Minnesota Healthcare Setting Employee Influenza Vaccination Program Survey

1
Minnesota Healthcare Setting Employee Influenza
Vaccination Program Survey

• Denise Dunn, RN, MPH
• Adult/Adolescent Immunization Coordinator
• Minnesota Department of Health
• August 2009

2
Overview

• Survey background
• Survey methods
• Initial findings
• Dissemination of results

3
Survey background

• National healthcare worker vaccination rate is
  about 45
• Interest in what Minnesotas rate might be
• Strong backing from MIPAC Influenza Subgroup to
  survey MN
• MDH decides to survey 2008-09 season
• National Health Interview Survey (NHIS), 2006-07

4
Survey background

• Decision to do more than just a declination
  survey
• Interest in obtaining Minnesota-specific
  information about employee influenza vaccination
  programs and rates in health care settings

5
Purpose of survey

• To collect
• Minnesota-specific employee influenza vaccination
  rates in health care settings to give us a
  benchmark to mark progress
• Information on various employee influenza
  vaccination program activities used by
  organizations
• Data on the perceived barriers to vaccination
  and
• Baseline information on utilization/usefulness of
  the Minnesota Immunization Information Connection
  (MIIC), our statewide immunization registry, for
  tracking employee influenza vaccinations.

6
Coverage sampling

• Survey population all hospitals and long-term
  care facilities in Minnesota
• Surveyed all hospitals (N145) and a random
  sample of long-care facilities (N135)
• Total facilities surveyed 280
• Facility lists obtained from Compliance
  Monitoring Division (MDH)

7
Survey methods

• Online survey available mid-April through May
  2009
• Paper version was available, but no requests for
  it
• Pre-letter to administrators, followed by
  instructional letter to infection control staff
  (if known) or again to administrators, by default
• ICP email list used, as available

8
Survey methods

• Reminders sent either via mail or email
• Response rate 62
• Excluded 6 incomplete surveys
• Total responses N 173
• Response deadlines were extended
• Last 2 weeks of original timeframe were extremely
  busy for hospitals with H1N1
• Analysis is still underway

9
Survey findings

• Overall employee influenza vaccination rate (all
  facilities combined) 70.1

10
Survey findings

• Influenza vaccination rates by facility type
• Hospital 78
• LTC 63
• Both 73
• Other 77

11
Survey findings

• 100 of healthcare facilities surveyed provided
  influenza vaccination to all employees during the
  2008-09 season

12
Survey findings

• In addition to employees, who was included in
  your vaccination program?
• Volunteers 61
• Licensed independent contractors 42
• Students 31
• Community providers 11
• Vendors 6

13
Survey findings

• 99 of facilities provided vaccination onsite
• 86 provided vaccination during all work shifts
• 99 provided vaccination at no cost

14
Vaccination delivery methods

• Vaccination clinics/fairs 73
• Peer-vaccinators 60
• Mobile carts 50
• Coordination with other programs 39
• Occupational health site 28
• Using congregating areas 25
• Flu captains/teams 12

15
Promotional activities

• Respondents used the following promotional
  activities to enhance vaccination programs
• Reminders 91
• Promotional campaign 70
• Strong support by admin 49
• One on one counseling 42
• Incentives 38
• Rates reviewed by admin 35
• Rates shared within facility 32
• Kick off event 21
• Influenza champions 12

16
Educational activities

• 92 of facilities provide education as part of
  their employee vaccination program
• Of those facilities that provided education
• In 34, education was required
• In 66, education was not required

17
Survey findings

• Respondents track employee influenza vaccinations
  using
• Paper forms 88
• Other computer application 23
• MIIC 10
• Other, included consent forms, checklists, sign
  up sheets, employee health records

18
Survey findings

• Barriers cited to using MIIC to track employee
  vaccinations
• Lack of time for entering data 26
• Prefer own system 25
• Lack of awareness about MIIC benefits 21
• Lack of trained personnel 13
• General difficulty in use 4
• Privacy concerns 2

19
Declination

• Did your organization use a declination form as
  part of its employee influenza vaccination
  program during the 2008-09 season?
• Yes 70
• No 30

20
Declination

• For those who used declinations forms, was it
  mandatory for employees to return the form?
• Yes 72.7
• No 27.3

21
Declination

• Reasons given for not using declination forms
• Lack of time or personnel resources
  25
• Not convinced of value 21
• Leadership does not endorse
  17
• Union barriers 6
• Other included never used before, unaware of
  form, employee rights, tried with little effect

22
Declination

• Will your organization use a declination process
  next influenza season?
• Yes 67
• No 5
• Unknown 28

23
Findings

• Vaccination rate comparison
• Used declination form 75
• No declination form 60

24
Declination reasons

• Fear of adverse events 9
• Fear of getting sick from vaccine 6
• Fear of injections 5
• Medical contraindications 3
• average reported, of those facilities that use
  declination forms

25
Initial findings

• Program characteristics of facilities with high
  vaccination rates (close to or gt90)
• Provide flu vaccine at no cost to employee
• Provide vaccination during all work shifts
• Expand vaccine offerings to other workers
• Use reminder methods

26
Initial findings

• Program characteristics of facilities with high
  vaccination rates (close to or gt90)
• Most had a strongly motivated administrator
  leading the vaccination drive
• Most held kick-off events and campaigns
• Almost all provide education on influenza and flu
  vaccine to staff
• Most used declination forms and required their
  return

27
Initial findings

• Program characteristics of facilities with high
  vaccination rates (close to or gt90)
• All evaluate influenza vaccination rates annually
• All set influenza vaccination rate goals annually
• Almost all track reasons why employees choose not
  to participate
• All track the previous seasons data

28
Data analysis continues

• Still analyzing data
• Continue analyzing specific activities associated
  with high-rate facilities
• Compare vaccination rates of facilities that use
  declination forms to those that do not
• Look at nonresponders

29
Dissemination of results

• Internal MDH stakeholders
• MIPAC Influenza Subgroup
• CDC site visit
• Brown bag for additional MDH employees
• Fact sheet with summary of results / web
• MN Influenza Vaccination Plan 2009-10
• State, regional, and/or national conferences

30
Whats next

• Amend sample declination form
• Finish analysis and disseminate results
• Plan to repeat survey next year
• Possibly add sampling of clinics
• H1N1 vaccine campaign may complicate next years
  survey

31
Questions/Discussion

• Denise Dunn
• Denise.Dunn_at_state.mn.us
• 651-201-5560