ࡱ> @= x6N04x&ab} ExZ]lTE>sV!Pئ(4P F@ihe>jk|k } jTbmH# ;lglEmN=sΙoDth6>AtIPybQs5Qmu{+'~I$go_]嘖$8]/Myi߰zeb{1٠z|0FA !D2Ans(9 Tv }U%S!Ls2p-MqlŊNJ4~[x8(oc1|Ѕ孆.o o_XWlܮь+/ViW~9>A#{qD_8X&Fx?jf .OLb_ɜM)\^aDKWWI)> *p;>lއ2Sk76ni0)ۻQvqWx6BḓbƿX'% o1!_{'-W5l^@bN),GDa((>aHvR9r~:1Ħ=y' pc8˩O\oSX}ZZ(05=@ϢL L<=>,g9&%Ibeֽ!E1l T~8@C/ Ki-}^QWϾJQ߫H߀. 3N6tsXPttFǤ+qűfŤ(ܜC3H7C#p< 2Q<+7/tU~݃AwNց^G>kEk+*<$6r/*,s%Su|_埒/hb_!1 Wַc|ų#}L93?gܠ")(^IȘ|IDٝ7> OӗM 1 @Ҟ\gLMe"^,]]rWmk蒀}tI]l~Oy}=n>f\oǻ,0d7]kwۑL7!BR;r:⼉F63`oTSLZLhܿm]1Y.Awag8ݠ$]_$VV/H^o eb3.VPPv փVS11`|n"Y=&'[#sqTy>"כ۫[\*y%;Cci.-I> @=< k+IQ,aɷ} ExY]L\E>s"F nDBn[EK(VVLB 6Ǿ ĘXSHCÃML1ڈ;,Y]aK>fo9sf {*3BtUPpha;Q}D6y  mM6߉@Iz+Q9%wRn]Ҧ[%FSz-g4O$-vIʘ;G"[Li2dh̗qX *e݌WYL]=އw'<}BfhScBeZZ8VFD@.Ʃe";Ngdoi{`~xhB9='=8{M3N=홸 iX燿;7?>3(O"}{N4ȹZN{[g׍zzx1w6p|[Q^s~80cLFzVXWK5=H3vXyP _YރH\t\<#֣Uzz!W Co y!/ܚ7O"5i}jE]o y=-|td\1+gI!'FCX;ğͻmC#w8M,OgbNY:yf rIb -O;/v,!,;DPy~ROY,Nޏe]'n/'g1u{tyg=@>yy:{ȉP~p /7(YlN?;uU{ of&оOrΡ(7 *`ߔsl+y!y ^% Ϙ{S8}!%UZ9C%Cy?ߧ}3>c.١6j:3Ss 5>}~ ~md%6LtN ;p_o o/%+ }1:IFQIY.0M!=?2]?}$H_DaC}T|6߾~0˾} m!D^DsN;|wNAҗ]KeWoUQ~Ws&mmMF ֪c+ޠ8O3۶;g[ٜteT3u8}R 6 *CDC Dan Fishbein Susan Manning Edith Gary &''Q;OutlineQuestion Reasons for low immunization rates Phases of  Baton Rouge Effort Isolating variables Results Conclusions<K 7 7 7K J4Question| Are reasons for decreased late season flu immunization different from reasons for decreased early season flu immunization. }}>+#Patient Reasons to be Un-Vaccinated6$$$$ $Inadequate Knowledge, Attitudes & Practices (KAP) knowing, caring or wanting vaccination Expense Direct cost of vaccine & MD visit Indirect cost of missing workn30s2'0s20s2@0s2 ('@?,"Providers Reasons to not Vaccinate # $$Inadequate Provider KAP Non traditional providers (ex. ER Docs) Extension of vaccination season Direct and Indirect  Costs Cost of vaccine and vaccination Counseling can be very time consumingn}H}}}F}HFYdR<OutlineQuestion Reasons for low immunization rates Phases of  Baton Rouge Effort Isolating variables Results Conclusions<K 7 7 7K :'+4""Phase 2: Indirect Cost to Patients# $ &*6$,Phase 3: Varying Patient Out of Pocket Costs-- ~Conclusions  ED immunization facilitated by para-professionals feasible Incremental increases in a patient s direct cost decreased vaccination acceptance Note: Providers minimally involved6##.,O8Phase 4b, Baton Rouge EffortsNovember 2005  March 2006 Larger hospital assessed 24/7 Smaller hospital assessed 10 AM to 10 PMN7Phase 4b, Baton Rouge EffortsUFlu vaccination in 2 busiest EDs Physicians signed standard orders Nurses vaccinated "UPxV6-B/Racial Disparities F0ZInfluenza Vaccination, Patients in ACIP Risk Groups by Race, Hospital A ED, Dec. 5-Feb. 16[[G1ZInfluenza Vaccination, Patients in ACIP Risk Groups by Race, Hospital A ED, Dec. 5-Feb. 16[[ S>Question| Are reasons for decreased late season flu immunization different from reasons for decreased early season flu immunization. }}P9Late Season ImmunizationP No significant decrease in late and early season acceptance of flu immunizationQPQK5#Patient Reasons to be Un-Vaccinated6$$$$ $Inadequate Knowledge, Attitudes & Practices (KAP) Direct and Indirect  Costs 430s2} E"Overall ConclusionsPara-professionals in EDs can increase patient s KAP towards