Spring Updates Hepatitis B and PPV Vaccination Quality Improvement Activity May 17, 2017
Meeting Facilitators / Hosts Anna Bennett Education Coordinator ESRD Networks of New York & the South Atlantic abennett@nw2.esrd.net 516-209-5474 919-463-4528 Carol Lyden, RN, BSN, MS, CNN Quality Improvement Director, NW2 clyden@nw2.esrd.net 516-209-5302 6
Agenda • Overview of QIA Activities & Timeline • Overview of Vaccination Data Flow • Vaccination Root Cause Analysis Results • Discuss Facility Needs – Data Needs – Clinical Needs • Review Vaccination Data Tip Sheet • Open Forum Q&A • Closing Remarks/Next Steps 7
Learning Objectives • Discuss the Vaccination QIA Requirements and Goals • Understand new approaches and develop best practices • Identify needed interventions and materials • Understand reporting requirements and deadline dates 8
2017 Spring Overview Hepatitis B and PPV Vaccination QIA Anna Bennett, Education Coordinator, NW2 & NW6
QIA Goals and Timeline – To Graduate: > 60% vaccination rate for both HPV and PPV – Improve Patient and Provider Health – Improve Tracking and documentation of HPV and PPV vaccinations in CROWNWeb Now - September 2017 Network sponsored education and best practice sharing opportunities. • Monthly progress reports provided to facilities • Individual facility conference calls as needed • September 2017 Final re-measure and project completion • 10
Hep B and PPV Vaccination Data Flow Your ur Data a say ays WHAT??? ??? EHR to CROWNWeb Why Data Reconciliation is IMPORTANT CROWNWeb data is used for: Network Projects • ESRD QIP • 5 Star Rankings • USRDS • Medicare Patient • Management ESRD Network Annual • Report to Congress Public Health Studies • Dialysis Facility Compare • Staff Contact Information • Patient Representative • Information 11
2017 Root Cause Analysis Results
RCA: What YOU Reported Key Questions: When do you offer Vaccinations? As Needed Standing Orders? Annual Does your EMR Match Semi-Annual CROWNWeb? Quarterly Does your facility offer HBV and Monthly PPV? Initial Dialysis 0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100% If a patient refuses? Automatic reminders? Physician talks speaks with patient Unknown Ask the patient why they do not want the vaccine and trend… Document in the reason patient refused in Medical Record No Discuss with the patient why they are refusing Offer vaccine again at a later Yes time Education on importance of vaccination 0% 20% 40% 60% 80% 100% 13 0% 20% 40% 60% 80% 100%
RCA: What YOU Reported (continued) Do you Request Documentation? Tracking in CROWN Web 100% 100% 80% 80% Vaccinations 60% 60% Received at At other the Dialysis 84% 40% 40% locations Unit, 100% 74% 20% 20% 16% 0% 0% Yes No Staff Barriers? Lack of a process to document vaccinations in CROWNWeb Lack of documentation when vaccine is received outside of facility Facility systematic process to manage reminders for patient vaccinations Staff education protocol when patient refuses a vaccination Staff education protocol prior to vaccination offering 0% 20% 40% 60% 80% 100% 14
Intervention: Documentation/Patient Education • Help us design a useful Wallet Card 15
Poll Question • Why aren’t more patients immunized ? 16
Clinical: Common Barriers 17
Clinical: STIC Interventions Safe & Timely Immunizations Coalitions (STIC) Standing orders Provider reminder systems Provider assessment and feedback Patient reminders Patient education Others 18
Clinical: Provider Reminder Systems Informs the provider that individual patient is due for vaccine Examples: – Notation, prompt, or sticker in patient chart – Standardized checklists – Computerized database or registry 19
Clinical: What do you think? Other Interventions to Consider: • Immunization Education Day/Week • Immunization Counseling • Staff Vaccination Initiative • Monitoring 20
Clinical: May is Hepatitis Awareness Month 21
Data: CROWNWEB Vaccination Data Tip Sheet • YOUR Staff are the End Users: – Have you tried it? – Edits? – Questions? – Need Additional Information? 22
Open Forum Q&A • CROWNWeb HelpDesk Follow up • Tracker Follow up • Patient Education • QAPI • Plan of Care Meetings • What do you need? 23
Closing Remarks/Next Steps
Next Steps • Through the end of September 2017, monthly evaluation will continue using the CROWNWeb data. • Wallet Card will be distributed • Process for staff utilization of Wallet Card • The Network will notify facilities of their progress through emails • Individual conference calls will be held with facilities not showing improvement. – Barriers will be identified – Potential solutions and interventions will be discussed – Corrective action plans will be updated. 25 26 26
Future Meetings • July Webinar • October- Project Summarization • Monthly One on One Data Reconciliation 25 27 27
We need your feedback and suggestions! Please complete our Webinar Evaluation to share your thoughts. We welcome and value your input!
Thank You for Attending our Vaccination QIA Spring Update Anna Bennett, Education Coordinator
Anna Bennett Education Coordinator abennett@nw2.esrd.net abennett@nw6.esrd.net Phone: 516-209-5474 Presentation Template 919-463-4500 Draft for Review Corporate Headquarters 1979 Marcus Avenue Lake Success, NY 11042-1002 www.ipro.org April 6, 2017 p. 1
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