title: A group-randomized evaluation of a quality improvement intervention to improve influenza vaccination rates in dialysis centers.
abstract: BACKGROUND
  Patients with end-stage renal disease (ESRD) are at high risk of complications from influenza, but many dialysis centers report <50% influenza immunization coverage.
  
  
  METHODS
  A group-randomized evaluation of a multicomponent intervention to increase influenza vaccination rates in poorly performing dialysis centers in ESRD Networks 6, 11, and 15.
  
  
  METHODS
  Facilities with the lowest immunization percentages in 2006-2007 were selected from each network and randomly assigned to a standard (n = 39) or intensive intervention (n = 38).
  
  
  METHODS
  Standard intervention included a feedback report with comparison to other centers in their network and educational materials for staff and patients. Intensive-intervention centers also received 3 educational seminars, assistance with and review of center-specific action plans, and monthly monitoring of vaccination plan and rates.
  
  
  RESULTS
  Change in vaccination rate in following year.
  
  
  METHODS
  Dialysis center records of patient vaccination status.
  
  
  RESULTS
  There was an 8.9% (P = 0.04) adjusted mean absolute difference in improvement between intensive- and standard-intervention centers.
  
  
  CONCLUSIONS
  Some vaccinations were self-reported by patients. The vaccination data form does not have an option for patient data unavailable, which may have caused patients without data to be coded as unvaccinated.
  
  
  CONCLUSIONS
  Multicomponent interventions may serve as a successful strategy to increase influenza vaccination rates at poorly performing centers, with a benefit beyond that provided by usual oversight and support.
authors.affiliation: Department of Epidemiology, Emory University, Atlanta, GA 30322, USA. tcbphd2@gmail.com
authors.forename: T Christopher
authors.initials: TC
authors.lastname: Bond
authors.forename: Priti R
authors.initials: PR
authors.lastname: Patel
authors.forename: Jenna
authors.initials: J
authors.lastname: Krisher
authors.forename: Leighann
authors.initials: L
authors.lastname: Sauls
authors.forename: Jan
authors.initials: J
authors.lastname: Deane
authors.forename: Karen
authors.initials: K
authors.lastname: Strott
authors.forename: William
authors.initials: W
authors.lastname: McClellan
mesh_terms: D005260:Female; D006268:Health Facilities; D006801:Humans; D017589:Immunization Programs; D007252:Influenza Vaccines / Q000627:therapeutic use*; D007251:Influenza, Human / Q000517:prevention & control*; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011785:Quality Assurance, Health Care; D006435:Renal Dialysis; D012189:Retrospective Studies
chemical_list: D007252:Influenza Vaccines