Community Acquired Pneumonia
Conditions
Keywords
Pneumococcal vaccination rates, ambulatory settings
Brief summary
The purpose of this quality improvement project is to improve the immunization rates of an at-risk adult population seen in an ambulatory healthcare environment, through the use of targeted health education messages regarding pneumococcal immunization. Patients seen in an out-patient pre-surgical testing center will receive 1) a one-page written information sheet that outlines the benefits of pneumococcal immunization and 2) verbal reinforcement of this message, provided by the clinical staff, during the patient's interview. At-risk adult patients (as defined by Centers for Disease Control) seen in an ambulatory healthcare environment (a pre-surgical testing center) will receive a one page, gain-framed message that emphasizes the benefits of pneumococcal vaccinations. This educational material will be reviewed and reinforced by clinical staff during the assessment phase of the clinical visit. Among this group, there will be increased vaccination rate compared with at-risk adult patients who did not receive this communication (prospective vs retrospective data).
Detailed description
The purpose of this project was to improve the immunization rates of an at-risk adult population seen in an ambulatory environment, through the use of targeted and evidence-based health education messages regarding pneumococcal immunization and staff training on the use of gain-framed messaging. We hypothesized that there would be an increase in immunization rates for at-risk adults following implementation of the intervention. The objective of the project was to increase our local immunization rate by 30% (from 20% to 50%) and to provide tools and processes that can be utilized in other ambulatory healthcare settings.
Interventions
OTHERFocused Health Education
A two-phase quality improvement study was designed to modify staff and patient behaviors. The project incorporated evidence-based strategies of staff education, feedback and incentives for performance and patient education. The staff received monthly feedback on departmental immunization rates, and incentives for performance. A one-page patient education flyer, written at 3rd grade reading level, was added to encourage patients to inquire about it.
Sponsors
Merck Sharp & Dohme LLC
Carilion Clinic
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 110 Years
Healthy volunteers
Yes
Inclusion criteria
* Patient seen in out-patient pre-surgical testing center * At-risk adult patient as defined by the Centers for Disease Control (CDC)
Exclusion criteria
* Minors
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Improving Pneumococcal Vaccination Rates Following Focused Health Education of Staff and Patients | 12 Months | Pneumococcal vaccination rates, tracked biweekly, following 1) staff education, audit and feedback of rates and 2) patient education |
Countries
United States
Participant flow
Recruitment details
All patients seen in the presurgical testing center who were eligible were offered the pneumococcal vaccine.
Participants by arm
| Arm | Count |
|---|---|
| Health Education, Audit and Feedback Prospective single group intervention with retrospective control group with no intervention.
Focused Health Education: A two-phase quality improvement study was designed to modify staff and patient behaviors. The project incorporated evidence-based strategies of staff education, feedback and incentives for performance and patient education.
The staff received monthly feedback on departmental immunization rates, and incentives for performance. A one-page patient education flyer, written at 3rd grade reading level, was added to encourage patients to inquire about it. | 2,509 |
| Total | 2,509 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | refused | 1,413 |
Baseline characteristics
| Characteristic | Health Education, Audit and Feedback |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 752 Participants |
| Age, Categorical Between 18 and 65 years | 1757 Participants |
| Age, Continuous | 57 years |
| Region of Enrollment United States | 2509 participants |
| Sex: Female, Male Female | 1531 Participants |
| Sex: Female, Male Male | 978 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 0 / 2,509 |
| serious Total, serious adverse events | 0 / 2,509 |
Outcome results
Primary
Improving Pneumococcal Vaccination Rates Following Focused Health Education of Staff and Patients
Pneumococcal vaccination rates, tracked biweekly, following 1) staff education, audit and feedback of rates and 2) patient education
Time frame: 12 Months
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Health Education, Audit and Feedback | Improving Pneumococcal Vaccination Rates Following Focused Health Education of Staff and Patients | 1096 participants |
Comparison: Prospective data from 12 months were compared to data that had been collected for the previous 12 month period to determine statistical significance and trended outcomes for comparative periods. Patients were screened for eligibility during the first 12 months, and staff and patients received the interventions during the second 12 month period.p-value: <0.000195% CI: [1.65, 1.96]Chi-squared