title: Organizational strategies to improve influenza vaccine delivery. A standing order in a general medicine clinic.
abstract: Educational programs designed to modify physician compliance with influenza vaccination guidelines have yielded only modest improvement. We examined the impact of a standing order on the influenza vaccination rate in a general medicine clinic (GMC). The standing order gave GMC nurses the responsibility to identify and vaccinate high-risk elderly patients. The vaccine order rate in GMC patients seen during the one-month study period in 1986 (n = 97) was compared with the rate in GMC patients from a similar period in 1984 (n = 77) and with the rate in patients seen in three subspecialty clinics during the 1986 study period (n = 106). Comparison patients were vaccinated only by specific physician order. Following the intervention, 79 (81%) of 1986 GMC study patients had vaccination orders, vs 20 (28%) of the 1984 GMC comparison group and 31 (29%) of the 1986 subspecialty clinic comparison group. A simple organizational change consisting of a standing order profoundly improved compliance with vaccination guidelines.
authors.affiliation: Department of Medicine, Minneapolis Veterans Administration Medical Center.
authors.forename: K L
authors.initials: KL
authors.lastname: Margolis
authors.forename: R P
authors.initials: RP
authors.lastname: Lofgren
authors.forename: J E
authors.initials: JE
authors.lastname: Korn
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration*; D000368:Aged; D003695:Delivery of Health Care / Q000592:standards*; D006787:Hospitals, Veterans / Q000458:organization & administration*; D006801:Humans; D007252:Influenza Vaccines; D008910:Minnesota; D009720:Nurse Clinicians; D010349:Patient Compliance; D014611:Vaccination
chemical_list: D007252:Influenza Vaccines