Major Article
Novel use of the intranet to document health care personnel participation in a mandatory influenza vaccination reporting program

https://doi.org/10.1016/j.ajic.2006.10.005Get rights and content

Background

The Advisory Committee on Immunization Practices and the Healthcare Infection Control Practices Advisory Committee recommend health care personnel (HCP) influenza vaccination to prevent transmission to patients. Recommendations include documenting declination and providing feedback of rates. We report the use of the intranet to achieve recommendations with mandatory participation of 20,170 HCP in an 1100-bed hospital.

Methods

Employees were required to log onto the intranet and select “vaccine received,” “contraindicated,” or “declined.” Declining employees automatically received a screen with education about vaccination. A Microsoft Structured Query Language database was created and linked to a Human Resource database. Administrators were provided feedback on participation rates. Employees were notified of the program via letter. Reminders were provided through managers and newsletters.

Results

Eighty-nine percent (17,998/20,170) accessed the intranet. Fifty-five percent (11,068) indicated “vaccine received” versus 38% in 2004-2005 (P < .000001), 31% (6300) “declined,” and 3% (630) had “contraindications.” Unit rates ranged from 24% to 91%.

Conclusion

The intranet provides a tool for measuring and reporting participation, declination, and vaccination rates. The intranet and a mandatory participation program were associated with an increase in rates. Low rates in HCP with access to, and education about, vaccine may impact consideration of a mandatory vaccination program.

Section snippets

Background

The Cleveland Clinic is a 1100-bed flagship tertiary care hospital of the 10 hospitals that make up the Cleveland Clinic Health Care System.

Study subjects

This study included HCP working at the Cleveland Clinic and associated regional outpatient ambulatory clinics. The HCP are defined as paid and unpaid persons working in health care settings and includes persons not directly involved in patient care but potentially exposed to infectious agents that can be transmitted to and from HCP.

Vaccine coverage levels among health care personnel

Vaccine coverage levels

Results

The overall reporting participation rate by HCP during the 11-week period was 89.2% (17,998/20,170), with 55% (11,068) receiving influenza vaccination. Sixty-nine percent of the divisions had a ≥90% reporting participation rate. The HCP in regional ambulatory clinics had among the highest reporting participation and vaccine acceptance rates. Overall, 31% (6300) of employees declined vaccine. Only 3% (630) declined vaccine based on medical contraindications. Declination rates for employees in

Discussion

A program of mandatory HCP participation in an influenza reporting program, coupled to an intranet Web site, was associated with a significant increase in the HCP vaccination rate (55% in 2005-2006 versus 38% in 2004-2005). The intranet provided an inexpensive tool for the measuring and timely reporting of employee participation, declination, and vaccination rates. Data management was accomplished without significant expense and cumbersome paperwork. The site provided education to large numbers

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