title: Long-term success with the national health objective for influenza vaccination: an institution-wide model.
abstract: OBJECTIVE
  To assess the long-term effectiveness of an influenza vaccination program.
  
  
  METHODS
  725-bed university-affiliated VA teaching hospital providing care to over 35,000 outpatients.
  
  
  METHODS
  500 randomly selected outpatients were surveyed following each immunization season using a validated, self-administered, postcard questionnaire.
  
  
  METHODS
  The institution-wide program, designed to function automatically and to be independent of physician initiative, emphasizes organizational and patient-oriented educational strategies: 1) a hospital policy allowing nurses to vaccinate without a physician's order; 2) a walk-in flu shot clinic; 3) reminders on clinic progress notes; and 4) an educational mailing to all outpatients. The program was initiated in 1987 and has been maintained for each subsequent immunization season.
  
  
  RESULTS
  The response rate was over 75% for each of the four years in which there were two mailings. The response rate for 1988-1989, in which there were three mailings, was over 85%. Approximately 70% of the respondents were at high risk for influenza and its complications. Vaccination rates for these high-risk outpatients have been sustained at over 58% for each immunization season. The program is well received by the hospital staff and now functions on autopilot each year.
  
  
  CONCLUSIONS
  This highly successful institution-wide influenza vaccination program can be sustained long-term. Elements of this program may help others take advantage of opportunities for influenza prevention.
authors.affiliation: Section of General Internal Medicine, VA Medical Center, Minneapolis, MN 55417.
authors.forename: K L
authors.initials: KL
authors.lastname: Nichol
mesh_terms: D000368:Aged; D001428:Bacterial Vaccines; D006193:Haemophilus influenzae / Q000276:immunology*; D006746:Hospital Bed Capacity, 500 and over; D006787:Hospitals, Veterans / Q000458:organization & administration*; D006801:Humans; D007251:Influenza, Human / Q000517:prevention & control*; D008875:Middle Aged; D008910:Minnesota; D011314:Preventive Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D015397:Program Evaluation; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D001428:Bacterial Vaccines