Automated Screening of Hospitalized Children for Influenza Vaccination

Background: This study was designed to determine whether an automated hospital-based influenza vaccination screening program leveraging the electronic medical record (EMR) increases vaccination rates.

Methods: We performed a retrospective cohort study of all children ≥6 months old admitted to medical, surgical, rehabilitation, or psychiatry services during influenza seasons between 2003 and 2012 at a tertiary care pediatric hospital. We compared influenza vaccination rates before (preintervention phase) and after (intervention phase) the introduction of an automated EMR intervention that utilized a nursing-based electronic screening tool to determine eligibility for influenza vaccine and facilitated vaccine ordering without requiring involvement of a physician or other provider.

Results: Overall, 42 716 (72.8%) of the 58,648 subjects admitted during the study period met inclusion criteria. The intervention phase included 20,651 admissions, of which 11 194 (54.2%) were screened. Screening increased significantly over time in the intervention phase (19.8%-77.1%; P < .001). In-hospital influenza vaccination rates increased from a mean of 2.1% (n = 472) of all subjects preintervention phase to 8.0% (n = 1645) in the intervention phase (odds ratio = 6.8; 95% confidence interval, 6.14-7.47). Of the 11 194 screened subjects, 5505 (49.2%) were found to have already been vaccinated at the time of screening. The screening process identified 478 (4.3%) subjects who were unable to receive vaccine for medical reasons, and an additional 2865 (25.6%) whose caregiver refused the vaccine.

Conclusions: An automated, hospital-based influenza vaccination program integrated into the EMR can increase vaccinations of hospitalized patients and provide insight into the vaccination history and declination reasons for children not receiving the vaccine.