Senior Vaccinations

A federally funded program is now in place in three long-term care organizations with the goal of setting LTC industry-wide standards for resident and staff immunizations.

The pilot program, which kicked off July 13 along with a new website, is part of the five-year Moving Needles initiative, led by AMDA – The Society for Post-Acute and Long-Term Care Medicine and backed by a $10.5 million grant from the Centers for Disease Control and Prevention. 

Over the next year, clinicians at nine sites (three each) operated by Saber Healthcare Group, UPMC and ALG Senior, will assess, recommend, administer and document relevant routine adult vaccinations. These will include influenza, COVID-19, pneumococcal, Tdap and shingles for residents, and influenza, COVID-19 and Hepatitis B for staff members. 

The sites will submit monthly data and participate in educational calls and check-ins with an AMDA quality improvement specialist. The goal is to develop evidence-based interventions that follow federal standards and help to improve historically low immunization rates among LTC residents and staff members. 

The initiative is part of a larger effort by federal health officials to improve immunization rates using pandemic-related funds, AMDA told McKnight’s Clinical Daily

“There have been conversations about this around the flu for many years. But this pandemic funding stream allowed for focused resources and quality improvement pilots to begin in earnest,” said Elizabeth Sobczyk, MSW, MPH, AMDA project director with the CDC Cooperative Agreement on Immunization. 

Cost-benefit analysis

AMDA aims to find improvement in at least one vaccination rate per site when the LTC pilot program wraps up in June 2023. The main goal is “to see sustainable process improvements and a resulting rate increase,” Sobczyk said. The organization also will collect data on the financial costs and benefits of investing in an immunization program — including when staff is limited, she told McKnight’s.

“We would like to show how such an investment can impact census, daily revenue, 5-star ratings and surveys,” she said.

Initiative leaders are also encouraging electronic health record vendors to support the pilot participants. Ideally, the EHR will prompt staff when a patient is due or overdue for a vaccine, offer easy-to-use dashboards to measure facility immunization rates, and support standing immunization orders, Sobczyk said. AMDA is also encouraging these vendors to link bidirectionally to state-run immunization information systems (or registries). 

Community-based services next in line

Starting in July 2023, AMDA will extend lessons learned when it moves to another one-year test program involving providers of home and community-based services, and Institutional Special Needs Plans.  

By years four and five of the initiative, the organization hopes to have developed an immunization standards “change package” that it can make broadly available to AMDA members and partners. This will include the tested interventions, implementation support and measurement tools.

AMDA staff will be on hand to provide technical assistance to facilities who wish to include these immunization processes in their standards of care, Sobczyk said

Sharing resources

AMDA is eager to share information. The organization chose to begin the pilot program with large skilled nursing and assisted living chain operators and geographically diverse sites to better facilitate learning and scale-up, Sobczyk told McKnight’s.

“While our primary focus is on the pilot sites right now … we are able to provide resources from the website to other facilities or chains, and are happy to share processes and materials with anyone looking to improve their immunization rates among staff and residents.”

Interested facilities can visit the website to find more information.

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