title: Automated Screening of Hospitalized Children for Influenza Vaccination.
abstract: BACKGROUND
  This study was designed to determine whether an automated hospital-based influenza vaccination screening program leveraging the electronic medical record (EMR) increases vaccination rates.
  
  
  METHODS
  We performed a retrospective cohort study of all children ≥6 months old admitted to medical, surgical, rehabilitation, or psychiatry services during influenza seasons between 2003 and 2012 at a tertiary care pediatric hospital. We compared influenza vaccination rates before (preintervention phase) and after (intervention phase) the introduction of an automated EMR intervention that utilized a nursing-based electronic screening tool to determine eligibility for influenza vaccine and facilitated vaccine ordering without requiring involvement of a physician or other provider.
  
  
  RESULTS
  Overall, 42 716 (72.8%) of the 58,648 subjects admitted during the study period met inclusion criteria. The intervention phase included 20,651 admissions, of which 11 194 (54.2%) were screened. Screening increased significantly over time in the intervention phase (19.8%-77.1%; P < .001). In-hospital influenza vaccination rates increased from a mean of 2.1% (n = 472) of all subjects preintervention phase to 8.0% (n = 1645) in the intervention phase (odds ratio = 6.8; 95% confidence interval, 6.14-7.47). Of the 11 194 screened subjects, 5505 (49.2%) were found to have already been vaccinated at the time of screening. The screening process identified 478 (4.3%) subjects who were unable to receive vaccine for medical reasons, and an additional 2865 (25.6%) whose caregiver refused the vaccine.
  
  
  CONCLUSIONS
  An automated, hospital-based influenza vaccination program integrated into the EMR can increase vaccinations of hospitalized patients and provide insight into the vaccination history and declination reasons for children not receiving the vaccine.
authors.affiliation: Division of Nephrology, and Department of Pediatrics, University of Washington School of Medicine ari.pollack@seattlechildrens.org.
authors.forename: Ari H
authors.initials: AH
authors.lastname: Pollack
authors.affiliation: Division Infectious Diseases, Seattle Children's Hospital Department of Pediatrics, University of Washington School of Medicine.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Kronman
authors.affiliation: Department of Pediatrics, University of Washington School of Medicine Division of General Pediatrics, Seattle Children's Hospital, Washington.
authors.forename: Chuan
authors.initials: C
authors.lastname: Zhou
authors.affiliation: Division Infectious Diseases, Seattle Children's Hospital Department of Pediatrics, University of Washington School of Medicine.
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Zerr
keywords: electronic records; hospitalization; influenza; pediatric; vaccines