729. Impact of a quality improvement initiative to increase vaccination of patients at high risk of influenza complications at a pediatric hospital
Session: Poster Abstract Session: Vaccines: Improving Delivery
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • 729_IDWPOSTER.pdf (1.4 MB)
  • Background: An enterprise-wide comprehensive quality improvement (QI) initiative was undertaken at Lurie Children’s (LC) to improve influenza vaccination coverage during the 2015-16 season. Methods:  The QI initiative included: leveraging the electronic medical record (EMR) to proactively identify children as being at high risk per CDC criteria; using EMR best practice advisories to consistently remind providers to vaccinate, staging the reminders to focus on high-risk children early in the season when vaccine inventory is limited, and capturing reasons for non-vaccination; and engaging pediatric subspecialties in the vaccination program to capture high-risk children. The impact was evaluated in terms of the frequency and timing of vaccination, the subspecialty clinic associated with the doses administered, coverage of high-risk patients, and characteristics of influenza-associated pediatric intensive care unit (PICU) admissions. Results: Influenza vaccine dose administrations associated with LC encounters increased 35%, from 5,979 in 2014-15 to 8,059 in 2015-16 (Figure 1). Among patients flagged as high risk who were age-eligible in both seasons, the increase was 83% (from 1,451 to 2,650). In 2015-16, doses were administered to high-risk patients with higher frequency and earlier in the season (Figure 2). A greater number of doses were administered in 2015-16 in the subspecialties where the intervention was in place throughout the season (Figure 3). Among high-risk patients with at least one visit to these subspecialties or LC primary care during the season, 64% had vaccination documented in the EMR (including through patient report) in 2015-16, compared to 51% in 2014-15. In 2014-15 there were 30 PICU admissions associated with laboratory-confirmed influenza infection, and 12 (40%) of these had an LC encounter earlier in the season that represented a missed opportunity for vaccination. In 2015-16, 3 of the 18 (17%) influenza-related PICU admissions represented a missed opportunity. Conclusion: Compared to the previous season, implementation of the QI initiative was associated with higher numbers of vaccinations and coverage rates, and a lower rate of missed opportunities among patients admitted to the PICU.

    Roderick Jones, MPH, Data Analytics and Reporting, ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO, CHICAGO, IL, Larry Kociolek, MD, Pediatric Infectious Diseases, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, Anne Bobb, RPh, Clinical Quality Excellence, ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO, CHICAGO, IL, Jeremy Hoge, N/A, Center for Excellence, ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO, CHICAGO, IL, Arnold Butiu, MBA, BSN, RN-BC, Ambulatory Services, ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO, Chicago, IL, Lee Budin, MD, Center for Excellence, ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO, Chicago, IL, Michael Kelleher, MD, Chairman's Office, ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO, Chicago, IL and Jenifer Cartland, PhD, Data Analytics and Reporting, ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO, Chicago, IL

    Disclosures:

    R. Jones, None

    L. Kociolek, None

    A. Bobb, None

    J. Hoge, None

    A. Butiu, None

    L. Budin, None

    M. Kelleher, None

    J. Cartland, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.