HPV Call-to-Action SEPTEMBER 13, 2017
Agenda Welcome & Housekeeping Speaker Introductions Increasing HPV Rates in South Dakota- Lexi Pugsley, RN, BSN Sanford Health Comprehensive Cancer HPV Vaccination Grant- Andrea Polkinghorn, BSN, RN CDC Resources & Messaging for the release of the 2016 NIS-Teen Data- Ian Branam Q&A
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Lexi Pugsley is a registered nurse and the Comprehensive Cancer Control Program Coordinator for the South Dakota Department of Health, Office of Chronic Disease Prevention and Health Promotion. The SD Comprehensive Cancer Control Program is a statewide partnership of organizations united in the vision to reduce the burden of cancer on South Dakotans through the promotion and support of collaborative programs and policies for cancer prevention and control.
Andrea Polkinghorn works as a Clinical Services Manager for Sanford Health. She graduated with her bachelors of science in nursing from South Dakota State University in 2007. Her background includes Neonatal Intensive Care, Family Medicine, as well as Health Coaching. Through her current role Andrea is able to educate and support 100 clinics in eastern South Dakota, Northwest Iowa, and southwest Minnesota. She serves as the chair of Sanford s Sioux Falls Region Immunization Workgroup and Vice Chair for the Sioux Falls Area Immunization Coalition in South Dakota.
Ian Branam is a health communication specialist in the National Center for Immunization and Respiratory Diseases (NCIRD) at the Centers for Disease Control and Prevention. Ian has been supporting health communication activities in NCIRD since 2014 and currently works on NCIRD s public affairs team. Ian recently coordinated communication activities around the latest National Immunization Survey-Teen report. Ian earned his master s in journalism and mass communication from the University of Georgia in 2014. Prior to coming to CDC, Ian worked as a freelance health and science writer.
Efforts to Increase HPV Vaccination Coverage Rates in SD Problem: Low HPV Vaccination Coverage Rates Among Adolescents in SD Three-dose HPV vaccine series completion (NIS-Teen) 2013 (revised) 2014 2015 Males ages 13-17 7.7% 23.5% 22.0% Females ages 13-17 40.9% 33.1% 32.4% Solution: Target health systems to implement evidence-based interventions to increase vaccination rates
Increasing HPV Vaccination Rates in South Dakota Approach: Develop a structured Request for Application process to select health system partners to collaborate on HPV vaccination interventions Partners: SD Cancer Prevention and Control Program, SD Cancer Coalition, SD Breast and Cervical Early Detection Program (All Women Count!), and the SD Immunization Program Award Requirements: -Systems level change approach that impacts the permanent organizational culture around HPV vaccination -Demonstrate potential for sustained efforts and lasting impact -Quality improvement team -Funds could not cover vaccine or vaccine administration fees -Monthly and Quarterly Data and Progress Reporting Requirements Evidence-based Intervention Options: -Client Reminder and Recall Systems -Provider Assessment and Feedback -Provider Reminders -Standing Orders -Reducing Structural Barriers -Community Based Interventions (Implemented in Combination) -Someone You Love Screening -Professional Education SD DOH Support: -Funding, practice coach, evaluation support, data feedback
Partner Recruitment Round One: July 1, 2015 - June 30, 2016 1 Applicant: Sanford Health - 7 clinic sites Round Two: July 1, 2016 - June 30, 2017 Continuation Application: Sanford Health 39 clinic sites Round Three: March 1, 2017 - February 28, 2018 2 Applicants: Avera Health and Community Health Care Association of the Black Hills Round Four: (applications closed 9/7/17) October 1, 2017 - September 30, 2018 Expanded eligibility to also include QI orgs, professional orgs, health plans, schools Lessons Learned: Collaborative Partnership Team Approach Data Flexibility
Contact Information: Lexi Pugsley, RN, BSN SD Comprehensive Cancer Control Program Coordinator South Dakota Department of Health P: 605.626.2660 lexi.pugsley@state.sd.us SD Cancer Coalition Website: cancersd.com
Sanford Health Comprehensive Cancer HPV Vaccination Grant Andrea Polkinghorn, BSN, RN Clinical Services Manager
Our organization is a large integrated healthcare delivery system that provides healthcare in nine states and three countries. As an enterprise we have 43 medical centers, 289 clinics, 22 long-term care facilities, 27,000 employees and 1,400 physicians who offer expertise in 80 specialties. Our organization s mission is dedicated to the work of health and healing. Our vision is to improve the human condition through exceptional care, innovation and discovery. Every day, we show that commitment by delivering the highest quality of care to the communities we serve.
