title: A statewide system for improving influenza vaccination rates in hospital employees.
abstract: OBJECTIVE
  To describe and report the progress of a provider-initiated approach to increase influenza immunization rates for healthcare workers.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  The State of Iowa.
  
  
  METHODS
  Acute care hospitals in Iowa.
  
  
  METHODS
  Hospitals reported rates of employee influenza vaccination to a provider-based collaborative during 2 influenza seasons (2006-2007 and 2007-2008). Hospital characteristics related to higher vaccination rates were examined.
  
  
  RESULTS
  One hundred (87.0%) of 115 Iowa hospitals and/or health systems participated in season 1; individual hospital vaccination rates ranged from 43.5% to 99.2% (mean, 72.4%; median, 73.1%). In season 2, 115 (100%) of 115 Iowa hospitals and/or health systems participated. Individual hospital vaccination rates ranged from 53.6% to 100% (mean, 79.5%; median, 82.0%). In both seasons, urban and large hospitals had vaccination rates that were 6.3% to 7.6% lower than those of hospitals in other locations. Hospitals that used declination statements had influenza vaccination rates 12.6% higher than hospitals that did not use declination statements in season 2.
  
  
  CONCLUSIONS
  The initial vaccination rates were high for healthcare workers in Iowa, especially in smaller rural hospitals, and rates increased during season 2. The successful voluntary approach for reporting influenza vaccination rates that we describe provides an efficient platform for collecting and disseminating other statewide measures of healthcare quality.
authors.affiliation: Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa 52242, USA.
authors.forename: Philip M
authors.initials: PM
authors.lastname: Polgreen
authors.forename: Linnea A
authors.initials: LA
authors.lastname: Polgreen
authors.forename: Thomas
authors.initials: T
authors.lastname: Evans
authors.forename: Charles
authors.initials: C
authors.lastname: Helms