CDC scraps 30-day flu vaccine reporting rule
Count everyone in hospital for one day
Reporting influenza immunization rates will be a bit easier this flu season, thanks to the efforts of employee health professionals.
As of January 2013, the Centers for Medicare & Medicaid Services (CMS) required acute care hospitals to report vaccination rates of employees, licensed independent practitioners, students or trainees, and volunteers through the National Healthcare Safety Network (NHSN) of the Centers for Disease Control and Prevention (CDC).
The problem: Only individuals who worked in the hospital for 30 days or more between October 1 and March 31 were to be counted.
That 30-day rule was initially created to reduce the reporting burden on hospitals by eliminating people who spend only a day or a few days there, says Megan Lindley, MPH, a CDC epidemiologist coordinating the reporting project. However, for many hospitals, it turned out to be much harder to determine who was in the facility for 30 days.
"They basically all said, This isn’t really how we track people in the facility. It actually doesn’t make it easier, it makes it more difficult,’" she says.
For Lydia F. Crutchfield, BSN, RN, director of Corporate Teammate Health at Carolinas HealthCare System in Charlotte, NC, the greatest challenge came in counting licensed independent practitioners. If a physician came to the hospital to visit patients, there was no way to track whether that physician accumulated 30 working days during the flu season or not.
"An occupational health professional would not know when they entered the building ," she says. "There was no tracking mechanism."
Crutchfield developed a short survey and sent it to fellow members of the Association of Occupational Health Professionals in Healthcare (AOHP). She received 261 responses, which overwhelmingly expressed concerns about the 30-day tracking methodology.
Individual employee health professionals and health care facilities also contacted CDC. Within a few weeks, Crutchfield received word that the measure would change to count any employees, licensed independent professionals, volunteers or students who were in the facility for at least one day during the flu season.
For AOHP members, it was gratifying to know "their voice can be heard on a national level," says Crutchfield.
The National Quality Forum agreed to alter the measure, says Lindley. The data are reported to CMS on May 15 of each year through the National Healthcare Safety Network (NHSN). The measure launched in January, in the middle of the flu season, so the May 2013 reports were essentially a trial run, says Lindley.
This 2013-2014 flu season will be the first publicly reported data, she says.
The heightened attention to influenza immunization of health care workers has led to dramatically higher rates. While a few years ago, less than half of health care workers reported receiving the vaccine, the most recent rate for hospital-based health care workers was 82.5%, according to CDC.
Some hospitals have achieved rates close to 100% through mandatory programs, but even voluntary vaccination programs are recording very high rates. At Carolinas HealthCare System, for example, about 87% of employees received the vaccine last year.
Crutchfield expects even better results this year again with a voluntary system. "The culture is changing," she says. "With the education we provide and the accountability, we do expect a greater vaccination rate."