flu vaccination Eliminating patient s direct & indirect cost increases immunization rates ED immunization decreases disparities Providers: Role is problematic ps-- Conclusions of Phase 4bLate flu season immunization is feasible and accepted by patients. Patient issues associated with late flu immunization are apparently similar to early season issues Provider issues may be importantPsKT=OutlineQuestion Reasons for low immunization rates Phases of  Baton Rouge Effort Isolating variables Results Conclusions<K 7 7 7K   ` 33` Sf3f` 33g` f` www3PP` ZXdbmo` \ғ3y`Ӣ` 3f3ff` 3f3FKf` hk]wwwfܹ` ff>>\`Y{ff` R>&- {p_/̴>?" dd@(|?" dd@   " @ ` n?" dd@   @@``PR    @ ` ` p>> f(    6q  `}  T Click to edit Master title style! !  0t  `  RClick to edit Master text styles Second level Third level Fourth level Fifth level!     S  04{ ^ `  >*  0 ^   @*  0 ^ `  @*h  Bfvd޽h @ ?"  33D<___PPT10..M9o Default Design 0 zrh (  h h 0 D P   D P*   h 0TD    D R*  d h c $ ?  D h 0t D  0 D RClick to edit Master text styles Second level Third level Fourth level Fifth level!     S h 6D _P  D P*   h 6$D _  D R*  H h 0޽h ? 3380___PPT10.Z=V% 88(  8 8 0 .D P   D >*  8 0T2D    D @*  8 67D _P  D >*  8 6l;D _  D @* H 8 0޽h ? 3380___PPT10.e9 0(  x  c $B ` B x  c $B @ B H  0޽h ? 33___PPT10i.M9kHo+D=' = @B +  H(  Hr H S M `}  M r H S F   J r H S UDp ` D H H 0޽h ? 33___PPT10i.A͐+D=' = @B +}   P$(  Pr P S  `}   r P S  `  H P 0޽h ? 33___PPT10i.A(+D=' = @B +}  0$(  0r 0 S  `}   r 0 S tK  H 0 0޽h ? 33___PPT10i.Ar+D=' = @B +  \(  x  c $[D}  D   c $\D0 <$D 0 D H  0޽h ? 33 ~ ___PPT10^ .O90؉+YD2 ' = @B D ' = @BA?%,( < +O%,( < +D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*3%(D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*3Z%(D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*Zb%(D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*b%(D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*%(+   \(   x   c $eD `}  D    c $fD `<$D 0 D H   0޽h ? 33___PPT10.O90؉+YDn' = @B D)' = @BA?%,( < +O%,( < +D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<* %(D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<* @%(D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<* @`%(D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<* a~%(D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<* ~%(D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<* %(+0  0T0(  Tx T c $|gB `}  B x T c $hlB ` B H T 0޽h ? 3380___PPT10.A( <4$>(   p  # #"0  F  BP F?x   @ @`  B,F?` 1  @ @`  BF ?"`   J$0 @`  BF ?"` 1  J$0 @`  6TF? p1 W Direct Cost   @`  BܶF?`  @ @`   BܾF?`1`  @ @`   6F?`p 1 OKAP @`   B F? x  @ @`   B4F?1  @ @`   6@F?p1 Y Indirect Cost @`  <F?p`1 QChanges @`  <F? `  RProvider   @`  <F?1`  QPatient @``B  0o ?ppZB  s *1 ?  `B  0o ?  `B  0o ?p ZB  s *1 ?`p` `B  0o ?p ZB  s *1 ?11ZB  s *1 ? p ZB  s *1 ?p ZB  s *1 ?` 1` ZB  s *1 ?x x   0DG0 QPhase 1 of 4, Assessment/Reminder forms for 6 vaccines in 3 Primary Care SettingsR(2R `R  s *"` 0R `B  s *"` R `B  s *"`P R p `2  s *f"` 4p `R ! s *"` P " `R " s *"`P , # s *G,$D 0 lConclusions: Providers did not give recommended vaccines, unable to assess effect of increasing patient KAPm 2m  > s * GF @,$D 0 ~LResults: No significant increase in immunizations in the intervention group.M 2MH  0޽h ? 