Adolescent Immunization Program Overview

Transcription

1 Adolescent Immunization Program Overview Kendra Julien, MPH Adolescent Immunization Specialist Partnership for Maternal and Child Health of Northern NJ 05/21/18 Organizational Overview Maternal and Child Health Consortium 501c(3) organization 24 Member Hospitals Covering Northern NJ Counties: Sussex Passaic Warren Morris Essex Union Hudson Bergen Program Background Adolescent Immunization Program is funded by NJDOH Vaccine Preventable Disease Program. Program started in January 2016 due to HPV vaccination coverage levels lagging behind in New Jersey. The goal for the HPV program is to increase vaccination coverage among adolescents aged years through outreach to providers, hospitals, local health departments, Federally Qualified Health Centers and other community initiatives. 1

2 Adolescent Immunization Program March 2016 December 2017 Community Education Clinical Education 359 Parents via Group Education Sessions 1,700+ Community Members via Health Fairs 372 HCPs have signed up for CEU presentation 29 clinics have received technical assistance for improving HPV rates 344 HCPs have completed HPV CEU Phase 1: HPV Technical Assistance Recruitment Process: Adolescent Immunization Specialist developed list of pediatric providers within the service region. Letters were sent out to private pediatric offices and Federally Qualified Health Centers in the 8 northern counties of NJ via mail. Specialist followed up with phone calls 1 week later to gauge interest in enrolling in the project. Phase II: Provider Outreach Outreach to Essex Metro Immunization Coalition members to assist with recruiting In-person visits with provider offices Program overview materials were left with office manager/physician or nurse A flyer for the Continuing Education Program developed by the Partnership for nurses was included as incentive for staff to participate in on-site education session Ø CE program offers 1.0 nursing credit and is a traveling program. 2

3 Enrollment for 2016-Current Successfully enrolled 29 provider sites in technical assistance (TA) program component 9 sites completed the TA program 6 sites closed or were lost to follow up 2 sites merged into 1 Currently working with a total of 13 sites and continuing active recruitment of new offices HPV Report Card Quality Improvement Resources Plan, Do, Study, Act (PDSA) is a useful quality improvement tool used for documenting a test of change. This involves carrying out the test, observing and learning from the consequences and determining what modifications should be made to the test to increase success with subsequent test cycles 1. June 2017 we started encouraging the use of PDSA cycles with clinics to help focus their quality improvement efforts

4 Sample PDSA Cycle Sample PDSA Outcome Met with provider to review the site s progress towards its goals. The site exceeded its goal: Ø 113 VFC patients and 20 private patients had received HPV doses since the last meeting. Results and Outcomes 4

5 HPV rates for 1 st dose among age and girls and boys 40 % OF POPULATION VACCINATED F M F M AGE RANGE INITIAL 4MONTHS 8MONTHS HPV Overall Average Improvement for 1 st Dose Among Year Old Girls and Boys After analyzing the data for 1 st dose among year old girls and boys, the data revealed: Over the course of 3-4 months, overall site data did not show a significant increase in 1 st dose administration. This may not have been enough time to demonstrate a rate increase for sites. However, the percentage for the 1 st dose completion between the initial TA visit and a follow up visit at 7 months to 1 year showed an average increase of 49.4%. One explanation for this is that sites may need longer periods of time to see an improvement in coverage rates after implementing QI plans. Barriers and Strategies Discussed at Provider Sites Reported Barriers by Providers: Patients not returning for subsequent doses Myths and fears among parents Not mandatory for school entry Lack of reminder/recall in some offices No system to promote HPV vaccine Unaware of current recommendations RNs not educating patients Recommended Strategies: Schedule appointment same day Offer a bundled vaccine recommendation Emphasize cancer prevention Provide educational materials Initiate reminder/recall with staff Adopt a policy/plan with staff Encouraging staff to participate in CEU program 5

6 Lessons Learned for 2018 Establishing a rapport with local pediatric offices is critical with the recruitment process. Providing a 2 nd round of training to health care professionals about discussing the HPV vaccine with parents is useful due to staff turnover. Giving providers patient education materials helped them to feel more comfortable continuing the conversation with hesitant parents. Contact Information Kendra Julien, MPH Adolescent Immunization Specialist Tel: x119 kjulien@partnershipmch.org 6