Evidence map›Paper›PMID 33028656›Full record

ArticleBMJ open quality2020

Longitudinal, multidisciplinary, resident-driven intervention to increase immunisation rates for Medicaid, low-income and uninsured patients.

Cynthia Cantu, Kristopher Koch, Ramon S Cancino

Abstract read
In one paragraph

Article in BMJ open quality, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Cynthia CantuDepartment of Medicine, University of Texas Health San Antonio, San Antonio, Texas, United States CLCANTU5@GMAIL.COM.ORCID 0000-0003-2952-1435
Kristopher KochDepartment of Medicine, University of Texas Health San Antonio, San Antonio, Texas, United States.
Ramon S CancinoDepartment of Family and Community Medicine, University of Texas Health San Antonio, San Antonio, Texas, United States.ORCID 0000-0002-5758-5025

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMore payers are closely linking reimbursement to high-value care outcomes such as immunisation rates. Despite this, there remain high rates of pneumonia and influenza-related hospitalisations generating hospital expenditures as high as $11 000 per hospitalisation. Vaccinating the public is an integral part of preventing poor health and utilisation outcomes and is particularly relevant to high-risk patients. As part of a multidisciplinary effort between family and internal medicine residency programmes, our goal was to improve vaccination rates to an average of 76% of eligible Medicaid, low-income and uninsured (MLIU) patients at an academic primary care practice.

methodsThe quality improvement project was completed over 3 months by three primary care resident groups. The setting was a suburban academic primary care practice and eligible patients were 18 years of age or older. Our aim was to increase immunisation rates of pneumococcal, influenza, varicella, herpes zoster virus and tetanus and diphtheria vaccination. There were 1690 patients eligible for the vaccination composite metric. Data were derived from the electronic health record and administrative data.

interventionsCohort 1 developed an initial intervention that consisted of a vaccine questionnaire for patients to complete while in the waiting room. Cohort 2 modified questionnaire after reviewing results from initial intervention. Cohort 3 recommended elimination of questionnaire and implementation of a bundled intervention approach.

resultsThere were minimal improvements in patient immunisation rates after using a patient-directed paper questionnaire. After implementation of multiple interventions via an improvement bundle, there were improvements in immunisation rates which were sustained and the result of special cause variation.

conclusionA key to improving immunisation rates for MLIU patients in this clinic was developing relationships with faculty and staff stakeholders. We received feedback from all the medical staff and then applied it to the interventions and made an impact in the average of vaccinations.

Indexed as

AdolescentAdultCohort StudiesFemaleHumansImmunization ProgramsInternship and ResidencyLongitudinal StudiesMaleMedicaidMedically UninsuredMiddle AgedPovertyQuality ImprovementStudent Run ClinicUnited Statesambulatory carehealthcare quality improvementmedical educationpatient educationprimary care

Identifiers

PMID33028656
PMCPMC7542614

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