Main Line Health Case Study

Case Study Snapshot, June 2011

Main Line Health
[pdf of this page: PA-HCW Universal Flu Vax_Main Line Health Case Study_June_2011

Overview
After averaging seasonal vaccine uptake among its HCWs of about 60% for several years despite active annual campaigns, Main Line Health adopted a mandated program for the 2010-11 flu season, achieving a 99.99% uptake.

Seasonal Influenza Vaccine Uptake

Pre-mandate            Post-mandate

≈ 60%                    99.99%

Program Justification
Positioned as a patient safety initiative which involves entire Main Line Health community including physicians.

Program Details
– establishes seasonal flu vaccination as a condition of employment
– impacts all employees, employed physicians, volunteers, students, vendors with patient contact (consent form)
– impacts non-employee professional staff credentialed by medical staff (privilege suspension)
– integrates medical exemptions (physician letter; no allergy testing) and religious exemptions (letter from clergy reviewed by outside independent party (retired judge)): very low incidence rate

Key Champion(s)
Main Line Health CEO John Lynch
– drove the initial decision based, in part, on his experience in Houston with a hospital flood event: act where you can to avoid disaster
Infection Preventionists/Occupational health
HR Directors (data sharing with managers on unit uptake)

Timeline
April-August 2009:
– Initial consideration of a mandate program…HR Directors meeting…H1N1 pandemic and vaccine supply pushes decision off to next cycle

Jan-Feb 2010:
– Groundwork laid with legal, HR
– Steering Group formed/mandate decision affirmed: CMO, HR, Legal, Patient Safety, Occupational Health, Nursing, Infectious Disease++)

May-June 2010:
– Review and approvals by Medical Executive Committee and Board of Directors
– Launch letter to employees from CEO/CMO

Late Dec 2010/early Jan 2011
– Formal campaign window

Key Strategies/Success Factors
– Use of own employees (community health nurses) to “deliver” immunizations in the mandate context
– Use of employee intranet to post key program content ands help assure continuity of messaging across stakeholder groups
– Posted base set of 10 Frequently Asked Questions (FAQs) which built to twenty; employees could post new questions and get direct response
– Emphasis on physician inclusion in requirement: increased safety perception, etc.
– Moving from paper-based form to badge reader to track

Best sound bite(s)
During formal campaign and rounding visits to key units, the VP of Nursing from one hospital encountered “senior” maternity nurses:
Question: “Are you really going to fire all of us if we don’t get vaccinated?”
Answer: “Yes ladies, we are.”
Result: They accepted influenza vaccinations towards the deadline.

Leadership Team (functions that made it happen)
The Steering Group pared down to a handful of key players who held weekly status phone calls, then almost daily calls during the last week.  Key players included Infection Prevention, Infectious Diseases, Occupational Health, Chief Medical Officer, Human Resources Director, and others as necessary.

Main Line Health
Main Line Health is suburban Philadelphia’s most comprehensive healthcare resource, offering a full range of medical, surgical, obstetric, pediatric, psychiatric and emergency services. Forming the core of Main Line Health are four of the region’s most respected acute care hospitals—Lankenau, Bryn Mawr, Paoli and Riddle—as well as one of the nation’s premier facilities for rehabilitative medicine, Bryn Mawr Rehab Hospital. We’re especially recognized for our cardiac, orthopedic, oncology, rehabilitation and women’s clinical services. In addition, Main Line Health trains more than 100 interns, residents and fellows annually from medical schools throughout the country. We are actively involved in numerous scientific research studies, many of which are funded by the National Institutes of Health.
[10,000 employees, 2,750 physicians]
http://www.mainlinehealth.org/oth/Page.asp?PageID=OTH000030

Contacts:
– Constance Cutler, RN, MS, CIC, FSHEA; Director, Infection Prevention and Control, Main Line Health, CutlerC@MLHS.ORG; (484) 476-3906

– Patty McBride, RN, MSN, CIC; Infection Preventionist, Bryn Mawr Hospital,  McBrideP@MLHS.ORG; (484) 337-3470

.

Key Resources

– MLH CEO/CMO Campaign Letter 2010: MainLineHealth_CEO-CMO Campaign Letter

– MLH Employee Flu Vaccination Admin Policy: MLH_Flu Vaccination Policy 2010

– MLH Intranet Frequently Asked Questions: MLH_Flu vaccine – Frequently Asked Questions 2010

– MLH Medical Exemption Form 2010: MLH_Flu Vax Medical Exemption Form – 2010

– MLH Campaign Poster (above): MLH_FluFlyer-8 5×11

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