PILLAR 3: Enhanced Vaccination Systems

3 pillars

Improving Your Vaccination Systems

Problem:  Missed opportunities to vaccinate. Office vaccination systems may need to be modified to enhance assessment of vaccination status, add standing order protocols and remind patients about follow-up vaccines.

Solution:  Better assessment of vaccination status

  • Assessment of vaccination as a routine part of the office visit by nursing staff should become a standard operating procedure. This should occur at all visits whether the patient is sick or well.
    • Options include: Routinely addressing as part of vital signs, or reviewing charts for scheduled patients the day before or at the daily huddle.
    • To help determine vaccination status, some practice rely on patient self-report while others rely on the electronic medical record (EMR). Below are tips for using either.

 

No EMR  EMR

 If the practice relies on patient self-report,  understand that accuracy of vaccination history  from self-report of:

  • Influenza is reliable. 
  • PPSV is acceptable.
  • Tdap is unreliable-consult medical records.
  • HPV is unreliable-consult medical records.

 Turn on electronic reminders/prompts  for specific vaccines.

 Review EMR's health maintenance,  immunization and/or other similar tab  or page.

 Check your state's immunization  registry if available. 

Source: Zimmerman et al. found the sensitivity of patient self-report of influenza vaccination status was 98%, compared to the medical record vaccine 2003;21:1486-91.