Evidence map›Paper›PMID 36410781›Full record

ArticleBMJ open quality2022

An electronic medical record-based intervention to improve hepatitis A vaccination rates in the emergency department during a regional outbreak.

Miriam A Bukhsh, Rama Thyagarajan, Brett Todd, Nai-Wei Chen, Lihua Qu, Lakshmi Swaminathan

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open quality, 2022. 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
0.6field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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, 4 citations in OpenAlex.

  1. Article
  2. Article
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

6 authors at 5 institutions in 1 country.

Miriam A BukhshDepartment of Emergency Medicine, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia, USA mbukhsh@mfa.gwu.edu.ORCID 0000-0002-7421-535X
Rama ThyagarajanDepartment of Internal Medicine, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA.
Brett ToddDepartment of Emergency Medicine, Beaumont Hospital - Royal Oak, Royal Oak, Michigan, USA.
Nai-Wei ChenDivision of Informatics and Biostatistics, Beaumont Research Institute, Royal Oak, Michigan, USA.
Lihua QuOutcomes Research Department, Beaumont Research Institute, Royal Oak, Michigan, USA.
Lakshmi SwaminathanHospital Medicine, St Joseph Mercy Ann Arbor Hospital, Ypsilanti, Michigan, USA.
Beaumont Health · USBeaumont Hospital, Royal Oak · USGeorge Washington University · USThe University of Texas at Austin · USTrinity Health Ann Arbor Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn response to the severe hepatitis A outbreak that occurred in Michigan between August 2016 and September 2019, our multihospital health system implemented an electronic medical record (EMR)-based vaccination intervention across its nine emergency departments (EDs). The objectives were to explore the impact of this intervention on increasing vaccination rates among high-risk individuals and to assess the barriers to use of a computerised vaccine reminder system.

methodsAll patients who were 18 years or older were screened using an electronic nursing questionnaire. If a patient was at high risk based on the questionnaire, an electronic best practice advisory (BPA) would trigger and give the physician or advanced practice provider the option to order the hepatitis A vaccine. We explored the vaccination rates in the 24-month preintervention and the 18-month intervention periods. We then administered a survey to physicians, advanced practice providers and nurses evaluating their perceptions and barriers to use of the EMR intervention.

resultsDuring the preintervention period, 49 vaccines were ordered (5.5 per 100 000 patient visits) and 32 were administered (3.6 per 100 000 patient visits). During the intervention period, 574 865 patient visits (74.3%) were screened. 2494 vaccines (322 per 100 000 patient visits) were ordered, and 1205 vaccines (155 per 100 000 patients visits) were administered. Physicians and advanced practice providers were initially compliant with the BPA's use, but compliance declined over time. Surveys revealed that the major barrier to use was lack of time.

conclusionsEMR screening tools and BPAs can be used in the ED as an effective strategy to vaccinate high-risk individuals. This may be translatable to outbreaks of other vaccine-preventable illnesses like influenza, measles or SARS-CoV-2. Providing ongoing education about the public health initiative and giving feedback to physicians, advanced practice providers and nurses about tool compliance are needed to sustain the improvement over time.

Indexed as

COVID-19Hepatitis AInfluenza VaccinesDisease OutbreaksElectronic Health RecordsEmergency Service, HospitalHumansSARS-CoV-2VaccinationInfluenza VaccinesDecision support, computerisedElectronic Health RecordsEmergency departmentInfection controlVaccination

Identifiers

PMID36410781
PMCPMC9680321
OpenAlexW4309654954

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.