The Influencer Model & Employee Influenza Vaccination Program Oregon Partnership for Patients Meeting April Huggler & Gretchen Landgraf June 25, 2013
Joint Commission Guy Protect your patients, protect your family, protect yourself
Brainstorming Exercise
What our data told us
2011 Current State OHSU 2011 Employee Flu Vaccine Performance 44% Vaccinated 6% Declination (incl. vaccinated elsewhere) 50% UNKNOWN The Joint Commission National Patient Safety Goal 90% Vaccination Rate by 2020 OR State law prohibits Employee Flu Vaccine Mandate
Goal For the protection of patients, employees, and the community, OHSU aims to achieve an employee influenza vaccination rate of 95% in 2012-2013
Project Expectations One time improvement investment With sustainable interventions for future years High performance standard Effective adherence strategies Clear expectations communicated
Stakeholder Analysis Occupational Health Pharmacy Internal Communications Emergency Department/Nursing Ambulatory Clinic Management Pediatric Nursing Organizational Effectiveness Concierge & Volunteer Services Patient Safety Student Health Schools (SOD, SON, SOM) Human Resources Residents Professional Services Infectious Disease/Infection Prevention & Control
Demand Demonstrate Data/Diagnosis Burning Platform Ideas State Reportable Personnel Ongoing internal data reporting Multiple reporting databases Multiple reportable categories Report to include number vaccinated and location Exemplar programs - Peace Health, WA OHSU success - Family Medicine, CHH Positive deviation/best practices TJC State Health Public and Consumer Groups Infection Prevention and Control Recommendation SEC
Shared Vision More of Units providing vaccinations Unit competition Documented declinations Unit champions Blanket marketing Personal responsibility Leaders out there Employee initiative Magnet movement Data visible to staff Sore arms Resources for Employee Health Going to meetings and committees Pervasive emphasis Less of Procrastination Myths Refusals Lines Deferred responsibility Apathy Absenteeism Nosocomial influenza Harm to patients Risk to patients Missing data Negative publicity
Systems & Structures Systems & Structures Helping Hindering Staffing Flu Team Lack education; culture of safety? Development NEO physician orientation?; educating RN students for vaccination types Measures what is declination?; when is declination measured? Rewards Communications Organizational Design Information Systems Resource Allocation coffee; free vaccine; personal motivation packets to units Org Safety Priority type of incentive; no alternative rewards; no group rewards not enough or "right information"; bad info; frequency of communication; types of communication; teaching hospital - students learning to vaccinate no unit champions; too high tech? slow and laborious process; Alert system integration; reporting declinations at the time of offer; students; tb testing & fit testing
Methodology
Identify Crucial Moments Should I get a flu shot? Where would I get one?
Structural Social Personal Project Team Just in-time Training Motivation Ability Make the undesirable desirable Do I enjoy it? Does it speak to my values? Overinvest in skill building Am I personally able? Harness Peer Pressure Do others motivate? Find Strength in Numbers Do others enable? Design Rewards & Demand Accountability Do things motivate? Change the Environment Do things enable?
6 Reasons Only 44% Got Vaccinated Worth it? Can I? Me Other People Things
Joint Commission Guy Protect your patients, protect your family, protect yourself
Structural Social Personal Applied Interventions Motivation Marketing Messages Protect your patients, protect your family, protect yourself Internal Communication O2 blogs, NNTP, Joint Commission Guy Blue check mark sticker Leadership Support Visibility & Alignment Packet utilization Vaccine & declination rates Unit competition Incentive/Disincentive Strategies Double the café gift card HealthySteps points Recognition Eligibility for Aetna PPO Masking Policy Ability Enable Units to give vaccinations Packets pushed to units More Resources for OH QM assists with data entry & high volume call return Pharmacy & SON for vaccination troops Compliance Data Collection & Reporting Weekly updates to Statit & email updates to managers Strategic Communication Consistent, prolific, educational messaging Vaccination where the people are At high volume meetings Via packets in departments/units Attestation/Declination Forms Distributed earlier in season
Structural Social Personal High Impact Interventions Motivation Ability Protect your patients, protect your family, protect yourself Packets pushed to units Internal compliance reporting and follow-up Incentive/Disincentive Portfolio Availability of vaccination options
Weekly Feedback to Managers
Joint Commission Guy Protect your patients, protect your family, protect yourself
Results Flu Vaccine Rates for all OHSU Branch Employee Count % Compliant % Decline % Reported Allied Health 28 64% 0% 64% Outreach/Public Health 114 61% 6% 67% Facilities 238 61% 12% 73% SON 339 44% 3% 47% SOD 320 68% 6% 74% Support 981 58% 3% 61% SOM 4234 64% 5% 69% Health Care System 6872 81% 11% 92% Research 1057 60% 4% 64% TOTAL 14183 10092 71% 1077 8% 79% Note: Residents reached 95.7% compliance!
Evaluation and Sustainability Project Evaluation Manager survey Improvement team workshop Proposal and project action plan Formal handoff to Occupational Health Flu Season 13-14 planning well underway
Questions? Thank you