A Statewide System for Improving Influenza Vaccination Rates in Hospital Employees

OBJECTIVE. To describe and report the progress of a provider-initiated approach to increase influenza immunization rates for healthcare workers. DESIGN. Observational study. SETTING. The State of Iowa. SUBJECTS. Acute care hospitals in Iowa. METHODS. Hospitals reported rates of employee influenza vaccination to a provider-based collaborative during 2 influenza seasons (2006 2007 and 2007-2008). Hospital characteristics related to higher vaccination rates were examined. RESULTS. One hundred (87.0%) of 115 Iowa hospitals and/or health systems participated in season 1; individual hospital vaccination rates ranged from 43.5% to 99.2% (mean, 72.4%; median, 73.1%). In season 2, 115 (100%) of 115 Iowa hospitals and/or health systems participated. Individual hospital vaccination rates ranged from 53.6% to 100% (mean, 79.5%; median, 82.0%). In both seasons, urban and large hospitals had vaccination rates that were 6.3% to 7.6% lower than those of hospitals in other locations. Hospitals that used declination statements had influenza vaccination rates 12.6% higher than hospitals that did not use declination statements in season 2. CONCLUSION. The initial vaccination rates were high for healthcare workers in Iowa, especially in smaller rural hospitals, and rates increased during season 2. The successful voluntary approach for reporting influenza vaccination rates that we describe provides an efficient platform for collecting and disseminating other statewide measures of healthcare quality.