Pneumococcal polysaccharide vaccine (PPSV23) is recommended to all adults 65 years and older, people 2 through 64 years with certain medical conditions and all adults older than 19 years who smoke. This vaccine prevents severe pneumococcal disease, reducing hospital admissions and risk of death. As part of a quality improvement project, a group Internal Medicine resident physicians with continuity clinic at the UNMH Westside Clinic sought to increase our vaccinations rates with PPSV23 in patients older than 65 years.
A list of 282 patients aged 65 or older receiving primary care at the UNMH Westside Clinic were identified who had not received the PPSV23 vaccine. The list of eligible patients was organized by listed primary care provider. Then this list was divided numerically so each resident physician was responsible for calling 55-56 patients. After thorough chart review to evaluate if there had been any documentation errors in the EMR, and the patients had received the vaccine prior, patients were contacted via telephone and advised of the benefits of PPSV23. If the patients were amenable to the vaccination, a nurse visit or primary care visit, if needed, was scheduled for administration of the vaccine. Patients were also advised of how to seek the vaccine in the community.
Results or expected outcome.
Many of the patients had already received the vaccine, though the initial data set marked these patients as not having the vaccine. One hundred and three patients had received the vaccine but it was not documented in the EMR correctly. Fifteen patients got the vaccine during the study period after receiving calls. After outreach, based on preliminary data, 118 out of 282 of the identified patients received the PPSV23 vaccine.
This project quality improvement project was envisioned in the setting of the COVID-19 pandemic, as outreach to improve vaccination rates and education of patients at the UNMH Westside Clinic, prior to the availability of COVID-19 vaccines. Overall, the QI project can be seen as a success. There was a 41.8% increase in patients vaccinated with the PPSV23 vaccine. A large portion of the was mainly due to an initial data set that did not reflect the actual number of patients who had received the vaccination due to inaccurate EMR documentation. Telephone outreach by clinic providers was successful at improving PPSV23 vaccination rates at the UNMH Westside Clinic. More telephone outreach could certainly be used to improve other healthcare metrics at the clinic.
Keller, Meredith; Ashley Wildman; Julia Howard; Leland Abrams; and Erika Jones. "Improving pneumococcal vaccination adherence in eligible candidates over 65 years of age per USPFT guidelines at Westside Clinic." (2021). https://digitalrepository.unm.edu/hsc_qips/57