33\T___PPT104.?g+OD' = @B DS' = @BA?%,( < +O%,( < +DA' =%(D' =%(D' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*>%(DA' =%(D' =%(D' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*#%(+p+0+#G ++0+>G + .R(  J   . #"}}x~ G  B@1G ?"`   J$0 @`  6t9G?   W Direct Cost   @`   BXCG?  n&Standing Orders, Provider not involved'' @`   BKG?   ] A/R FORM"   @`   6\G?  OKAP @`   BhWG?   @ @`  6dnG?  Y Indirect Cost @`  <wG?  QChanges @`  <yG?  RProvider   @`  <G?   QPatient @``B  0o ?ZB  s *1 ?  `B  0o ?`B  0o ?ZB  s *1 ?`B  0o ?ZB  s *1 ?  ZB  s *1 ?  ZB  s *1 ?   0xG`  XPhase 2 of 4 Para-professionals approached ED patients, Immediate vs. Later VaccinationY(Y `2 # s *f"`  f2 & 0"` Bp H  0޽h ? 33___PPT10i.?g+D=' = @B +  `\(  x  c $G`  G x  c $$yG ` G $  0G  ~Results - Immediate vaccination with greater acceptance rate. Conclusions  Eliminating patient s indirect costs significantly increases vaccination coverage Note: Provider role eliminated *0nH  0޽h ? 33___PPT10i.P9i+D=' = @B +  \(    ` \ #"` G X BЪG? ` fProvider signed standard order @`  BG ?"`   Q $0, 5, 10   @`  6G?  W Direct Cost   @`   BG? ` M+( @`   BhG?  U A/R FORM   @`   6G?  OKAP @`   BXG?  J$0 @`  6G? Y Indirect Cost @`  <G? QChanges @`  <G? ` RProvider   @`  <I?  QPatient @``B  0o ?ZB  s *1 ?  `B  0o ?```B  0o ?`ZB  s *1 ?``B  0o ?`ZB  s *1 ?ZB  s *1 ?  `ZB  s *1 ?   0t I0 ]Phase 3 of 4, Para-professionals Using A/R Forms, Patients Randomized to $0, $5, $10 Co-pay<^n1 , `B 6 s *"`@^ `B P s *"`0 R R W s * ` H  0޽h ? 33___PPT10i.?g+D=' = @B +  0(  x  c $0I0P}  I x  c $4I ` I H  0޽h ? 33___PPT10i.c=_L+D=' = @B + }*(    Tl ) #"nGHTl I  BP,I? $ l J$0 @`  BdG?$ l @ @`  B@6I ?"` $  J$0 @`  6\?I? T W Direct Cost   @`  B@I?$ l @ @`  BPPI? $  U A/R FORM   @`  60YI?T  OKAP @`  BaI?$  J$0 @`   64cI?T Y Indirect Cost @`   <LtI?T QChanges @`   <T}I?$ l RProvider   @`   <\I?$  QPatient @``B   0o ?TTZB  s *1 ?$ $ `B  0o ?ll`B  0o ?TlZB  s *1 ?Tl`B  0o ?TlZB  s *1 ?ZB  s *1 ? T lZB  s *1 ?TlQ  0I` gPhase 4a of 4, City Wide Effort: Para-professionals Using A/R Forms, Providers signing standard ordersnh}     - `R & s *"` `2 ' s *f"`n 2  * s *Je,$D 0 r@Results: Anomalous year Larger ED with better cost benefit ratioA 2AH  0޽h ? 33___PPT10.?g+ !7DO' = @B D ' = @BA?%,( < +O%,( < +DA' =%(D' =%(D' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<**%(+8+0+*D +  @0(  @x @ c $9F `}  F x @ c $DF ` F H @ 0޽h ? 33___PPT10i.P9i+D=' = @B +2   <\(  <x < c $D%f `}  J  < c $@HF `<$D 0 f H < 0޽h ? 33___PPT10.P9i+YD' = @B Du' = @BA?%,( < +O%,( < +D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*<!%(D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*<!C%(D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*<CU%(+R ia(    ` # #" I  BI? ` J$0 @`  BI? ` @ @`  BI ?"`   J$0 @`  6lI?  W Direct Cost   @`  BXI? ` @ @`  BI?  U A/R FORM   @`   6I?  OKAP @`   B I?  J$0 @`   6I? Y Indirect Cost @`   <I? QChanges @`   <J? ` RProvider   @`  < J?  QPatient @``B  0o ?ZB  s *1 ?  `B  0o ?```B  0o ?`ZB  s *1 ?``B  0o ?`ZB  s *1 ?ZB  s *1 ?  `ZB  s *1 ?`7  0<J` oPhase 4b of 4, Para-professional - A/R Forms, Providers signing standard orders 2 Busiest Emergency DepartmentsLp}"  -  `R  s *"`P `2  s *f"` 2pH  0޽h ? 