MACHA Annual Meeting November 6, 2014 Normal, Illinois. Strategies to increase influenza vaccination rates among college students

Transcription

1 MACHA Annual Meeting November 6, 2014 Normal, Illinois Strategies to increase influenza vaccination rates among college students Christie Bellak, MSN, RN Public Health Program Manager Ann Clifton, ANP-BC, MSN, CHES Chief Nursing Officer Wayne State University Detroit, Michigan

2 Program Objectives 1. List 3 strategies to increase influenza vaccination rates among college students 2. Describe how effective EHR utilization can increase clinic staff compliance with assessing flu shot status and offering flu shots to all patients 3. Describe how influenza-like-illness (ILI) surveillance has the potential to be a useful tool in increasing vaccination rates

3 Wayne State University ~27,500 students ~18,300 Undergrad ~3,000 In residence halls/university Apartments Historically commuter school

4 Campus Health Center Wayne State University 2005: Established as a pilot project with grant funding; staff employed by WSU 2008: EHR implemented 2009: Operations transferred to Nursing Practice Corporation (NPC) NPC contracted to provide health care services to students of WSU

5 Background Influenza overview Influenza (flu) can cause serious illness and death, particularly in high risk populations Annual flu vaccination is the best way to prevent flu 1 Based on a study of the flu season, flu vaccination was found to have prevented an estimated 6.6 million illnesses, 3.2 million medically attended illnesses, and 79,260 hospitalizations. 2 CDC recommendations: All persons >6 months of age; especially high risk groups

6 Background Flu vaccine rates, CDC, season: years (High risk = 38.7) (Not at high risk = 31.1) Importance of vaccinating college students

7 Influenza vaccine has been associated with substantial reductions in ILI and ILI-associated healthcare use and impairment of school performance among college students. College students can experience substantial benefits from influenza vaccinations. (4)

8 Correlation of reported Flu Vaccination rates and ILI among college students* 50% 45% 40% 35% 30% 25% 20% Flu Shot FluShotAve Sick SickAve 15% 10% novel H1N1 5% 0% FA 2008 SP 2009 FA 2009 SP 2010 FA 2010 SP 2011 FA 2011 SP 2012 FA 2012 SP 2013 *NCHA Data Fall 2008-Spring 2013 (5)

9 CHC Flu Shots by Academic Year # doses H1N1 pandemic

10 How did we do it? Streamline Clinic Work Flow Effective EHR utilization Marketing Education Increase accessibility Expand outreach efforts University partnerships

11 Streamline Clinic Work Flow Front office staff Inquire about flu shot interest at check in MA s Screen for flu shot status at triage Standing orders to administer flu shot Providers Encourage/educate about flu shot at every visit

12 Flu Shot Administration Location Monthly % 90% 80% 70% 60% % doses given 50% 40% 30% 20% 10% 0% Aug Sept Oct Nov Dec Jan Feb March April May June CHC Appt CHC walk in Outreach

13 Effective EHR utilization Custom Flu form EHR reports EHR manager

14 Every patient, Every visit

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16 Marketing & Education CHC website Social Media Signage on campus LCD Screens on campus Signage at CHC Department and university s

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21 Increase accessibility No out-of-pocket charge for students Walk-in hours Flu Shot appointments Outreach walk in Outreach Special Clinics Pre-registration option

22 Location, Location, Location! Undergrad Library College of Education Old Main

23 Student Center Social Work Int l Students Bldg

24 Physician Assistants Med School

25 Expanded outreach and University partnerships Multiple campus buildings Special clinics for academic programs and student groups (e.g. Medicine, Nursing, athletics, etc) Inter-professional Collaboration Online group clinic request form Dean of Students Utilize student volunteers

26 Student Volunteers Pharmacy Nursing Inter-Professional Collaboration

27 Flu Shots by College # dosess Med Nurs Lib Al. Arts Eng Heal th Int'l Edu Oth Fac/ St Com Bus Law SW # doses

28 Surveillance Prevent ILI outbreaks in dorms Decreased incidence of ILI (Influenza-like illness) among WSU students Use info for marketing & education to increase students knowledge of influenza/ili and prevention strategies Increase proportion of WSU students vaccinated against influenza annually Internal Surveillance Michigan ILI Network

29 Surveillance Data Collected Total number of patient visits each week Weekly counts of the total number of patient visits with influenza-like illness* (ILI) Temp. >100 C AND: Cough or sore throat Respiratory specimens from a sample of patients with influenza-like illness for respiratory virus culture sent to state lab

30 References (1) CDC. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices--United States, MMWR Recomm Rep 2013;62:1-43. (2) CDC. Estimated influenza illnesses and hospitalizations averted by influenza vaccination-united States, influenza season. MMWR Morb Mortal Wkly Rep 2013;62: (3) CDC, Flu Vaccination Coverage, United States, Influenza Season, (4) Nicol, K.L., D Heilly, S., Ehlinger, E.P. (2008). (12), Arch Pediatr Adolescent Med, 162 (5) National College Health Association Data,

31 The Fab Four!

32 Christie Bellak, MSN, RN Ann Clifton, ANP-BC, MSN, CHES Health.wayne.edu