Ari H Pollack1, Matthew P Kronman2, Chuan Zhou3, Danielle M Zerr2. 1. Division of Nephrology, and Department of Pediatrics, University of Washington School of Medicine ari.pollack@seattlechildrens.org. 2. Division Infectious Diseases, Seattle Children's Hospital Department of Pediatrics, University of Washington School of Medicine. 3. Department of Pediatrics, University of Washington School of Medicine Division of General Pediatrics, Seattle Children's Hospital, Washington.
Abstract
BACKGROUND: This study was designed to determine whether an automated hospital-based influenza vaccination screening program leveraging the electronic medical record (EMR) increases vaccination rates. METHODS: We performed a retrospective cohort study of all children ≥6 months old admitted to medical, surgical, rehabilitation, or psychiatry services during influenza seasons between 2003 and 2012 at a tertiary care pediatric hospital. We compared influenza vaccination rates before (preintervention phase) and after (intervention phase) the introduction of an automated EMR intervention that utilized a nursing-based electronic screening tool to determine eligibility for influenza vaccine and facilitated vaccine ordering without requiring involvement of a physician or other provider. RESULTS: Overall, 42 716 (72.8%) of the 58,648 subjects admitted during the study period met inclusion criteria. The intervention phase included 20,651 admissions, of which 11 194 (54.2%) were screened. Screening increased significantly over time in the intervention phase (19.8%-77.1%; P < .001). In-hospital influenza vaccination rates increased from a mean of 2.1% (n = 472) of all subjects preintervention phase to 8.0% (n = 1645) in the intervention phase (odds ratio = 6.8; 95% confidence interval, 6.14-7.47). Of the 11 194 screened subjects, 5505 (49.2%) were found to have already been vaccinated at the time of screening. The screening process identified 478 (4.3%) subjects who were unable to receive vaccine for medical reasons, and an additional 2865 (25.6%) whose caregiver refused the vaccine. CONCLUSIONS: An automated, hospital-based influenza vaccination program integrated into the EMR can increase vaccinations of hospitalized patients and provide insight into the vaccination history and declination reasons for children not receiving the vaccine.
BACKGROUND: This study was designed to determine whether an automated hospital-based influenza vaccination screening program leveraging the electronic medical record (EMR) increases vaccination rates. METHODS: We performed a retrospective cohort study of all children ≥6 months old admitted to medical, surgical, rehabilitation, or psychiatry services during influenza seasons between 2003 and 2012 at a tertiary care pediatric hospital. We compared influenza vaccination rates before (preintervention phase) and after (intervention phase) the introduction of an automated EMR intervention that utilized a nursing-based electronic screening tool to determine eligibility for influenza vaccine and facilitated vaccine ordering without requiring involvement of a physician or other provider. RESULTS: Overall, 42 716 (72.8%) of the 58,648 subjects admitted during the study period met inclusion criteria. The intervention phase included 20,651 admissions, of which 11 194 (54.2%) were screened. Screening increased significantly over time in the intervention phase (19.8%-77.1%; P < .001). In-hospital influenza vaccination rates increased from a mean of 2.1% (n = 472) of all subjects preintervention phase to 8.0% (n = 1645) in the intervention phase (odds ratio = 6.8; 95% confidence interval, 6.14-7.47). Of the 11 194 screened subjects, 5505 (49.2%) were found to have already been vaccinated at the time of screening. The screening process identified 478 (4.3%) subjects who were unable to receive vaccine for medical reasons, and an additional 2865 (25.6%) whose caregiver refused the vaccine. CONCLUSIONS: An automated, hospital-based influenza vaccination program integrated into the EMR can increase vaccinations of hospitalized patients and provide insight into the vaccination history and declination reasons for children not receiving the vaccine.
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