Pennsylvania Health Care Worker Flu Immunization Campaign A Patient Safety

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Pennsylvania Health Care Worker Flu Immunization
CampaignA Patient Safety Employee Health
InitiativeTraining ResourcesCast Study
Module Main Line HealthVersion 1.1June 2011
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Case Study Modules

• Based on interviews with leaders at institutions
  representing best and promising practices
• Focus on common elements of strategy, decision to
  implement programs, internal support and barriers
• Focus on mandatory programs given policy and
  ethics foundations
• Recognition that each institution is unique, but
  overall goal (90 uptake) is patient safety/
  employee safety imperative is same everywhere!

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• Case Study SnapshotMain Line Health
• Main Line Health is suburban Philadelphia's most
  comprehensive healthcare resource, offering a
  full range of medical, surgical, obstetric,
  pediatric, psychiatric and emergency services.
  Forming the core of Main Line Health are four of
  the region's most respected acute care
  hospitalsLankenau, Bryn Mawr, Paoli and
  Riddleas well as one of the nation's premier
  facilities for rehabilitative medicine, Bryn Mawr
  Rehab Hospital. We're especially recognized for
  our cardiac, orthopedic, oncology, rehabilitation
  and women's clinical services. 10,000 employees,
  2,750 physicianshttp//www.mainlinehealth.org/ot
  h/Page.asp?PageIDOTH000030
• Contacts- Constance Cutler, RN, MS, CIC, FSHEA
  Director, Infection Prevention and
• Control, Main Line Health, CutlerC_at_MLHS.ORG
  [phone]
• Patty McBride, RN, MSN, CIC Infection
  Preventionist, Bryn Mawr
• Hospital,  McBrideP_at_MLHS.ORG [phone]

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Case Study SnapshotMain Line Health OverviewAfte
r averaging seasonal vaccine uptake among its
HCWs of about 60 for several years despite
active annual campaigns, Main Line Health adopted
a mandated program for the 2010-11 flu season,
achieving a 99.99 uptake. Seasonal Influenza
Vaccine Uptake Pre-mandate     
       Post-mandate 60                   
99.99
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Case Study SnapshotMain Line Health Program
JustificationPositioned as a patient safety
initiative which involves entire Main Line Health
community including physicians. Program
Details- establishes seasonal flu vaccination as
a condition of employment - impacts all
employees, employed physicians, volunteers,
students, vendors with patient contact
(consent form) - impacts non-employee
professional staff credentialed by medical staff
(privilege suspension) - integrates
medical exemptions (physician letter no allergy
testing) and religious exemptions (letter
from clergy reviewed by outside independent
party (retired judge)) very low incidence rate
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Case Study SnapshotMain Line Health Key
Champion(s)- Main Line Health CEO John Lynch
- drove the initial decision based, in part, on
his experience in Houston with a hospital
flood event act where you can to avoid
disaster- Infection Preventionists/Occupational
health- HR Directors (data sharing with managers
on unit uptake) Best sound bite(s)During formal
campaign and rounding visits to key units, the VP
of Nursing from one hospital encountered senior
maternity nurses Question Are you really
going to fire all of us if we dont get
vaccinated? Answer Yes ladies, we
are. Result They accepted influenza
vaccinations towards the deadline.
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Case Study SnapshotMain Line Health TimelineApri
l-August 2009- Initial consideration of a
mandate programHR Directors meetingH1N1
pandemic and vaccine supply pushes decision off
to next cycle Jan-Feb 2010- Groundwork laid
with legal, HR- Steering Group formed/mandate
decision affirmed CMO, HR, Legal, Patient
Safety, Occupational Health, Nursing, Infectious
Disease) May-June 2010- Review and approvals
by Medical Executive Committee and Board of
Directors- Launch letter to employees from
CEO/CMO Late Dec 2010/early Jan 2011- Formal
campaign window
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• Case Study SnapshotMain Line Health
• Key Strategies/Success Factors- Use of own
  employees (community health nurses) to deliver
• immunizations in the mandate context
• Use of employee intranet to post key program
  content ands help assure
• continuity of messaging across stakeholder
  groups
• Posted base set of 10 Frequently Asked Questions
  (FAQs) which built to
• twenty employees could post new questions
  and get direct response
• Emphasis on physician inclusion in requirement
  increased safety
• perception, etc.
• Moving from paper-based form to badge reader to
  track

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• Case Study SnapshotMain Line Health
• Leadership Team (functions that made it
  happen)The Steering Group pared down to a
  handful of key players who held weekly status
  phone calls, then almost daily calls during the
  last week.  Key players included
• Infection Prevention
• Infectious Diseases
• Occupational Health
• Chief Medical Officer
• Human Resources Director
• others as necessary

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Case Study SnapshotMain Line Health
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• Case Study SnapshotMain Line Health
• Key Resources on website
• MLH CEO/CMO Campaign Letter 2010
  MainLineHealth_CEO-CMO Campaign Letter
• MLH Employee Flu Vaccination Admin Policy
  MLH_Flu Vaccination Policy 2010
• MLH Intranet Frequently Asked Questions MLH_Flu
  vaccine Frequently Asked Questions 2010
• MLH Medical Exemption Form 2010 MLH_Flu Vax
  Medical Exemption Form 2010
• MLH Campaign Poster (above) MLH_FluFlyer-8 511

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Group Exercise

• What strategies from the Main Line case study
  might work well in your institution? Why?
• What parts of the Main Line experience would NOT
  work for your institution? Why?
• What barriers do you see within your institution
  moving towards a mandatory program?
• Which barriers are not addressed in the Main Line
  experience?
• We will use observations and answers to build a
  collection of frequently-asked-questions (FAQs)
  for the website