Journal Article

\TAKING A SHOT\ AT INFLUENCES AND INTERVENTIONS TO IMPROVE IMMUNIZATION RATES IN PATIENTS WITH CANCER: LEARNINGS FROM A QUALITY IMPROVEMENT PROJECT

Thompson, Nancy, Canoy, Anna, Case, Andy

2025

Overview

Significance & Background: Our community cancer center is one of 8 institutions in the United States chosen to participate in a 5-year cooperative grant from the Centers for Disease Control, focused on exploring, understanding, and improving our immunization processes and creating a positive impact in patient outcomes through interventions based on current, established national guidelines and recommendations. The value of immunization as a powerful tool to help patients with cancer improve outcomes is nationally recognized. However, management of immunization care gaps at our practice is generally deferred to primary care providers. This project focuses on the outpatient oncology practitioners and caregivers taking proactive steps in assessing and reconciling immunization care gaps, educating the patients and families, planning and recommending appropriate immunizations, administering vaccines or referring the patient to the primary care, and documenting interventions in the electronic medical record. Purpose: To develop sustainable interventions aimed at making management of immunization care gaps as a standard of care for the outpatient oncology setting at our cancer institute. Interventions: An immunization core team comprised of a Physician Leader, Quality Director, Project Manager, Nurse Practitioner, Clinical Nurse Specialist, and a Nursing Supervisor was organized to help lead the initiatives related to the project. PDSA model was used to guide discoveries and focus on project objectives. A strong collaborative, ongoing partnership between the immunization core team, physician leaders, caregivers, educators, nurses, pharmacists, and ancillary support worked together to address issues and develop interventions. A multi-disciplinary approach using variable methods of education and communication was utilized to address learning gaps and improve on the 3-month PDSA cycles. Surveys offered perspective on project questions and needs. Data was regularly reviewed and reported to the Council of Medical Specialty Societies platform as required by the grant, which guided ongoing and future work on the initiatives. Results: Improvement in the assessment and reconciliation of immunization care gaps as well as administration of vaccines at the cancer institute was established. Variations in practices and revelations of persisting misconceptions and roadblocks to recommendations and administration of vaccines persisted as seen in data review. Discussion: While immunization care gap assessment and reconciliation have improved, opportunities abound in further streamlining processes including onsite administration, patient referral for vaccine administration, immunization ordering, and documentation. Factors influencing vaccine hesitancy also need to be addressed in the system.

• Publisher: Oncology Nursing Society
• Subject: Cancer / Caregivers / Immunization / Oncology / Patients / Primary care / Vaccines