Open Reporting of Employee and Non-Employee Healthcare Personnel Influenza Vaccination .

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Public Reporting of Employee and Non-Employee Healthcare Personnel Influenza Vaccination/Informed Declination Rates. Influenza Subcommittee HAI Advisory Committee July 7, 2010. Members . Raymond Chinn, MD (Chair)
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Open Reporting of Employee and Non-Employee Healthcare Personnel Influenza Vaccination/Informed Declination Rates Influenza Subcommittee HAI Advisory Committee July 7, 2010

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Members Raymond Chinn, MD (Chair) Lilly Guardia-LaBar, RN, CIC Julie Marleau Tricia McLendon, MPH (CDPH) Carole Moss Frank Myers, MA, CIC Terry Nelson, MBA, RN, CIC Rebecca Siiteri, RN, MPH (CDPH) Dawn Terashita, MD, MPH Francesca Torriani, MD Kavita Trivedi, MD (CDPH)

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California Health and Safety Code, Section 1250 Requires that all authorized general intense care doctor\'s facilities (GACH) must: Offer yearly on location flu inoculations, upon accessibility, to all representatives at no cost to the worker; Require its workers to be immunized to get a composed assertion that the worker declined immunization; and Annually answer to CDPH contamination counteractive action prepare measures as prescribed by the CDC Healthcare Infection Control Practices Advisory Committee, including however not restricted to flu inoculation measures of social insurance personnel 

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Challenges Accuracy of submitted information Various elucidations of what constitutes a worker Inclusion or rejection of representatives inoculated somewhere else Broad meaning of non-worker medicinal services staff (HCP): surrendered over to the foundation to choose Difficulty in catching data on HCPs

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For 2008-09 and 2009-10 Seasons Post disclaimer that information gathered had critical impediments making correlations hard to translate Attach report depicting confinements inside and out

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Non-Reporting Hospitals for the 2008-2009 Influenza Season Epidemiology Unit has/will contact ~ 100 doctor\'s facilities to check non-reporting status Request to re-submit information for those doctor\'s facilities that expressed that information was submitted ? Re-investigation of total information

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Reporting Influenza for the 2008-2009 Post total CA information, w/rundown of reporting offices and non-reporting offices after CDPH contacts non-reporting offices to confirm reporting status Aggregate information to incorporate representatives just: Report total immunization percent Report total declination percent Report "obscure" percent

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Reporting for 2009-2010 Issues: accessibility of antibody and pandemic strain Hospitals given a 90 day beauty period (4/30 – 7/1, 2010) to submit or revise/re-submit information Oct. 30, 2010: like reporting of 2008-09 season for representatives: post total CA information, w/rundown of reporting offices and non-reporting offices Aggregate information to incorporate workers just : Report total inoculation percent Report total declination percent Report "obscure" percent

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For the 2010 – 2011 Season Input from EOHD consultants Michael Allerton (Kaiser) Connie Perez-English (Kaiser) Annie McCary (LAC-USC) Robert Harrison, MD (CDPH, UCSF) Survey: 2 information gathering frames from Epidemiology Unit: HCP bunches versus unit Sent out to clinics in LA for contribution by Dawn Terashita, MD

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Reporting for 2010-2011 Season Vaccination rates for representatives: posting by healing facilities Denominator: Use "paycheck" (in-patient "surveyable": Kaiser) from foundation as surrogate marker Include just representatives who are on finance on 03/31 Exclude each one of the individuals who are on "time away" on 03/31 Numerator (cut off date 03/31/10): Total number immunized (subcategories: those inoculated at the establishment and those inoculated somewhere else) Total number of representatives who declined (bar those representatives who declined in light of the fact that they were immunized somewhere else) Total number of obscure CDPH to ascertain immunization and inoculation/educated declination (outreach) rates

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Comments and Responses Regarding Issues with Employees Reporting Accuracy of information when work drive is powerful: reaction: not flawless, best that should be possible is to utilize a cutoff date Is separate classification of immunized somewhere else fundamental? reaction: yes, to catch the aggregate number immunized Some representatives who are inoculated somewhere else won\'t answer address (HIPAA) and fill in "other" in their declination; reaction: incorporated into declination is a class of "immunized somewhere else" so this ought to suffice

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Definition of Healthcare Personnel Healthcare work force may incorporate (however are not restricted to) doctors, attendants, nursing associates, specialists, experts, crisis restorative administration faculty, dental staff, drug specialists, research facility staff, post-mortem faculty, understudies and learners, authoritative staff not utilized by the human services office, and people (e.g., administrative, dietary, housekeeping, upkeep, and volunteers) not straightforwardly included in patient care.

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Non-Employee HCP: 2010-11 Option 1 Target uncommon gatherings , e.g. Incorporates all permit free experts (LIPs) who have benefits at the doctor\'s facility on March 31: requires Medical Staff office bolster Volunteers no March 31: data could be caught by EOHD Contract offices/registries rates: how to best get data

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HCP Surveillance: Targeted Group Issue of denominator for non-worker HCP

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Issues with Groups How to catch different gatherings that are focused on: MDs: troublesome for EOHD; reaction: needs oversight of Medical Staff office Volunteers: why is this gathering vital; reaction: volunteers in a few establishments have close contact with patients Registry: ought to this be all or none, or focused on? Troublesome since there might be numerous in this gathering; reaction: consolidate into contract to guarantee consistence Classify MD and other non-representative HCPs; reaction: the last gathering excessively troublesome get information Separate by patient contact; remark: likewise

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Contract/Registry HCP: AFL 08-17 Page 4 August 29, 2008: an Alternative As flu inoculation of all human services faculty is prescribed by the CDC, it is proposed that intense care clinics set up a procedure guaranteeing that agreement offices give proof of flu immunization as well as check of educated declination for all contracted social insurance work force.

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Recommendation for Registry/Contract HCPs Require healing facilities to give a confirmation from registry and contract organizations affirming that they require their representatives to either get immunized for flu or sign a declination Denominators and numerators of inoculated or declined registry would not be gathered

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Non-Employee HCP2010-11 Option 2 Target unique tend to high hazard patients, e.g. ED, ICU, pediatric units, s SF General model: point predominance observation Every HCP is required to have documentation of inoculation/educated declination when giving consideration in the assigned patient care unit.  The oversight will be the unit chief

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HCP Surveillance: Targeted Areas Issue of denominator for non-worker HCP

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Issues with Targeted Areas Confusion amongst representatives and human services faculty Difficult to catch registry staff How ought to numerator and denominator for registry provided?

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Motions Format for 2008-2009 reporting Format for 2009-2010 reporting Format for 2010-2011 reporting for workers Format for 2010-2011 reporting for non-representative social insurance staff

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