Ochsner Health System Adult Immunization Collaborative Group 2 Webinar Update

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1 Ochsner Health System Adult Immunization Collaborative Group 2 Webinar Update Tuesday, November 14, 2018

2 Since we last spoke Increased provider, staff and pharmacy awareness and knowledge through vaccine education NIAM held ~20 individual educational sessions at ambulatory clinics around the System on OHS targeted vaccines Pneumonia-specific educational sessions Improved Retail/Community Pharmacy access Creation of Pharmacist-specific order mode in EHR to allow Retail Pharmacists to enter vaccine orders for all ACIP allowed vaccines in the state of LA without a provider order Reconciliation from LINKS into EHR for Pharmacists and Pharmacy Technicians now possible Increased awareness in Pharmacy to vaccinate (now have immunization goal) NIAM: provided vaccine education to more than 130 nurses, providers and pharmacists Updated nursing WOGs Continuing to create partnerships for educating staff and vaccinating patients Performance dashboard 2

3 Improvement Interventions Education Continuing to focus on education with nursing and pharmacists to ensure they have the foundation for ACIP recommendations, ADRs, and CIs in order to assess and make strong recommendations for vaccination Access Updates in EHR that gave Retail Pharmacist their own order mode to vaccinate within the Retail Pharmacy Update in EHR that gave Retail Pharmacist security access needed to reconcile immunizations from LINKS into EHR. Update in EHR that gave Pharmacy Technicians security access needed to utilize the HM screen and ability to reconcile immunizations from LINKS into EHR. Plans to utilize claims data to close care gaps in EHR including immunizations. Quality Dashboard Completion of dashboard where adult ambulatory providers can now see their performance metric for immunizations. 3

4 Outcomes Immunization awareness and knowledge has increased. Immunization administration has increased. Retail Pharmacy has vaccinated ~1000 patients against pneumonia and ~4000 patients against the flu so far in 2017! All four immunization measures have improved. Flu baseline: 25% Flu Qtr 3: 55% PNA 65yo baseline: 72% PNA 65yo Qtr 3: 76% PNA 19-64yo w/high-risk conditions baseline: 34% PNA 19-64yo w/high-risk conditions Qtr 3: 42% PNA 19-64yo w/at-risk conditions baseline: 26% PNA 19-64yo w/at-risk conditions Qtr 3: 37% System employee influenza rate currently: 75.14% (deadline Dec 1 st ) 4

5 Challenges Have you experienced any challenges or barriers thus far? YES!!! What are your biggest challenges? We re a very large System and fostering new ownerships/partnerships everyday (seems like everyday) which has either caused us to miss some locations in the education or have to circle back to complete education in new facilities. Clinic make-up of MAs versus RNs/LPNs. Continuing to focus on the other 3 vaccines that we have targeted as well. Lack of access in retail pharmacy we didn t know they couldn t reconcile! Pharmacy Technician access required higher-up approval before being granted. 5

6 Celebrating Accomplishments Availability of immunization dashboard for performance by clinic/provider/region. Retail Pharmacy access in EHR and partnership to vaccinate. ~5000 patients vaccinated in the OHS retail pharmacies!!! Increasing immunization rates across all measures as well as additional vaccines. Increased awareness of Vaccine Subcommittee, WOG and vaccine knowledge. 6

7 Lessons Learned It s a process be patient, try not to get frustrated or discouraged. It takes time to get changes approved/implemented, to see rates move. Support and encouragement will come in waves from various personnel. Pick your battles (for change) you won t win all of them! It s okay to step back and take a break from it all! Each week you learn something new that s not working how you expected! Change what you can; the rest can wait! Share your story with others! You d be surprised in who might have resources to help to improve your population health! 7

8 Next Steps Continue to partner with retail pharmacy to vaccinate patients in the retail setting. Continue to provide vaccine education to staff to increase confidence and awareness. Pilot an immunization station in ambulatory setting that provides a central location for patients to be vaccinated for all immunizations. 8

9 Questions Has anyone who utilizes a State Immunization Registry with their EHR (Epic) found a way to automate immunization record update from IIS into their EHR? Currently this is a manual process that has to be executed when you are in the patient record. Anyone utilizing an immunization station to vaccinate patients outside of the clinic? How is it working for you? Challenges? Are you using TransactRx? Any successful partnerships with chain retail pharmacies to vaccinate patients? 9