33___PPT10i.?g+D=' = @B +5(  L'D'P?F&(  x  c $8J `}  J $& 7 F #"*. J  <;J? 7 B @`  <GJ?   B @`  <BJ?   B @`  <YJ?  B @`   <pbJ?f B @`   <kJ?f QP Value @`   6HtJ? 7 S64.9% @`   6eJ? 7 F @`   6J? 7 S52.6% @`  6J? 7 F @`  <ȗJ? 7 VTotal coverage @`  6 J?   S19.0% @`  6(J?    P81 @`  60J?   S24.5% @`  68J?  Q326 @`  <,J?   R Vaccinated   @`  6J?   S45.9% @`  6J?   Q196 @`  6J?   S28.2% @`  6dJ?   Q375 @`  <J?   KUTD @`  6J?  F @`   6M?   Q427 @` ! 6J?   F @` " 6@M?  R1332 @` # <pM?  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(2 +Health Sciences Center      .-80B 0 B .  @n?" dd@  @@``  \X' #% W!),]-/.+/68c<?=@A\EGFGJKMNOPRSTU_$"$ x6N04$$"$< k+IQ, 0AA0 ff@wmJ ʚ;r8ʚ;g4BdBd B 0ppp@ <4ddddLpC 08<4BdBdLpC 08 80___PPT10 ?  %;(<Increasing (Late Season) Influenza Vaccinations- Baton Rouge*= $ $&$1FWilliam Cassidy, MD Louisiana State University Health Sciences CenterGGM:AcknowledgementscLSU Dale Marrioneaux Aubrey Lipham Sal Baghian Baton Rouge General Staff Our Lady of the Lake Staff&``> 6 *CDC Dan Fishbein Susan Manning Edith Gary &''Q;OutlineQuestion Reasons for low immunization rates Phases of  Baton Rouge Effort Isolating variables Results Conclusions<K 7 7 7K J4Question| Are reasons for decreased late season flu immunization different from reasons for decreased early season flu immunization. }}>+#Patient Reasons to be Un-Vaccinated6$$$$ $Inadequate Knowledge, Attitudes & Practices (KAP) knowing, caring or wanting vaccination Expense Direct cost of vaccine & MD visit Indirect cost of missing workn30s2'0s20s2@0s2 ('@?,"Providers Reasons to not Vaccinate # $$Inadequate Provider KAP Non traditional providers (ex. ER Docs) Extension of vaccination season Direct and Indirect  Costs Cost of vaccine and vaccination Counseling can be very time consumingn}H}}}F}HFR<OutlineQuestion Reasons for low immunization rates Phases of  Baton Rouge Effort Isolating variables Results Conclusions<K 7 7 7K :'+4""Phase 2: Indirect Cost to Patients# $ &*6$,Phase 3: Varying Patient Out of Pocket Costs-- ~Conclusions  ED immunization facilitated by para-professionals feasible Incremental increases in a patient s direct cost decreased vaccination acceptance Note: Providers minimally involved6##.,O8Phase 4b, Baton Rouge EffortsNovember 2005  March 2006 Larger hospital assessed 24/7 Smaller hospital assessed 10 AM to 10 PMN7Phase 4b, Baton Rouge EffortsUFlu vaccination in 2 busiest EDs Physicians signed standard orders Nurses vaccinated "UPxV6-B/Racial Disparities F0ZInfluenza Vaccination, Patients in ACIP Risk Groups by Race, Hospital A ED, Dec. 5-Feb. 16[[G1ZInfluenza Vaccination, Patients in ACIP Risk Groups by Race, Hospital A ED, Dec. 5-Feb. 16[[ S>Question| Are reasons for decreased late season flu immunization different from reasons for decreased early season flu immunization. }}P9Late Season ImmunizationP No significant decrease in late and early season acceptance of flu immunizationQPQK5#Patient Reasons to be Un-Vaccinated6$$$$ $Inadequate Knowledge, Attitudes & Practices (KAP) Direct and Indirect  Costs 430s2} E"Overall ConclusionsPara-professionals in EDs can increase patient s KAP towards flu vaccination Eliminating patient s direct & indirect cost increases