: (1) Vaccination data collected from management sources (doses from pharmacies, denominator data from payrolls); (2) a Web-based survey aligned with a previously administered instrument (Wisconsin Health Department), piloted in-house, modified to reflect national strategies and improvements; and (3) semistructured telephone interviews with influenza coordinators at facilities that improved or worsened by more than 20% between the 2007-2008 and 2008-2009 influenza seasons. RESULTS: Vaccination acceptance rates improved from 45% of healthcare workers in 2005-2006 to 66.5% in 2008-2009. Facilities with lower complexity had higher vaccination rates. No individual factors were associated with improved performance. CONCLUSIONS: Sustained management attention can lead to improvements in healthcare worker influenza vaccination rates. Wavering of attention, though, may lead to rapid loss of effectiveness. Declination statements in this system did not contribute to vaccine acceptance.
OBJECTIVE: To document successful substantial increases in healthcare worker influenza vaccination rates and to identify reasons for success and failure. DESIGN: (1) Four-year longitudinal characterization of facility vaccination rates, (2) Web-based facility-level questionnaire for influenza coordinators to identify success factors in year 3, and (3) semistructured telephone interviews of influenza coordinators at facilities with substantial increases or declines in year 4. SETTING: National single-payer hospital (healthcare) system with 153 hospitals in 5 levels of complexity. PATIENTS: Facility leadership staff. METHODS: (1) Vaccination data collected from management sources (doses from pharmacies, denominator data from payrolls); (2) a Web-based survey aligned with a previously administered instrument (Wisconsin Health Department), piloted in-house, modified to reflect national strategies and improvements; and (3) semistructured telephone interviews with influenza coordinators at facilities that improved or worsened by more than 20% between the 2007-2008 and 2008-2009 influenza seasons. RESULTS: Vaccination acceptance rates improved from 45% of healthcare workers in 2005-2006 to 66.5% in 2008-2009. Facilities with lower complexity had higher vaccination rates. No individual factors were associated with improved performance. CONCLUSIONS: Sustained management attention can lead to improvements in healthcare worker influenza vaccination rates. Wavering of attention, though, may lead to rapid loss of effectiveness. Declination statements in this system did not contribute to vaccine acceptance.
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