Mandatory Influenza Testing for Hospital Personnel Enhances Patient Safety

As part of a comprehensive quality and patient safety program, a major national hospital network reported in the Journal of Healthcare Quality (JHQ) that more than 90 percent of its clinical personnel in the last three years received seasonal influenza vaccinations to help protect patients and co-workers from flu-transmission risk. JHQ is published by the National Association for Healthcare Quality (NAHQ).

 Our Influenza Patient Safety Program combined an emphasis on seasonal influenza vaccination with other interventions, such as requiring employees to stay home when ill, early identification and triage of patients with influenza-like symptoms, strong focus on hand hygiene and education on cough etiquette, says lead author Jonathan B. Perlin, MD, senior vice president of quality and chief medical officer for Hospital Corporation of America (HCA). As a result of this effort, the mean vaccination rate increased from 58 percent in 2008 to more than 90 percent during the next three years.

Several lessons learned in the applied research include: the involvement of a multidisciplinary team, visible leadership support, effective communications, clear expectations, consistent data collection and feedback and coordination of logistics.
The authors further noted that as the seasonal influenza vaccination program matures it requires yearly assessment to promote adherence to evidence-based practices and maintain high vaccination rates. They concluded: These policy changes reflect the declining acceptance of unacceptably low influenza vaccination rates by patients, payers and healthcare workers themselves and the recognition that these policies should be part of the standard of care for responsible providers.

Factors Contributing to Vaccination Program Success
Perlin and coauthors attributed the success of the HCA influenza vaccination program to:
1. Multidisciplinary Involvement: A multidisciplinary team designed and implemented the vaccination program and made certain it was evidence-based and supported by leaders and experts in various clinical disciplines.
2. Visible Leadership Support: Corporate leadership communicated consistent patient safety messages and allowed program teams to focus on distributing resources and assisting facilities with program implementation.
3. Effective Communication and Clear Expectations: Several communication and employee education initiatives were utilized, including an influenza email account and corporate intranet to explain the rationale for immunization and address vaccination safety concerns.
4. Consistent Data Collection and Feedback: Rates of vaccination acceptances and declinations were communicated to leadership weekly. Policies were modified based on feedback. For example, three new vaccine options (nasal, high-dose and intradermal) were added.
5. Logistics Coordination: Supply-chain managers helped facilities with vaccine ordering and ensured timely delivery.

Source: National Association for Healthcare Quality