A pneumococcal pneumonia and influenza vaccination quality improvement program for women receiving chemotherapy for gynecologic cancers at a major tertiary cancer Centre

• Published in: Gynecologic oncology 2021-04, Vol.161 (1), p.236-243
• Main Authors: McGinnis, Justin M., Jones, Rebecca, Hillis, Christopher, Kokus, Heather, Thomas, Heidi, Thomas, Jason, Alyafi, Mohammad, Bernard, Laurence, Eiriksson, Lua R., Elit, Lorraine M., Hirte, Hal, Jimenez, Waldo, Reade, Clare J., Kumar Tyagi, Nidhi, Helpman, Limor
• Format: Article
• Language: English
• Subjects: Cancer Care Facilities - organization & administration; Female; Genital Neoplasms, Female - complications; Genital Neoplasms, Female - drug therapy; Health Care Surveys; Health Services Accessibility - organization & administration; Humans; Immunization Programs - organization & administration; Immunocompromised host; Influenza Vaccines; Influenza, Human - etiology; Influenza, Human - prevention & control; Ontario; Patient Acceptance of Health Care - statistics & numerical data; Pneumococcal Vaccines; Pneumonia, Pneumococcal - etiology; Pneumonia, Pneumococcal - prevention & control; Practice Patterns, Physicians' - standards; Practice Patterns, Physicians' - statistics & numerical data; Professional-Patient Relations; Quality improvement; Quality Improvement - organization & administration; Tertiary Care Centers - organization & administration; Vaccine-preventable diseases
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2021.01.014

International guidelines recommend pneumococcal pneumonia and influenza vaccination for all patients with solid organ malignancies prior to initiating chemotherapy. Baseline vaccination rates (March 2019) for pneumococcal pneumonia and influenza at our tertiary cancer centre were 8% and 40%, respectively. The aim of this study was to increase the number of gynecologic chemotherapy patients receiving pneumococcal and influenza vaccinations to 80% by March 2020. We performed an interrupted time series study using structured quality improvement methodology. Three interventions were introduced to address vaccination barriers: an in-house vaccination program, a staff education campaign, and a patient care bundle (pre-printed prescription, information brochure, vaccine record booklet). Process and outcome data were collected by patient survey and pharmacy audit and analyzed on statistical process control charts. We identified 195 eligible patients. Pneumococcal and influenza vaccination rates rose significantly from 5% to a monthly mean of 61% and from 36% to a monthly mean of 67%, respectively. The 80% target was reached for both vaccines during one or more months of study. The in-house vaccination and staff education programs were major contributors to the improvement, whereas the information brochure and record booklet were minor contributors. Three interventions to promote pneumococcal and influenza vaccination among chemotherapy patients resulted in significantly improved vaccination rates. Lessons learned about promoting vaccine uptake may be generalizable to different populations and vaccine types. In response to the global COVID-19 pandemic, initiatives to expand the program to all chemotherapy patients at our centre are underway. •We report the first quality improvement program targeting pneumococcal and influenza vaccination in chemotherapy patients.•Introduction of 3 simple interventions resulted in significantly increased vaccination rates at our tertiary cancer centre.•Identified barriers to vaccination and strategies to overcome them may be applicable to other vaccine types.•Studies evaluating vaccine implementation may help guide SARS-CoV-2 vaccine roll-out for immunocompromised patients.