Implementation of an Influenza Immunization Program in an Urban Veteran Affairs Emergency Department

Abstract

Background: The Centers for Disease Control and Prevention (CDC) recommend an annual influenza immunization for all people ages 6 months or older. According to the Veteran Health Administration (VHA) the influenza virus contributes to 5,000 veteran deaths, 13,000 hospitalizations, and $48 million in healthcare costs annually. It is estimated that influenza immunization can avert one fourth of influenza related deaths. Objective: A quality improvement project was implemented in an urban Veteran Affairs (VA) emergency department (ED) to increase veteran influenza immunization rates and improve influenza immunization HEDIS measures using nursing triage. Method: Nursing staff were provided in-service about screening veterans visiting the VA ED for influenza immunization based on eligibility criteria. Eligible patients either received an influenza immunization, refused the immunization, or stated they received the immunization elsewhere. Results: Of the VA ED patients seen 45% were eligible to be screened for influenza immunization, 8.8% of the eligible patients were screened, and 53% of the screened patients were given an influenza immunization. The HEDIS scores for the 2017 4th quarter showed that influenza immunization screening for 18-64 years old increased 9% over 2016 and screening for those 65 years and older increased 2% over 2016. Implications: An ED can be an appropriate place to offer influenza immunization. Offering a preventative measure in an acute care setting can increase influenza immunization compliance. The increased vaccination of a population group like veterans not only benefits and protects the group but the public as well.