Educate Year One June 2015-Mandatory education for all providers and nurses in each Family Medicine Clinic. February 2016 - Second round of education to providers and nursing Year Two June 2016- Mandatory education for providers and nurses at the additional SF region clinics. Merck assisted with vaccine and disease education, framing of the conversation, and supplied reminder resources such as magnets (year 1 only) and a texting program
Reports created to show individual provider and clinic vaccination rates for Tdap, Meningococcal, and HPV Healthy People 2020 goals were shared at each education session and with monthly data Provider Feedback
HPV- Percentage of Completed Series Increased by 16% Increased by 18% Increased by 8%
Adolescent Immunizations Clinic Rates Increased by 10% Increased by 17% Decreased by 24% Increased by 16% Increased by 8%
Client Reminder System Year 1: 1 st Reminder: automated phone call and mailer 2 nd Reminder: automated call 3 rd Reminder: mailer Year 2: Combination of automated phone calls and mailer reminders Series Completion Reminders: Calls by Nursing Staff and Mailed Reminders
Client Reminders Year 1 Year 2 11000 10800 10600 10400 10200 10000 10919 10579 25000 20000 15000 10000 10880 9240 21377 17809 9800 9600 9400 9952 10126 Girls Boys Girls Boys 5000 0 Girls Boys Girls Boys 2769 920 TeleVox Reminders Mailed Reminders Over 41,500 client reminders disseminated TeleVox Reminders Mailed Reminders Nursing Staff Calls for Series Completion 62,995 client reminders disseminated Mailed Reminder for Series Completion
Client Reminders Reminder Phone calls via Nursing Staff- Patients ages 11-17 due for 2nd or 3rd HPV dose Nursing Telephone Call Results: Patients 18-26 Years of Age 37% 19% 45% 6% 20% 74% N=546 N=1,403 Patients who presented for their next HPV dose Patient's who moved away/disconnected phone number/refused additional doses Patient's who've been contacted but remain due Left Message or Patient States They Will Come in For Their Next Dose Up-to-Date Refused or Contraindicated
No Missed Opportunities Culture Every patient, every time Same Way, Same Day Missed Opportunities report created Chart audits for any missed opportunities and feedback provided to clinic providers, nursing, supervisor and director
HPV Vaccine Doses Administered Year 1: 7 Clinic Sites Year 2: 39 Clinic Sites 3500 3000 2986 12000 10000 10234 2500 2000 1500 1507 1479 1554 8000 6000 5049 5185 6883 1000 861 693 4000 3453 3430 500 2000 0 Girls Boys Total Baseline: July 1, 2014-June 30, 2015 Project Period: July 1, 2015-June 30, 2016 0 Girls Boys Total Baseline: July 1, 2015-June 30, 2016 Project Period: July 1, 2016-June 30, 2017
Zero Doses 22% Decrease in Zero Doses 70% 64% Years 1 & 2: 7 Primary Care Clinics 60% 50% 56% 54% 53% 50% 45% 43% 43% 42% 40% 30% 20% 10% 0% 6/30/15: Pt. Denominator 8706 9/30/15: Pt. Denominator 9902 12/31/15: Pt. Denominator 10758 3/31/16: Pt. Denominator 11490 6/30/16: Pt. Denominator 12248 09/30/2016: Pt. Denominator 13,347 12/31/16: Pt. Denominator 14,148 3/31/17: Pt. Denominator 15,044 6/30/17: Pt. Denominator 12,248 % of females and males ages 11-26 with zero doses of the HPV vaccine
Series Completion 15% Increase in Series Completion 45% Years 1 & 2: 7 Primary Care Clinics 40% 35% 30% 25% 20% 25% 26% 27% 30% 32% 34% 36% 38% 40% 15% 10% 5% 0% 6/30/15: Pt. Denominator 8706 9/30/15: Pt. Denominator 9902 12/31/15: Pt. Denominator 10758 3/31/16: Pt. Denominator 11490 6/30/16: Pt. Denominator 12248 09/30/2016: Pt. Denominator 13,347 12/31/16: Pt. Denominator 14,148 3/31/17: Pt. Denominator 15,044 6/30/17: Pt. Denominator 12,248 % of females and males ages 11-26 with series completion of the HPV vaccine
