title: A quality improvement initiative to increase pneumococcal vaccination coverage among children after kidney transplant.
abstract: Pneumococcal vaccination rates among children receiving a kidney transplant remain suboptimal. Current practice guidelines in the United States recommend giving the PPSV23 after priming with the PCV13. We conducted a QI initiative to increase pneumococcal vaccine rates in our kidney transplant recipients by developing an age-based vaccine algorithm, obtaining vaccine records, and generating reminders for patients and clinicians. A monthly report from the EHR tracked outcomes. The process metric was missed vaccine opportunities, and the overall objective was to improve coverage with both the PCV13 and PPSV23. Over the first six months, we increased the percentage of visits where the vaccine was given from a baseline of 4% to 33%. However, by the end of the 12-month period, the percentage of eligible visits where the vaccine was given decreased to 8.7%. Nevertheless, over the 12-month observation period, we were able to increase the percentage of transplant patients receiving the PCV13 and PPSV23 from 6% to 52%. Utilizing an age-based algorithm and the electronic medical record, vaccine champions can track both missed visit opportunities and the number of vaccinated patients to improve pneumococcal immunization coverage for these high-risk patients.
authors.affiliation: Division of Nephrology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.|Research Institute, Children's Hospital Colorado, Aurora, CO, USA.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Malone
authors.affiliation: Division of Nephrology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Clark
authors.affiliation: Division of Nephrology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Jo Ann
authors.initials: JA
authors.lastname: Palmer
authors.affiliation: Division of Nephrology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Sonya
authors.initials: S
authors.lastname: Lopez
authors.affiliation: Division of Nephrology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Madhura
authors.initials: M
authors.lastname: Pradhan
authors.affiliation: Division of Nephrology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Furth
authors.affiliation: Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Kim
authors.affiliation: Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Fisher
authors.affiliation: Division of Nephrology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Laskin
mesh_terms: D000293:Adolescent; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D057286:Electronic Health Records; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006776:Hospitals, Pediatric / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D016030:Kidney Transplantation; D010349:Patient Compliance / Q000706:statistics & numerical data*; D015143:Philadelphia; D022242:Pneumococcal Vaccines; D011182:Postoperative Care; D017410:Practice Guidelines as Topic; D058996:Quality Improvement / Q000458:organization & administration* / Q000706:statistics & numerical data; D017010:Reminder Systems; D012189:Retrospective Studies; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D022242:Pneumococcal Vaccines
keywords: children; infection; kidney transplant; vaccine