1. Overcoming Immunization Challenges in RHCs Becky Shipp, RN MSDH Immunization Program Director

2. Discussion Topics Addressing Immunization Challenges
Time & Competing Priorities
Lack of Awareness & Vaccine Hesitancy
Complex Processes & Training
Cost & Resources
Overcoming Immunization Challenges
Streamline & Normalize
Promotion & Education
Assign & Support
Review & Plan

3. Streamline & Normalize
Get the entire office involved
Medical & non-medical staff should be included
Meet with staff to discuss why vaccinating is so important
Staff need to understand the dangers of the diseases that they are protecting patients from
Empower team members to take an active role in protecting the patients you serve
Allow everyone to contribute suggestions and assistance
Establish a culture of health in the workplace
Encourage staff to ensure that they protect themselves and their families from vaccine preventable diseases

4. Streamline & Normalize
Non-medical Staff Involvement
Check-in Process
Print the patient’s immunization history from MIIX
Highlight the forecast at the bottom & provide a copy to the patient
Provide a copy to the medical staff or flag the EHR to denote vaccines forecasted as due
Assume all patients will elect to receive vaccines
Provide Vaccine Information Statements (VIS) for each forecasted vaccine
Utilize vaccine contraindication screening forms
Check-out Process
Schedule next appointment for immunizations

5. Patient Vaccination Record

8. Streamline & Normalize
Medical Staff Involvement
Review the MIIX or EHR vaccination forecast at every visit
Use standing orders to streamline the process
Make presumptive announcements regarding vaccinations
“The nurse will administer your flu and Tdap vaccinations today”
Answer questions or concerns just as you would any other questions or concerns regarding medication
Implement refusal forms for parents to sign if they refuse vaccination
The refusal form helps to emphasize your dedication to protecting the patient’s health and seriousness of preventable diseases.
Share information with patients and parents on where to find trustworthy health information online

10. Promotion & Education Non-medical Staff Involvement
Promote the importance of immunizing
Fliers at the front desk and checkout desk
Posters in the waiting rooms
Use MIIX or EHR reminder recall systems
Schedule next appointment for immunizations
Consistent messaging to patients
Vaccinations are important because they help to save lives and prevent hospitalizations

13. Promotion & Education Medical Staff Involvement
Promote the importance of immunizing
Hang posters or fliers in each clinical care room
Provide guidance to non-medical staff on specific ages to focus on for MIIX or EHR reminder recall systems
20 months to 3 years
13 years to 18 years
Strong provider recommendation
Share with patients that you protect yourself and your family through immunizations
Consistent messaging to patients
Vaccinations are important because they help to save lives and prevent hospitalizations

14. Assign & Support Assign
Select a specific person as the Vaccine Champion for the office
Delegate responsibilities to every staff member
Stay up-to-date on immunizations and processes
Provide training to medical and non-medical staff as needed
Oversee and share the team’s progress through Vaccine Coverage Rate Reports (available in MIIX)
Contact the MSDH Immunization Program for assistance

15. Assign & Support Support
Medical and non-medical staff members should support one another’s efforts to vaccinate patients
Ensure that leadership and administrative figures show support of vaccination efforts
Lead by example
Allow staff time to participate in immunization training opportunities
Encourage participation of all staff members during VFC site visits

16. Review & Plan
Review all potential opportunities to reduce financial barriers
Enroll in the Vaccines for Children (VFC) program to receive vaccines to administer to eligible children
Seek guidance from vaccine manufacturer representatives for potential:
Coding cheat sheets to improve accurate billing
Vaccine purchasing discounts
Postage paid postcards
Reminder recall services
Review AAP’s literature on financing, ordering, and maintaining vaccine supply
Review IAC’s Vaccinating Adults: A Step-by-Step Guide

17. Review & Plan
Make plans using available resources and evidence based practices
CDC.gov
Immunization Partners
Immunization Education & Training Section
CDC-INFO On Demand – Publications
2018 Vaccine Storage & Handling Toolkit
VaxView for Vaccination Coverage Rates by State
Vaccine Safety
Immunize.org
Vaccinating Adults: A Step-by-Step Guide
Wealth of information on vaccines, diseases, clinic tools, standing orders, templates, handouts, staff materials, VIS translations

18. Review & Plan AAP.org HPVRoundtable.org UMMC & American Cancer Society
Ordering, Financing & Maintaining Supply
Provider Resources
Parent Resources
HPVRoundtable.org
Cancer Prevention Through HPV Vaccination: An Action Guide for Small Private Practices
UMMC & American Cancer Society
HPV Vaccination ECHO
Monthly sessions starting in December 2018
CDC-INFO On Demand - Publications

19. Questions