Carrots and Sticks: Achieving High Healthcare Personnel Influenza Vaccination Rates without a Mandate
Carrots and Sticks: Achieving High Healthcare Personnel Influenza Vaccination Rates without a Mandate
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DOI：
10.1017/ice.2015.47
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发表时间：
2015-06-01
影响因子：
4.5
通讯作者：
Schwartz, J. Sanford
中科院分区：
文献类型：
--
作者：
Drees, Marci;Wroten, Kathleen;Schwartz, J. Sanford
OBJECTIVE.实现高的医疗保健人员（HCP）流感疫苗接种率通常需要强制接种疫苗，这往往是具有挑战性的实施。我们的目标是在没有强制要求的情况下实现>90%的员工接种流感疫苗。前瞻性质量改进计划的制定和参与者。所有员工的2医院，1,100张病床，以社区为基础的学术医疗保健系统。多模式HCP疫苗接种活动包括强制性的decompensation政策，未接种疫苗的HCP佩戴口罩，高度可见的“我接种了疫苗”悬挂徽章，改进的疫苗接种跟踪，每周向经理和副总裁提交合规报告，对不合规HCP的纪律措施，设施入口处的疫苗接种站，并在年度员工奖金计划中纳入目标员工疫苗接种率（> 75%）指标。该运动在2011-2012年流感季节实施，并在2012-2013年至2014-2015年流感季节持续开展。计算员工依从性、疫苗接种率、豁免率和减少率，并与干预前的季节进行比较。与干预前3年57%-72%的疫苗接种率相比，员工流感疫苗接种率在第1年增加到92%，在第2-4年增加到93%（P
OBJECTIVE. Achieving high healthcare personnel (HCP) influenza vaccination rates has typically required mandating vaccination, which is often challenging to implement. Our objective was to achieve >90% employee influenza vaccination without a mandate.DESIGN. Prospective quality improvement initiative setting and participants. All employees of a 2-hospital, 1,100-bed, community-based academic healthcare system.METHODS. The multimodal HCP vaccination campaign consisted of a mandatory declination policy, mask-wearing for non-vaccinated HCP, highly visible "I'm vaccinated" hanging badges, improved vaccination tracking, weekly compliance reports to managers and vice presidents, disciplinary measures for noncompliant HCP, vaccination stations at facility entrances, and inclusion of a target employee vaccination rate (> 75%) metric in the annual employee bonus program. The campaign was implemented in the 2011-2012 influenza season and continued throughout the 2012-2013 through 2014-2015 influenza seasons. Employee compliance, vaccination, exemption and declination rates were calculated and compared with those of the seasons prior to the intervention.RESULTS. Compared with vaccination rates of 57%-72% in the 3 years preceding the intervention, employee influenza vaccination increased to 92% in year 1 and 93% in years 2-4 (P