Becker's Hospital Review

28 Executive Briefing Sponsored by: Population Health Management: Geisinger's Focus on Vaccination SPONSORED BY: Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., has paid for and provided editorial input on this material. H istorically, hospitals have been destinations for acute medical care. Hospitals can have influence through their roles as respected organizations and large employers within their communities. Guided by growing evidence that much of one's health can be attributed to nonmedical determinants such as social, behavioral, and environmental factors, some hospitals are taking a broad population health stance. They can use their leadership expertise to act as catalysts, working with community organizations and public health departments to improve the health of their communities. Geisinger Health System, based in Danville, Pennsylvania, is representative of this shift. The system is committed to innovative, patient-centered care approaches. Geisinger serves more than 3 million residents throughout 45 counties in central, southcentral and northeast Pennsylvania and in southern New Jersey. In 1996, Geisinger implemented an Electronic Health Record (EHR) system. In January 2017, the health system announced its newest population health initiative, dubbed Springboard Health. The program focuses on improving the health of the Scranton community by coordinating and collaborating with local stakeholders to help manage and alleviate chronic medical conditions and eliminate preventable cancers, and look to address the socioeconomic health of the community. "We want to transform health care at its core by focusing on preventive care, behavioral health, and economic growth," said David Feinberg, MD, MBA, Ppresident and CEO of Geisinger Health System. Geisinger's approach to vaccination is indicative of the organization's commitment to preventive care, population health management, and patient-centered care. "We believe strongly that successful vaccination programs are the most important way to help protect our community from many communicable diseases," said Lisa Esolen, MD, FIDSA Medical Director, Infection Prevention Medical Director, Occupational Health Assistant Chief, Quality & Patient Safety, Geisinger Health System. "Indeed, vaccinations have had a significant impact in our society over the past 100 years. Accordingly, it has long been a priority for our health system, as for all quality health systems, to organize and coordinate effective vaccination programs." Adult vaccination coverage remains low for most routinely recommended vaccines and well below Healthy People 2020 targets. For example, in 2012, just 64.2% of American adults between 19 and 49 years of age were up to date on their tetanus vaccination, according to the Centers for Disease Control and Prevention (CDC). These findings highlight the importance of emphasizing efforts to boost vaccination rates among patient populations. At Geisinger, these efforts began with leadership. In 2016, Geisinger's strategies to boost vaccination rates helped the system meet Healthy People 2020 goals for all adult and adolescent vaccinations recommended by the Advisory Committee on Immunization Practices (ACIP). Empower vaccine champions Leadership support is an essential component of the Geisinger approach to vaccination. At the onset of the system's vaccination improvement initiative, leaders established a multidisciplinary vaccine committee. The committee was tasked with assessing the system's vaccination processes and rates, identifying potential roadblocks that could hinder efforts to improve vaccination rates and creating the support to achieve the goals of the initiative. The vaccine committee at the system is jointly sponsored by Amy Howell, MD, Geisinger's Community of Practice Service Line (CPSL) Bundle Leader, and Michael Ashton, MD, Geisinger's director of performance improvement. "We set goals for vaccination rates that initially seemed out of reach, but a team approach and constant diligence to improving our processes has brought great success," said Dr. Howell. Another key element of the system's approach is appointing and empowering a vaccine champion at each clinical site. Having a local, designated vaccine champion at each clinical site helps build support for the initiative and allows for the standardization of vaccine processes. These champions are tasked with identifying barriers to vaccination, monitoring vaccine errors, managing inventory, serving as vaccine advocates, and supporting system wide strategies to increase vaccination rates. "Our nurse vaccine champions do a tremendous job in coordinating our vaccination efforts at each site," said Dr. Ashton. "Our vaccine distribution and storage is more efficient, and our staff and patients are better informed because of the work they do."

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