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Blog: Flu shots compliance took arm-twisting at Delaware system

Christiana Care Health System has been on a campaign, vaccinating nearly all of its 11,100 employees against the flu. By the end of this month, it should easily top the 77% vaccination mark set last year among the nation's healthcare workforce.

Employee-vaccination rates for the two-hospital, Wilmington, Del.-based system have been around 93%, exceeding national records for the last four flu seasons. Officials are proud that they've accomplished this without making flu vaccination mandatory, as many healthcare systems have. But, it acknowledged that peer pressure is involved.

The system had only a 56.6% rate during the 2008-09 flu season, but that rose to 72% the next year as a result of the concern created by the H1N1 flu virus pandemic. The next year, it fell back down to 66.4% and Dr. Marci Drees, Christiana Care infection prevention officer and hospital epidemiologist, said the groundwork was set to institute a mandatory vaccination policy.

The Christiana Care voluntary program includes setting up vaccination tables near the entrances of its inpatient and outpatient facilities. Managers track who has been vaccinated on-site, who attests to being vaccinated off-site, and who has declined vaccination and why. Those who are vaccinated receive a tag that is attached to their ID badge that states, “I'm vaccinated because I care.” Those who are not vaccinated must wear a surgical mask when working within 6 feet of patients.

"Every year it gets a little easier," Drees said. "We've gotten to the point where it's really part of our culture."

Vaccination rates are also factored into patient-safety metrics, which can lead to employee bonuses. Nonvaccinated employees are still eligible for the bonuses though their non-immunized status works against their financial interests.

“We really did feel that all employees should be involved—even our IT folks who are miles away and may never set foot in a hospital,” Drees said. “Even if they are not interacting with patients, they are interacting with other healthcare workers who are.”

That said, Drees said it has still been difficult to find out why some employees don't feel the need to be vaccinated.

“A fair number of them don't feel they're at risk or that the flu is not a big deal,” she said.

Employees were asked given a form to fill out if they declined vaccination, and Drees said many just checked the box marked “other” without offering an explanation. In an effort to get more information, she said the “other” option has been eliminated from this year's form.


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