Long-term success with the national health objective for influenza vaccination

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Abstract
Purpose:To assess the long-term effectiveness of an influenza vaccination program. Setting:725-bed university-affiliated VA teaching hospital providing care to over 35,000 outpatients. Design and subjects:500 randomly selected outpatients were surveyed following each immunization season using a validated, self-administered, postcard questionnaire. Program description:The institution-wide program, designed to function automatically and to be independent of physician initiative, emphasizes organizational and patient-oriented educational strategies: 1) a hospital policy allowing nurses to vaccinate without a physician’s order; 2) a walk-influ shot clinic; 3) reminders on clinic progress notes; and 4) an educational mailing to all outpatients. The program was initiated in 1987 and has been maintained for each subsequent immunization season. Results:The response rate was over 75% for each of the four years in which there were two mailings. The response rate for 1988–1989, in which there were three mailings, was over 85%. Approximately 70% of the respondents were at high risk for influenza and its complications. Vaccination rates for these high-risk outpatients have been sustained at over 58% for each immunization season. The program is well received by the hospital staff and now functions on autopilot each year. Conclusion:This highly successful institution-wide influenza vaccination program can be sustained long-term. Elements of this program may help others take advantage of opportunities for influenza prevention.