Becker's Hospital Review

90 Executive Briefing For more than a century, Merck has been inventing for life, bringing forward medicines and vaccines for many of the world's most challenging diseases. Today, Merck continues be at the forefront of research to deliver innovative health solutions and advance the prevention and treatment of diseases that threaten people and animals around the world. high vaccination rates is necessary. A combination of strategies implemented with the goal of maintaining high vaccination rates should be aimed at both providers and the public. Vaccines: Alignment with quality measure goals Vaccination is closely aligned with quality goals. A number of organizations develop metrics to measure and evaluate qual- ity, and an even larger number of organizations collect mea- sures for the purpose of evaluating and reporting on the per- formance of providers. The Medicare Shared Savings Program and the Healthcare Effectiveness Data and Information Set (HE- DIS®), which 90% of private health plans use, are among quality improvement drivers that contain a vaccine component. Health systems and providers can use evidence-based stan- dards to assess the quality of their vaccination programs. Standards for adult vaccination were approved by the Na- tional Vaccine Advisory Committee in 2013 and are support- ed by the CDC, as well as a number of national medical asso- ciations. All healthcare professionals — whether they provide vaccination services or not — should follow these standards to ensure eligible adult patients are vaccinated against po- tentially serious diseases. ProMedica, a nonprofit health system serving northwest Ohio and southeast Michigan, is an example of a system that used a team-based approach to vaccination improvement by involving providers across disciplines. Vaccines are promoted through- out the system's physician groups, pharmacies, and clinics. According to Dee Ann Bialecki-Haase, MD, director of medical operations for ProMedica. "[Vaccination] is really about helping to protect the health of the most vulnerable members of our communities, which is where true population health manage- ment at a health system level comes in." "We're really all in this together, to do this and deliver quality care to patients, regardless of where [they are] in our system," said Dr Bialecki-Haase. Hospital-wide efforts to improve vaccination rates can be imple- mented with great success, as evidenced in a study published in Pediatrics in 2015. The study documents a vaccination ini- tiative launched at Children's Hospital of Philadelphia (CHOP). The CHOP initiative consisted of 5 components: • Vaccination education for patients' families, including the distribution of handouts on the influenza vaccine in clinic waiting rooms. • Dissemination of daily lists of patients due for vaccination to frontline providers. • Use of colored wristbands to alert providers of a patient's vaccination status. • Integration of vaccine orders into inpatient admission orders. • Education for providers on patient screening, vaccine or- dering and dosing, documentation of vaccine refusal, and contraindications precluding vaccination. CHOP's vaccination initiative boosted influenza vaccination rates among patients receiving chemotherapy by 20.1% to 64.5% over a 2-year period (2011–2013). A call to action Lack of information, as well as misinformation, can cause pa- tients to delay or skip certain vaccines altogether, which may increase their risk for vaccine-preventable diseases. Hospitals are often pillars in the communities they serve; they are uniquely positioned not only to treat patients for acute health issues, but also to engage and educate community members about health and wellness. Many hospitals and health systems are committed to patient education, including topics such as vaccination. Administrative commitment is essential for the successful im- plementation of a vaccination program. Leadership is critical in effective implementation of innovation in organizations, partic- ularly in health care. According to HHS' National Vaccine Advisory Committee stan- dards published in 2014 in Public Health Reports, keys to suc- cessful vaccination initiatives include: • Emphasizing the importance of vaccination during patient encounters • Strongly recommending all vaccinations patients need • Providing recommended vaccines at the time of patient visit • Ensuring employees are up to date on their own recom- mended vaccinations • Implementing systems to integrate vaccine assessment into routine outpatient care • Educating patients about vaccines using understandable language • Utilizing vaccination registries Quality Gaps exist between the number of patients who are recommended to receive vaccinations and those who actual- ly receive them. To see real improvement, initiatives across the healthcare system will be required to achieve increased vacci- nation rates in adults. n

• Cover