November 2, 2016
By Mountain-Pacific
The Pearl City Nursing Home in Hawaii increased staff influenza immunization rates by more than 40% in 2015 after implementing successful strategies to encourage immunizations. Mountain-Pacific Quality Health helped the facility plan and implement proven strategies to help increase staff immunization rates.
Denise Bilodeau, administrator of the Pearl City Nursing Home, knew she wanted to increase the immunization rates of her staff but wasn’t sure how to go about it.
“Last year’s immunization rate (2014 calendar year) was only 54% for a total staff of 178,” said Bilodeau.
“This included nursing, administration, social work, food services, activities, maintenance and housekeeping. I felt that this was unacceptable.”
During a West Hawaii Coordination of Care Coalition meeting in August of 2015 Mountain-Pacific staff member Cathy Nelson introduced herself to the group and explained the benefits of immunizations. That presentation and introduction would ultimately lead to the beginning of a successful partnership. When Nelson sat down after her presentation Bilodeau turned to her and expressed interest in working together to improve immunization rates.
Engaging leadership, planning for success
Creating the foundation for successful strategies requires planning. Nelson and Bilodeau held numerous meetings to start creating strategies to engage staff and encourage immunizations. The first task that was critical to ensure success was to engage leadership at the nursing homes.
“This wouldn’t have been successful without leadership buy in,” Nelson explained. “This was successful because the executives at the nursing home believed in and led this initiative.”
If leadership at the facility was reluctant or not engaged in the immunization initiative that reluctance would likely promulgate throughout the facility. Leading by example encouraged staff to see value in the initiative. But this was just the first step.
Creating an awareness of the benefits of flu immunizations amongst staff would be the second step. The facility placed immunization posters on every floor and managers and directors discussed the benefits and importance of flu immunizations at meetings. Now, staffers knew the benefits and that seed was planted and ready to flourish.
Strategies that worked
Nelson, acting as a consultant to bring forth nationwide best practices and strategies, worked with administrators and leadership at the hospital to create more interventions to increase the immunization rate for staff. Many of the ideas for the strategies also came from leadership itself.
Working together the team created the following strategies to help boost immunizations even more at the Pearl City Nursing Home:
- Mandatory masking for those who chose not to vaccinate
- Roving immunization stations on every unit
- Candy given to those who received vaccinations
- Vaccinated staff received stickers for their name badges “I got my flu shot, HAVE YOU?”
- Nurse managers discussed immunizations during staff meetings
- Immunization sign-in sheets were placed at all units
- The director of nursing personally recruited staff at each unit
- Immunization posters were posted on every floor
Some strategies had incentives tied to them, such as competitions and awards for those with the highest immunization rates. Units with an 80% immunization rate were given pizza parties. The Director of Nursing, Riza Hanneman, made the time to chat with staff to encourage immunizations. And by simply measuring how many staff received their flu shots helped improve the rate of vaccination.
Staffers who didn’t vaccinate had the disincentive of having to wear a mask during flu season.
“We found out that the mandatory masking is definitely an incentive to those who needed just a small nudge,” Bilodeau said.
Framework for the future, benefits of immunizations and community coalitions
Now that the facility had gone through the process of increasing immunizations during the 2015 calendar year, the 2016 immunization rate may likely increase. The tools and strategies are in place and the momentum will likely continue.
Since influenza is highly contagious and can spread by coughing, sneezing or touching an object that is infected with flu bacteria and then transmitting it to the body by touching your eyes, mouth or nose, the facility has safeguarded their residents. About 90% of influenza deaths in the U.S. occur in those aged 65-plus, according to the Centers for Disease Control and Prevention.
“I really appreciate the support Mountain-Pacific has given us with this project,” Bilodeau said.
The community coalitions are a venue for health care professionals to share knowledge and best practices. The coalitions comprise hospital staff, nursing home staff, care home staff, pharmacists and other staff from health care-related organizations. Outside of knowledge sharing, the coalitions serve as a forum to create relationships that improve health care and health outcomes – and this success story is one outcome of many to stem from coalition meetings.
“This project really gave Pearl City Nursing Home and our health care community a positive impression of how Mountain-Pacific and nursing homes can work together,” Nelson said. “This really is Pearl City Nursing Home’s success, not ours.”
About Mountain-Pacific—Mountain-Pacific is a 501(c)(3) nonprofit corporation and holds federal and state contracts that allow them to oversee the quality of care for Medicare and Medicaid members. Mountain-Pacific works within its region (Montana, Wyoming, Alaska, Hawaii and the U.S. Pacific
Territories of Guam and American Samoa and the Commonwealth of the Northern Mariana Islands) to help improve the delivery of health care and the systems that provide it. Mountain-Pacific’s goal is to increase access to high-quality health care that is affordable, safe and of value to the patients they serve. www.mpqhf.org