The bug stops here: This flu campaign never ends

Hospital works year-round to boost vaccines

Once a year, hospitals roll out the influenza campaign and try to immunize as many health care workers as possible. But therein lies a problem. Once a year may not be enough.

The flu campaign at Brigham and Women’s Hospital in Boston continues year-round, and employees can receive the shots throughout the flu season — from October to March. That sustained effort enabled the hospital to increase its immunization of health care workers from 11% to 57%. (Nationally, only about 36% of health care workers receive the annual vaccine, according to data from the National Health Interview Survey.)

Last year, the hospital’s occupational health service administered 6,212 doses of flu vaccine. That included doses given to 5,153 employees (of the hospital’s 9,000 employees). Others were provided to volunteers and physicians.

"We’re really trying to maximize our efforts to get our health care workers vaccinated," says Jean Franzini, MS, NP, occupational health nurse practitioner and coordinator of the influenza program. "We’re fortunate that senior management understands and are aware of the importance of having health care workers immunized against flu."

With support from senior management, she has the resources to conduct an effective campaign. The influenza vaccination program, including education and outreach, costs about $50,000 a year.

Franzini sets up her main campaign in one of the hospital’s lobbies, where it has high visibility. She conducts the campaign for two weekends and one full week in early November. She hires temporary staff to supplement the employee health staff, running as many as six vaccine stations during the hours of 6:30 a.m. to 5 p.m. "It’s set up to meet the needs of our busy clinical staff who can zip in, get a quick vaccine, and hurry on."

After the campaign, the occupational health service offers flu rounds, taking a flu cart to units to vaccinate anyone who missed the lobby stations. Some departments, such as the emergency department, also may vaccinate their own employees. And throughout the season, occupational health continues to vaccinate new hires and anyone who comes into the employee health clinic for a vaccine.

Here are some of the key aspects of Brigham and Women’s campaign. (Click here for a copy of the hospital’s model for year-round flu planning and vaccination.)

Develop a catchy theme.

In the summer, Brigham and Women’s develops a flu vaccine theme and prints educational materials. The theme usually last for two years; that saves expenses on the promotional materials, Franzini notes. "It has to be a broad message because we have a broad target audience."

"The flu bug stops here" is the message this year. The logo is on posters, stickers, and brochures. The message will even pop up on headers every time someone logs onto the in-house computer network.

Train vaccinators to educate.

The employees range from environmental service workers who speak English as a second language to Harvard Medical School physicians. They all need to understand why it’s so important to receive a flu vaccine, Franzini notes.

Even nurses may have misconceptions about the safety and effectiveness of the flu vaccine. But if they receive one, "it’s likely they’ll receive it in subsequent years," she says.

Franzini also goes to grand rounds and residents’ meetings to administer flu vaccine to physicians.

Focus on customer service.

Employees know they won’t have to wait long to receive their vaccine. "The whole focus of the flu program is customer service," she says. "[We want] to get our staff quickly and safety vaccinated, [and] answer their questions so they see it as a positive experience. We staff it well to decrease any lines and minimize waiting. It probably takes one to two minutes. Our staff now recognize that it’s a speedy process, and they appreciate the effort we make to get them in, get them out."

Provide updates about flu activity.

When the first patient is admitted with influenza, occupational health sends out a message on the all-user e-mail and puts an article in the newsletter. Occupational health also notifies health care workers who have had contact with the patient, asks if they have had the flu vaccine, and alerts them that the vaccine still is available.

"It lets them know it’s not just a theoretical threat, but we’re actually seeing patients who are admitted," Franzini says of the flu feedback. "That will generate a little activity in the occupational health clinic."

With more employees vaccinated against the flu, it should contribute to lower absenteeism and provide better patient care while protecting against nosocomial spread, Franzini adds. "We see it as a priority to protect our patients from illness and protect our staff from illness."