National Influenza Vaccination Week is December 4-10, 2016
by Lilliam R. Gomez, RN-BC, BSN, CPHQ, and Laurel E. Martin, RN, BSHCA, COS-C, First Choice Home Health, Inc., Boynton Beach, FL
The leadership and quality teams at First Choice Home Health, Inc. utilize evidence-based practices to improve disease management and ultimately our quality indicators including immunization rates. We are always updating our disease management programs to continue to improve the health and welfare of the patient populations. The Centers for Disease Control and Prevention (CDC) indicates that patients with heart disease are at a higher risk for serious complications from influenza (CDC, 2016) and/or pneumonia (CDC, 2016). Therefore we have integrated immunization into our pneumonia and heart failure disease management programs.
Data drives quality improvement! The immunization data reports from the Home Health Quality Improvement National Campaign (HHQI), CASPER and Home Health Compare are reviewed regularly for trending and progress towards improvement. We review our organization’s CASPER data reports, including tally reports, and utilize spreadsheets and graphs to disseminate the findings to all personnel at monthly staff meetings. In addition, all data is posted in key areas of the organization. The quality team reviews the ongoing CDC listserv for updates, current state influenza status, and the Morbidity and Mortality Weekly Report (MMWR).
Our quality team utilizes national resources from the CDC, HHQI, Joint Commission, CHAP and ACHC. Clinicians screen and educate all patients with heart failure about influenza and pneumoccocal immunizations. Specific patient education materials are available with the pneumonia and heart failure disease management programs. We provide regular clinician education and offer patient immunization and infection control pamphlets and resources at our monthly staff meetings. The Nursing Track from the HHQI Immunization & Infection Prevention Best Practice Intervention Package (BPIP) is provided to all nurses as part of their clinical education materials.
First Choice Home Health also works on improving staff influenza vaccination rates. The monthly staff meeting’s attendance form includes a checkbox to indicate if any staff member has had their influenza vaccination. There is a follow-up process to validate immunization or a declination of vaccination form. This process is also included in the orientation of all new staff.
Our agency is also participating in HHQI’s Home Health Cardiovascular Data Registry (HHCDR) which aligns with reducing risk of cardiovascular events. We are collecting data on:
- Ischemic Vascular Disease: Use of Aspirin or Another Antithrombotic
- Hypertension: Controlling High Blood Pressure
- Tobacco Use: Screening and Cessation
We are very proud to have achieved HHQI’s Cardio Milestone 4 and are currently working toward Milestone 5. Currently, only one other home health agency in the country has completed the fifth milestone.
Our efforts to improve immunizations for patients and staff have affected our publicly reported rates on Home Health Compare. First Choice Home Health, Inc. currently has a 4-star Quality of Patient Care Star Rating which includes influenza immunization rates and a 5-star Patient Surveys Star Rating. We are also in one of the nine states implementing the Home Health Value-Based Purchasing (HHVBP) model which includes both influenza rates for patients and for home health care personnel. We feel the leadership’s support for quality improvement including immunizations and the quality foundation we have created aligns us well for the first year of HHVBP.
Consistency is another key to our success. We stay focused on our quality work, integrate it into daily practice, and monitor our performance by conducting chart audits monthly and reviewing our data and progress at monthly staff meetings. We also see the value of keeping our cardiovascular patients current with their immunizations to improve their lives.
Leadership commitment and teamwork is a must, and First Choice has both!