Fourteen long-term care facilities in Pennsylvania dramatically increased their staff flu vaccination rate by having a regional pharmacy take over the process, according to a report issued Thursday by the Agency for Healthcare Quality and Research (AHQR).

High turnover at nursing homes creates challenges in achieving a high vaccination rate. New managers may not know facility’s policies or could decide to create new ones, the AHQR report notes. Nursing homes tend to have stable relationships with their pharmacy providers, so a project was devised to hand over nursing homes’ vaccination policies and administration to their shared regional pharmacy.

Since the Raising Immunizations Safely and Effectively (RISE) program was implemented in 2005, average immunization rates at the participating facilities went from the 30% to 40% range to about 75% in the 2010 to 2011 flu season, the report states. Some of the facilities have exceeded 90%.

The 14 RISE nursing homes ceded their staff flu program to RxPartners Inc. This involved accepting a standing order for vaccine administration from the pharmacy’s medical director, which eliminated the need for each long-term care facility to obtain a physician order to vaccinate workers, the report states.

The RISE protocol also eliminated worker consent forms, which had been used by some facilities, but which are not required by the federal government or most states (including Pennsylvania). Consent forms can scare workers off from vaccination by listing “any and all potential problems,” according to the AHQR document. Instead of consent forms, workers are given a vaccine information statement from the government, and they are required to fill out a declination form if they decided against being vaccinated.

Other program elements include: the designation of a “local champion” in each facility to promote vaccination and coordinate with the pharmacy; in-service training of LTC workers by pharmacy staff; and the creation of a steering committee of pharmacy and nursing home representatives to foster buy-in and guide implementation and execution.

The Centers for Disease Control and Prevention set a goal of 60% healthcare worker vaccination by 2010, and long-term care facilities in particular have struggled to meet this target. The CDC routinely pushes for long-term care to tackle this issue. The RISE program offers one attractive model, as it involves minimal costs and no new staff, according to AHQR.

RISE was developed at the University of Pittsburgh Medical Center.

Click here to access the complete report.