Improving Pneumococcal Vaccination Rates in an Ambulatory Pre-surgical Testing Setting
Study Details
Study Description
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).
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
|
N/A |
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.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
---|---|
Other: health education, audit and feedback Focused health education for staff and patients. |
Other: 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.
Other Names:
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Outcome Measures
Primary Outcome Measures
- 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
Eligibility Criteria
Criteria
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
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
---|---|---|---|---|---|
1 | Carilion Clinic | Roanoke | Virginia | United States | 24014 |
Sponsors and Collaborators
- Carilion Clinic
- Merck Sharp & Dohme LLC
Investigators
- Principal Investigator: Rebecca C Clark, PhD, Carilion Clinic
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- Clark_Merck_2.4.2013
Study Results
Participant Flow
Recruitment Details | All patients seen in the presurgical testing center who were eligible were offered the pneumococcal vaccine. |
---|---|
Pre-assignment Detail |
Arm/Group Title | Health Education, Audit and Feedback |
---|---|
Arm/Group Description | 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. |
Period Title: Overall Study | |
STARTED | 2509 |
COMPLETED | 1096 |
NOT COMPLETED | 1413 |
Baseline Characteristics
Arm/Group Title | Health Education, Audit and Feedback |
---|---|
Arm/Group Description | 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. |
Overall Participants | 2509 |
Age (years) [Mean (Full Range) ] | |
Mean (Full Range) [years] |
57
|
Age (Count of Participants) | |
<=18 years |
0
0%
|
Between 18 and 65 years |
1757
70%
|
>=65 years |
752
30%
|
Sex: Female, Male (Count of Participants) | |
Female |
1531
61%
|
Male |
978
39%
|
Region of Enrollment (participants) [Number] | |
United States |
2509
100%
|
Outcome Measures
Title | Improving Pneumococcal Vaccination Rates Following Focused Health Education of Staff and Patients |
---|---|
Description | Pneumococcal vaccination rates, tracked biweekly, following 1) staff education, audit and feedback of rates and 2) patient education |
Time Frame | 12 Months |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title | Health Education, Audit and Feedback |
---|---|
Arm/Group Description | Prospective single group 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 immunizations. |
Measure Participants | 2509 |
Number [participants] |
1096
43.7%
|
Statistical Analysis 1
Statistical Analysis Overview | Comparison Group Selection | Health Education, Audit and Feedback |
---|---|---|
Comments | 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. | |
Type of Statistical Test | Superiority or Other | |
Comments | ||
Statistical Test of Hypothesis | p-Value | <.0001 |
Comments | ||
Method | Chi-squared | |
Comments | ||
Method of Estimation | Estimation Parameter | Odds Ratio (OR) |
Estimated Value | 1.80 | |
Confidence Interval |
(2-Sided) 95% 1.65 to 1.96 |
|
Parameter Dispersion |
Type: Value: |
|
Estimation Comments |
Adverse Events
Time Frame | Time of visit to presurgical center | |
---|---|---|
Adverse Event Reporting Description | ||
Arm/Group Title | Health Education, Audit and Feedback | |
Arm/Group Description | 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. | |
All Cause Mortality |
||
Health Education, Audit and Feedback | ||
Affected / at Risk (%) | # Events | |
Total | / (NaN) | |
Serious Adverse Events |
||
Health Education, Audit and Feedback | ||
Affected / at Risk (%) | # Events | |
Total | 0/2509 (0%) | |
Other (Not Including Serious) Adverse Events |
||
Health Education, Audit and Feedback | ||
Affected / at Risk (%) | # Events | |
Total | 0/2509 (0%) |
Limitations/Caveats
More Information
Certain Agreements
Principal Investigators are NOT employed by the organization sponsoring the study.
There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
Results Point of Contact
Name/Title | Rebecca Culver Clark |
---|---|
Organization | Carilion Clinic |
Phone | 540-588-8184 |
rcclark@carilionclinic.org |
- Clark_Merck_2.4.2013