immunization rates ED immunization decreases disparities Providers: Role is problematic ps-- Conclusions of Phase 4bLate flu season immunization is feasible and accepted by patients. Patient issues associated with late flu immunization are apparently similar to early season issues Provider issues may be importantPsKT  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~Root EntrydO)PqFW@PicturesCurrent User,SummaryInformation(PowerPoint Document(DocumentSummaryInformation880B 0 B .  @n?" dd@  @@``  \X' #% W!),]-/.+/68c<?=@A\EGFGJKMNOPRSTU_$"$ x6N04$$"$< k+IQ, 0AA0 ff@wmJ ʚ;r8ʚ;g4BdBd B 0ppp@ <4ddddLpC 08<4BdBdLpC 08 80___PPT10 ?  %;(<Increasing (Late Season) Influenza Vaccinations- Baton Rouge*= $ $&$1FWilliam Cassidy, MD Louisiana State University Health Sciences CenterGGM:AcknowledgementscLSU Dale Marrioneaux Aubrey Lipham Sal Baghian Baton Rouge General Staff Our Lady of the Lake Staff&``> 6 *CDC Dan Fishbein Susan Manning Edith Gary &''Q;OutlineQuestion Reasons for low immunization rates Phases of  Baton Rouge Effort Isolating variables Results Conclusions<K 7 7 7K J4Question| Are reasons for decreased late season flu immunization different from reasons for decreased early season flu immunization. }}>+#Patient Reasons to be Un-Vaccinated6$$$$ $Inadequate Knowledge, Attitudes & Practices (KAP) knowing, caring or wanting vaccination Expense Direct cost of vaccine & MD visit Indirect cost of missing workn30s2'0s20s2@0s2 ('@?,"Providers Reasons to not Vaccinate # $$Inadequate Provider KAP Non traditional providers (ex. ER Docs) Extension of vaccination season Direct and Indirect  Costs Cost of vaccine and vaccination Counseling can be very time consumingn}H}}}F}HFR<OutlineQuestion Reasons for low immunization rates Phases of  Baton Rouge Effort Isolating variables Results Conclusions<K 7 7 7K :'+4""Phase 2: Indirect Cost to Patients# $ &*6$,Phase 3: Varying Patient Out of Pocket Costs-- ~Conclusions  ED immunization facilitated by para-professionals feasible Incremental increases in a patient s direct cost decreased vaccination acceptance Note: Providers minimally involved6##.,O8Phase 4b, Baton Rouge EffortsNovember 2005  March 2006 Larger hospital assessed 24/7 Smaller hospital assessed 10 AM to 10 PMN7Phase 4b, Baton Rouge EffortsUFlu vaccination in 2 busiest EDs Physicians signed standard orders Nurses vaccinated "UPxV6-B/Racial Disparities F0ZInfluenza Vaccination, Patients in ACIP Risk Groups by Race, Hospital A ED, Dec. 5-Feb. 16[[G1ZInfluenza Vaccination, Patients in ACIP Risk Groups by Race, Hospital A ED, Dec. 5-Feb. 16[[ S>Question| Are reasons for decreased late season flu immunization different from reasons for decreased early season flu immunization. }}P9Late Season ImmunizationP No significant decrease in late and early season acceptance of flu immunizationQPQK5#Patient Reasons to be Un-Vaccinated6$$$$ $Inadequate Knowledge, Attitudes & Practices (KAP) Direct and Indirect  Costs 430s2} E"Overall ConclusionsPara-professionals in EDs can increase patient s KAP towards flu vaccination Eliminating patient s direct & indirect cost increases immunization rates ED immunization decreases disparities Providers: Role is problematic ps-- Conclusions of Phase 4bLate flu season immunization is feasible and accepted by patients. Patient issues associated with late flu immunization are apparently similar to early season issues Provider issues may be importantPsKT=OutlineQuestion Reasons for low immunization rates Phases of  Baton Rouge Effort Isolating variables Results Conclusions<K 7 7 7K  0(  x  c $B ` B x  c $B @ B H  0޽h ? 