Improving respiratory vaccination rates in veterans with spinal cord injury/disorders: lessons learned.
The burden of respiratory disease following a spinal cord injury/disorder (SCI/D) is well-described and experienced by patients, families, health care providers, and the health care delivery system. Despite the effectiveness of respiratory vaccinations (influenza and pneumococcal), vaccination rates in this population have been historically low. The Veterans Health Administration (VHA) Spinal Cord Injury Quality Enhancement Research Initiative (QUERI) developed a program to increase vaccination rates for veterans with SCI/D. Patient, provider, and system-level strategies were used. The purpose of the study was to improve vaccination rates in this population using multiple strategies. The result was significant improvement in vaccination rates following intervention. This paper describes the lessons learned in implementing best practices for vaccination. In addition, the basic elements of this program, and the similarities with the Chronic Care Model, are described.
Weaver
Frances M
FM
Midwest Center for Health Services & Policy Research, Hines Veterans Affairs Hospital, Chicago, Illinois, USA.
Goldstein
Barry
B
Hammond
Margaret
M
D019985:Benchmarking / Q000458:organization & administration; D002908:Chronic Disease; D020000:Decision Support Systems, Clinical / Q000458:organization & administration; D019468:Disease Management; D006801:Humans; D007251:Influenza, Human / Q000209:etiology / Q000517:prevention & control; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D017146:Models, Organizational; D020380:Needs Assessment / Q000458:organization & administration; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D011018:Pneumonia, Pneumococcal / Q000209:etiology / Q000517:prevention & control; D012042:Registries; D017010:Reminder Systems; D012141:Respiratory Tract Infections / Q000209:etiology / Q000517:prevention & control*; D012307:Risk Factors; D012648:Self Care; D012944:Social Support; D013119:Spinal Cord Injuries / Q000150:complications / Q000523:psychology; D017749:Total Quality Management / Q000458:organization & administration*; D014481:United States; D014493:United States Department of Veterans Affairs / Q000458:organization & administration*; D014611:Vaccination / Q000523:psychology / Q000592:standards / Q000706:statistics & numerical data; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data