title: Pneumococcal vaccination process improvement in an acute care setting.
abstract: OBJECTIVE
  Despite the availability of the pneumococcal vaccine since 1977, the vaccine is greatly underutilised. Centers for Medicare and Medicaid Services, The Joint Commission and Healthy People 2010 have all listed the administration of the pneumococcal vaccine before hospital discharge as a standard of care and a quality initiative in the 21st century. SSM St Mary's Health Center chartered a multidisciplinary team to address a disappointing pneumococcal vaccination rate of 34.7% in the first quarter of 2005.
  
  
  METHODS
  The team utilised the improvement model of Plan-Do-Study-Act to implement and monitor process changes. Changes were made to four key steps in the pneumococcal vaccination process: assessment, ordering, obtaining and administering. The team also implemented a concurrent review process. The team tracked the hospital's pneumococcal vaccination rate per the published Centers for Medicare and Medicaid Services and The Joint Commission guidelines.
  
  
  RESULTS
  Over a 2-year period, the vaccination rate of pneumonia patients has improved incrementally from 34.7% and is now consistently greater than 90%.
  
  
  CONCLUSIONS
  Utilising Plan-Do-Study-Act allows for continual improvement of the vaccination process. Multiple cycles are necessary to achieve standardisation and optimal process flow.
authors.affiliation: Department of Pharmacy Practice, St Louis College of Pharmacy, St Louis, Missouri 63110-1088, USA. ayancey@stlcop.edu
authors.forename: Abigail M
authors.initials: AM
authors.lastname: Yancey
authors.forename: Anne B
authors.initials: AB
authors.lastname: Jundt
authors.forename: Kathryn J
authors.initials: KJ
authors.lastname: Nelson
mesh_terms: D014487:Centers for Medicare and Medicaid Services, U.S.; D004636:Emergency Service, Hospital; D019983:Guideline Adherence; D016519:Hospitals, Religious; D006801:Humans; D033183:Interdisciplinary Communication; D008923:Missouri; D019982:Organizational Case Studies; D011008:Pneumococcal Infections / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000627:therapeutic use*; D011785:Quality Assurance, Health Care; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000276:immunology; D014481:United States
chemical_list: D022242:Pneumococcal Vaccines