Zero Doses 9% Decrease in Zero Doses 60% 50% % of females and males ages 11-26 with zero doses of the HPV vaccine 54% 54% 48% 46% 45% 40% 30% 20% 10% 0% 6/30/16: Pt. Denominator 35, 737 09/30/2016: Pt. Denominator 38,794 12/31/16: Pt. Denominator 41,743 3/31/17: Pt. Denominator 43,736 6/30/17: Pt. Denominator 46,109 % of females and males ages 11-26 with zero doses of the HPV vaccine
Series Completion 8% Increase in Series Completion Year 2: 39 Clinic Sites 40% 35% 30% 25% 30% 32% 34% 36% 38% 20% 15% 10% 5% 0% 6/30/16: Pt. Denominator 35, 09/30/2016: Pt. Denominator 737 38,794 12/31/16: Pt. Denominator 41,743 3/31/17: Pt. Denominator 43,736 6/30/17: Pt. Denominator 46,109 % of females and males ages 11-26 with series completion of the HPV vaccine
Challenges and Lessons Learned Large number of clinics Patient populations Attribution methodology
Sanford Health HPV Vaccination Implementation Grant Overview During the Two Year Project Period: Over 100,000 client reminders distributed 13,220 doses of HPV vaccine administered 22% and 9% decrease in adolescents with zero doses of HPV vaccine administered 15% and 8% increase in adolescents who have completed the HPV series Hosted Someone You Love: the HPV Epidemic Documentary Screenings at colleges and for thepublic Conducted provider education
Contact Information: Andrea Polkinghorn, BSN, RN Sanford Clinic Clinical Services Manager Office: (605) 404-3903 Cell: (605) 261-2402 Fax: (605) 312-7601 andrea.polkinghorn@sanfordhealth.org
CDC Resources for the Release of the 2016 NIS-Teen Data
Overarching Framing Clinicians have been working hard to protect children from HPV cancers ever since the vaccine was first introduced over 10 years ago, and we are encouraged about the future trends in HPV vaccination. HPV vaccination is protecting against cancer-causing infections even better than we expected. Recent recommendations make it simpler for parents and healthcare professionals to protect children at the earliest age possible. This report shows that most U.S. parents are getting the first dose of HPV vaccine for their child.
Main Messages HPV vaccination prevents cancer. Most U.S. parents are getting the first dose of HPV vaccine for their child. Parents of girls AND boys are protecting their children from cancers caused by HPV infections. The gap in HPV vaccination rates between boys and girls continues to narrow. Although most children are getting their first dose of HPV vaccine, there continues to be many children who are not completing the vaccination series.
Main Messages, continued HPV vaccination coverage is also lower in rural and less urban areas. Those communities could benefit from additional efforts to increase coverage. More states have successfully increased HPV vaccination through focused efforts since 2013. Recent changes to HPV vaccine recommendations mean preventing HPV cancers is easier now than ever before. CDC recommends 11 to 12 year olds get just two doses of HPV vaccine to prevent HPV cancers.
Call to Action Now is the time for parents to protect their children from HPV cancers. Every year that adolescents aren t vaccinated is another year they are left unprotected from cancer-causing infections.
General Tweets #DidYouKnow there s a vaccine that can protect your kids from cancer? Talk to your child s doctor about HPV vaccine at their next appt. Most parents are choosing to get the first dose of HPV vaccine to protect their children from cancers caused by HPV infections. Are your kids protected? 6 in 10 children are getting the 1 st dose of #HPVvaccine. See 6 reasons to get HPV vaccine for your child.
Specific Tweets TWEET: Reason 1 to get #HPVvaccine for your child: HPV is a common virus that infects men and women. TWEET: Reason 2 to get #HPVvaccine for your child: HPV vaccination works.
https://www.cdc.gov/hpv/hcp/vacc-coverage.html
PRETEENVACCINES@CDC.GOV
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