A modest proposal? Joint Commission flu campaign

Will hospitals finally step up efforts?

Joint Commission Resources (JCR) has launched a "Flu Vaccination Challenge" this season targeting health care workers, but organizers only underscored the current woeful situation in setting the immunization goal. In a concession to a longstanding reality, the JCR announced that any facility that achieves a vaccination rate of 43% will "be recognized by JCR for their dedication to helping keep their employees healthy and helping to protect their patients."

According to the Centers for Disease Control and Prevention, the 2005-2006 flu season saw only 42% of health care workers receive a flu vaccination. It's not news to infection preventionists that health care workers have historically snubbed the seasonal flu shot for a variety of reasons, myths and misconceptions.

"We are certainly not asking organizations to stop if they are at 43%," says Louise Kuhny, RN, MPH, MBA, CIC, associate director for standards interpretation at the Joint Commission. "The national vaccination challenge goal is a recognition of the [current] national rate. We are hoping that everyone can get on the band wagon and be recognized if they can exceed that."

A patient safety issue

The JCR noted that flu infections have been documented in health care settings and workers have been implicated in outbreaks. In other words, it's a patient safety issue as much as an employee health issue. "As a professional devoted to 'do no harm,' flu vaccination gives me an opportunity to help protect my patients," says Barbara Soule, RN, MPA, CIC, practice leader in infection prevention and control services at JCR.

The vaccination challenge began in September 2008 and will continue through the flu season until May 2009. Since Jan. 1, 2007, The Joint Commission has required accredited hospitals, critical access hospitals and long-term care organizations to offer the flu vaccination annually, on site, to staff and licensed independent practitioners. The Joint Commission is keeping the campaign separate from its survey process, which probably is a good thing since some of the facilities participating in the challenge reported baseline immunization rates as low as 8%. Other facilities reported existing immunization rates as high as 98%, JCR organizers say. About 1,000 facilities are expected to sign up for the challenge, with those already above the goal using the campaign to push rates higher.

"The Joint Commission surveyors will be unaware of which organizations have signed up for this and which have not," Kuhny says. "It will have no bearing on the survey process, but our requirements will continue. I am also a surveyor. If I was at an organization and they showed me that they had an 8% vaccination rate last year, I would definitely have some questions about what they had done in terms of their educational program."

Motivating staff

The Joint Commission standard requires organizations to offer the vaccine and act on reasons for refusal in subsequent years. "That [means] if you were at 60% last year we expect you to know what you need to do to improve upon that the next year," she says.

The campaign and certificate recognition – which is open to nonaccredited organizations — may become an annual event. "This is a motivating tool for organizations," says Elizabeth Zhani, Joint Commission spokesperson. 'We are offering them a lot of resources on the web site. There are cases studies of organizations that have done these types of programs. So it really is a way for them to motivate their staff to join the health care workers that are getting vaccinated."

(Editor's note: For more on the campaign, go to: http://www.jcrinc.com/26814/audioconf/32205/.)