Vaccinating in the Emergency Department, a Novel Approach to Improve Influenza Vaccination Rates via a Quality Improvement Initiative

Baumer-Mouradian, Shannon H.; Kleinschmidt, Abigail; Servi, Ashley; Jaworski, Brian; Lazarevic, Kimberly; Kopetsky, Matthew; Nimmer, Mark; Hanson, Thomas; Gray, Matthew P.; Drendel, Amy L.

doi:10.1097/pq9.0000000000000322

Cited by 16 publications

(22 citation statements)

References 23 publications

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“…This study team found that parents decline vaccines due to uncertainty about the vaccine, a concern the child was too sick to receive the vaccine, or are unable/unwilling to wait for vaccination. 8 Similar barriers were identified during interviews with ED parents. 5 Focus groups with parents, teens, and healthcare workers characterized facilitators of vaccination.…”

Section: Introductionmentioning

confidence: 69%

“…Stage 1 represents season 1 enhancements. 8 Season 2, stage 2A and 2B enhancements focused on facilitating communication, identifying vaccine hesitancy, reminding nurses to administer the vaccine, and adding redundancy. To facilitate communication, a “flu column” was added to the universal ED track-board.…”

Section: Methodsmentioning

confidence: 99%

“… 5 , 9 Finally, prior studies have demonstrated how the electronic health record (EHR) can support ED healthcare workers to promote vaccination. 8 , 10 …”

Section: Introductionmentioning

confidence: 99%

“…Consequently, vaccination rates improved from 0% to only 9% (n = 1,235). 8 Therefore, our team aimed to develop a process to overcome vaccine hesitancy and improve administration rates in the pediatric ED.…”

Section: Introductionmentioning

confidence: 99%

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Vaccinating in the Emergency Department, a Model to Overcome Influenza Vaccine Hesitancy

Baumer-Mouradian

Servi

Kleinschmidt

et al. 2021

Pediatric Quality &Amp; Safety

Self Cite

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Introduction: Vaccine hesitancy and delays in vaccine administration time have limited the success of prior influenza vaccination initiatives in the pediatric emergency department (ED). In 2018–2019, season 1, this ED implemented mandatory vaccine screening and offered the vaccine to all eligible patients; however, only 9% of the eligible population received the vaccine. In 2019–2020, season 2, the team sought to improve influenza vaccination rates from 9% to 15% and administer over 2,000 vaccines to eligible ED patients. Methods: Key drivers included: identifying vaccine hesitancy, providing counseling, reducing administration delays, and developing reminders for vaccine administration. We tested interventions using plan-do-study-act cycles. We included discharged ED patients, age 6 months–18 years old, emergency severity index score 2–5, and no prior vaccine this season. Process measures included percent of patients screened, eligible, accepting the vaccine, and leaving before vaccination. Outcome measures were the percent of eligible patients vaccinated and the total number of vaccines administered. Vaccination time was the balancing measure. Results: We included 57,804 children in this study. Comparing season 1 to 2, screening rates (84%) and eligibility rates (58%) were similar. Vaccine acceptance rates improved from 13% to 22%, the proportion of patients leaving before vaccination decreased from 32% to 17%, and vaccination rates improved from 9% to 20%. Total vaccines administered increased from 1,309 to 3,180, and vaccination time was 5 minutes faster in season 2. Conclusions: This ED influenza vaccination process provides a model to overcome vaccine hesitancy and can be adapted and replicated for any vaccine-preventable illness.

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Section: Introductionmentioning

confidence: 69%

Section: Methodsmentioning

confidence: 99%

“… 5 , 9 Finally, prior studies have demonstrated how the electronic health record (EHR) can support ED healthcare workers to promote vaccination. 8 , 10 …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Vaccinating in the Emergency Department, a Model to Overcome Influenza Vaccine Hesitancy

Baumer-Mouradian

Servi

Kleinschmidt

et al. 2021

Pediatric Quality &Amp; Safety

Self Cite

View full text Add to dashboard Cite

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“…Before the coronavirus 2019 pandemic, the PED saw increases in income-disadvantaged children who received non-urgent care [ 20 ]. Consistent with other types of prevention efforts [ 21 ] and the goal to increase equity in obesity prevention [ 22 ], the PED is a novel location to reach at-risk children without regular primary care. Furthermore, during the pandemic, technology may help reach children for obesity prevention—especially those with health disparities [ 23 ]—for referral to programs tailored to children and parents [ 24 ], as well as screening for and informing on food security resources in a manner that minimizes stigma [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

Online Behavioral Screener with Tailored Obesity Prevention Messages: Application to a Pediatric Clinical Setting

et al. 2021

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Obesity prevention involves promoting healthy eating and physical activity across all children. Can we leverage technology to feasibly survey children’s health behaviors and deliver theory-based and user-tailored messages for brief clinical encounters? We assessed the acceptability and utility of an online pediatric-adapted liking survey (PALS) and tailored messages among children receiving non-urgent care in a pediatric emergency department (PED). Two hundred and forty-five children (average age = 10 years, racially/ethnically diverse, 34% overweight/obese from measured indices, 25% of families reporting food insecurity) and their parents/caregivers participated. Each reported the child’s activity and behaviors using the online PALS and received two to three messages tailored to the responses (aligned with elaboration likelihood and transtheoretical models) to motivate behavioral improvements or reinforce healthy behaviors. Most children and parents (>90%) agreed the PALS was easy to complete, encouraging thought about their own/child’s behaviors. The child’s PALS responses appeared reasonable (fair-to-good child–parent intraclass correlations). Most children and parents (≥75%) reported the tailored messages to be helpful and favorable for improving or maintaining the targeted behavior. Neither message type (motivating/reinforcing) nor favorability responses varied significantly by the child’s weight or family’s food security status. In summary, children and parents found the PALS with tailored messages acceptable and useful. The message types and responses could help focus brief clinical encounters.

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The Effect of a Quality Improvement Project on Improving Patients’ Willingness to Receive an Influenza Vaccination in the Emergency Department

German,

Lazenby,

Phillips

et al. 2024

J Immigrant Minority Health

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The aim of this project was to increase willingness to receive the influenza vaccine to the optimal rate of ≥ 70%. Low acuity adult patients who visited an Emergency Department (ED) were assessed regarding their willingness to receive the influenza vaccine before and after an educational intervention that included a provider recommendation and an educational handout. A total of seventy-six patients (n = 76) were assessed. Patients’ willingness to receive the influenza vaccine rose from 29% pre-intervention to 72% post-intervention without disrupting the clinical flow in a busy ED. Similar vaccine educational strategies can be applied to influenza and other vaccines in EDs to increase vaccination willingness in patients, including those who use the ED as a primary point of contact for healthcare, decreasing the burden of influenza illness in the community.

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Vaccinating in the Emergency Department, a Novel Approach to Improve Influenza Vaccination Rates via a Quality Improvement Initiative

Abstract: Supplemental Digital Content is available in the text.

Cited by 16 publications

References 23 publications

Vaccinating in the Emergency Department, a Model to Overcome Influenza Vaccine Hesitancy

Vaccinating in the Emergency Department, a Model to Overcome Influenza Vaccine Hesitancy

Online Behavioral Screener with Tailored Obesity Prevention Messages: Application to a Pediatric Clinical Setting

The Effect of a Quality Improvement Project on Improving Patients’ Willingness to Receive an Influenza Vaccination in the Emergency Department

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