4 Tips for Raising Vaccination Rates Among Healthcare Workers

Many healthcare organizations now make immunization a condition for employment. Here's how to facilitate the process of getting a flu shot.

Late summer might not seem like a good time to start thinking about healthcare worker immunization, but with classes at schools and colleges already commencing and providing fresh opportunities for germs to spread, now is the time to get these programs underway.

One strong motivator: Federal regulations now require hospitals to count vaccination rates for anyone who works in a healthcare facility between October 1 and March 31.

In anticipation of the regulation—or as a result—many healthcare organizations now make immunization a condition for employment. "I tell [employees], you either get vaccinated or you get deployed to a non-patient care area," says Linda Burns Bolton, RN, president of the American Organization of Nurse Executives and vice president and chief nursing officer at Cedars Sinai Medical Center in Los Angeles.

Push to Vaccinate Healthworkers is On

Immunization rates in her hospital increased from 88% to 95% once wearing a mask became the only other option other than non-patient care to healthcare workers who refused a yearly flu shot.

Most of Bolton's workers were already happy to get their shots, maybe because she discovered a few techniques along the way to make immunization less of a chore.

1. Executive Authority
"It's important to model the change you want to see in others," says Bolton, recommending a special immunization session at a board meeting for members of the C-suite to kick off the immunization push.

"The C-suite needs to not only be immunized, but they need to allow pictures to be taken, and then to allow those pictures to be used in marketing materials. When hospital leadership gets flu shots, others follow."

Flu Vaccination Pressures Ratchet Up at Hospitals

"Administrative support from the top down is an important part of this work," says Carolyn Bridges, MD, associate director of adult immunizations in the immunization services division at the Centers for Disease Control and Prevention in Atlanta. If hospital leadership is clearly behind immunizations, it sends a clear message that immunization is a priority at this facility.

"Make sure the recommendations around immunization are clear," she says. Also, make sure the medical staff have input in the process—once they sign on, getting everyone else to comply will be easier.

2. Educate, Educate, Educate
"This is a great starting point for a conversation on the importance of immunization," says Bridges.

Bolton echoes her sentiments. "Make sure the staff understand the 'why' behind this. Assure them that we are immunizing ourselves and our patients, to protect both ourselves and our community."

Influenza vaccination has been getting a disproportionate amount of attention lately, but healthcare workers shouldn't neglect other important immunizations, including MMR, TDAP and Hepatitis. "Many adults—including healthcare workers—neglect to stay up-to-date on their immunizations," says Bridges, For example, she says, only 20% of adults under the age of 65 recommended to receive pneumococcal vaccine actually get it.

Bridges strongly recommends creating an occupational health clinic and encouraging all hospital workers take advantage of it at least once a year to stay up-to-date on required immunizations.

3. Make it Fun
Immunizations can engender feelings of discomfort or anxiety in some people, but there are ways to not only reduce these unpleasant feelings, but to replace them with positive feelings.

Bolton says she likes to up the ante by creating interdepartmental competitions to see which team can reach a 100% vaccination rate first. "You can't imagine how competitive some of these departments get," she says. Despite the fierce competitiveness, she tries to keep the prizes simple, usually offering only lunch.

Only You Can Prevent a Greater Measles Outbreak

Other awareness-raising activities include poster-making contests, holding a raffle for gift certificates or other prizes for workers who received flu shots, and giving out a small token of appreciation, like a piece of candy or fruit as workers get their shots.

"Always try to make it fun and engaging," says Bolton. "Anything that normalizes vaccines and conveys to healthcare workers the importance of getting them."

4. Make it Easy
At Cedars Sinai, Bolton's team organizes "bands of roving nurses" called the "Flu Immunization Crew, who travel the hospital to provide vaccines. From barging into board meetings to lying in wait in the employee parking lot to nab employees as they arrive in the morning, the nurses make sure no one in the hospital can say they didn't have the opportunity to get a flu shot.

Increased opportunity to receive vaccinations and availability is one of the greatest predictors of likelihood to receive the vaccination, says Bridges. "If it's offered more than one day only, [vaccination] rates go up. If it's not available at all, those rates [of vaccination] are the lowest."

Have flu shots available to workers at every shift, and offer the shot multiple times over multiple weeks. Offering them free of charge will show workers that immunization is a priority in their workplace.

Most healthcare workers will probably want a shot provided free of charge by their employer, but some will inevitably opt to obtain one from another source—just make sure they provide documentation signed by the clinician who administered the shot.

Between motivating workers and making getting shots easy, it shouldn't be too hard to get the entire hospital onboard, says Bridges. "Having a culture where you treat immunization as a part of hospital life is key."