title: Increasing influenza immunization for long-term care facility staff using quality improvement.
abstract: OBJECTIVE
  To improve staff immunization rates for influenza in long-term care facilities (LTCFs).
  
  
  METHODS
  A quality improvement project.
  
  
  METHODS
  LTCFs ranging in size from 50 to 2,000 beds.
  
  
  METHODS
  Staff members at facilities.
  
  
  METHODS
  Change in staff influenza immunization rate.
  
  
  RESULTS
  Of the 13 nursing homes involved, 11 improved their staff influenza immunization rates; nine improved more than 10%, and six improved to a rate greater than 55%, a level that corresponds to substantial protection against outbreaks. Staff education was essential but insufficient. Direct encouragement and dramatic informative endeavors helped, as did financial incentives, competitions, and requiring unambiguously worded consents for refusals. Paying staff members $150 each achieved improvement rapidly.
  
  
  CONCLUSIONS
  Quality improvement increased staff immunization rates at LTCFs, which reduces the risk of an influenza outbreak. Based on the insights learned about effective changes, the project developed a change package for use by other LTCFs.
authors.affiliation: RAND Health, Arlington, Virginia, USA.
authors.forename: Kelly L
authors.initials: KL
authors.lastname: Sand
authors.forename: Joanne
authors.initials: J
authors.lastname: Lynn
authors.forename: Barbara
authors.initials: B
authors.lastname: Bardenheier
authors.forename: Hsien
authors.initials: H
authors.lastname: Seow
authors.forename: David A
authors.initials: DA
authors.lastname: Nace
mesh_terms: D000368:Aged; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D004196:Disease Outbreaks / Q000517:prevention & control*; D006266:Health Education / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control*; D007857:Leadership; D009042:Motivation; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010348:Patient Care Team / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care; D014481:United States; D014600:Utilization Review / Q000706:statistics & numerical data
chemical_list: D007252:Influenza Vaccines