The effect of additional shots on the vaccine administration process: results of a time-motion study in 2 settings.
BACKGROUND
The introduction of combination vaccines to the pediatric regimen offers the possibility of reducing the number of injections required to reach full vaccination status. Fewer injections benefit the patient/child and the parent/caregiver, and the healthcare provider may benefit from savings in personnel time associated with vaccine administration. To date, however, these savings have not been quantified.


OBJECTIVE
To study the vaccine administration process in a managed care environment.


METHODS
We studied 2 settings in which vaccinations were administered: (1) a devoted injection room and (2) the examination room as part of the well-child examination. For each setting, we documented the vaccine administration process, identified vaccine-related activities, and quantified the time savings in each activity by reductions in the number of shots.


METHODS
For vaccine recipients younger than 2 years, time-motion data on vaccine-related activities in 2 managed care settings were collected by a professional industrial engineering consultant. Activity time data by the number of shots administered were analyzed using linear regression adjusting for patient age.


RESULTS
We observed 276 vaccination visits (137 in an examination room, and 139 in an injection room). Total nurse time associated with vaccine administration decreased by 2.4 and 1.7 minutes per shot eliminated in the examination room setting (P = .006) and in the injection room setting (P < .001), respectively. Significant time savings were realized for activities associated with vaccine preparation, vaccine injection, and administrative duties. In addition, infant crying time decreased by 1.0 and 0.4 minutes per shot eliminated in the examination room and injection room settings, respectively (P < or = .001 for both).


CONCLUSIONS
Significant reductions in vaccine administration time could be achieved by eliminating injections during a well-child regimen.
Pellissier
J M
JM
Merck Research Laboratories, Blue Bell, PA 19422, USA. james_pellissier@merck.com
Coplan
P M
PM
Jackson
L A
LA
May
J E
JE
D002662:Child Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D003448:Crying; D004334:Drug Administration Schedule; D006801:Humans; D007223:Infant; D008329:Managed Care Programs / Q000458:organization & administration / Q000706:statistics & numerical data*; D009739:Nursing Services / Q000458:organization & administration / Q000706:statistics & numerical data; D009819:Office Visits / Q000706:statistics & numerical data*; D017064:Process Assessment, Health Care; D013996:Time and Motion Studies; D014611:Vaccination / Q000706:statistics & numerical data*; D017778:Vaccines, Combined
D017778:Vaccines, Combined