33___PPT10i.M9kHo+D=' = @B +r4F;ji(eFkTI.#(  P 8*C Chart MSGraph.Chart.80*Microsoft Graph Chart4D Chart MSGraph.Chart.80*Microsoft Graph Chart/ 0LDArial     ՜.+,0    GOn-screen ShowLSUHSC-EKLFAC ArialDefault DesignMicrosoft Graph Chart=Increasing (Late Season) Influenza Vaccinations- Baton RougeAcknowledgementsOutline QuestionOutline$Patient Reasons to be Un-Vaccinated#Providers Reasons to not VaccinateOutlineSlide 9 Slide 10#Phase 2: Indirect Cost to Patients Slide 12%Phase 3: Varied Patient Direct Costs Slide 14Phase 4b, Baton Rouge Efforts Slide 16Racial Disparities [Influenza Vaccination, Patients in ACIP Risk Groups by Race, Hospital A ED, Dec. 5-Feb. 16[Influenza Vaccination, Patients in ACIP Risk Groups by Race, Hospital A ED, Dec. 5-Feb. 16 QuestionLate Seaso =OutlineQuestion Reasons for low immunization rates Phases of  Baton Rouge Effort Isolating variables Results Conclusions<K 7 7 7K r7l(elmTIO$(  P :*C Chart MSGraph.Chart.80*Microsoft Graph Chart4D Chart MSGraph.Chart.80*Microsoft Graph Chart/ 0LDArial,0B 0 B .  @n?" dd@  @@`` ( `Y' #% W!),]-/.+/68c<?=@A\EGFGJKNOPRSTUV_$"$ x6N04$$"$< k+IQ, 0AA0 ff@wmJ ʚ;r8ʚ;g4BdBd B 0ppp@ <4ddddLpC 0|,<4BdBdLpC 0|, 80___PPT10 ?  %;(<Increasing (Late Season) Influenza Vaccinations- Baton Rouge*= $ $&$FWilliam Cassidy, MD Louisiana State University Health Sciences CenterGGM:AcknowledgementscLSU Dale Marrioneaux Aubrey Lipham Sal Baghian Baton Rouge General Staff Our Lady of the Lake Staff&``> 6 *CDC Dan Fishbein Susan Manning Edith Gary &''Q;OutlineQuestion Reasons for low immunization rates Phases of  Baton Rouge Effort Isolating variables Results Conclusions<K 7 7 7K J4Question| Are reasons for decreased late season flu immunization different from reasons for decreased early season flu immunization. }}U?OutlineQuestion Reasons for low immunization rates Phases of  Baton Rouge Effort Isolating variables Results Conclusions<K 7 7 7K >+#Patient Reasons to be Un-Vaccinated6$$$$ $Inadequate Knowledge, Attitudes & Practices (KAP) knowing, caring or wanting Expense Direct cost of vaccine & MD visit Indirect cost of missing workn30s20s20s2@0s2 (@?,"Providers Reasons to not Vaccinate # $$Inadequate Provider KAP Non traditional providers (ex. ER Docs) Extension of vaccination season Direct and Indirect  Costs Cost of vaccine and vaccination Counseling can be very time consumingn}H}}}F}HFR<OutlineQuestion Reasons for low immunization rates Phases of  Baton Rouge Effort Isolating variables Results Conclusions<K 7 7 7K :'+4""Phase 2: Indirect Cost to Patients# $ &*6$$Phase 3: Varied Patient Direct Costs%%$Results Incremental increases in a patient s direct cost decreased vaccination acceptance Conclusions  ED immunization facilitated by para-professionals feasible Note: Providers minimally involvedj@R@@;@#@R;#;,O8Phase 4b, Baton Rouge Efforts&November 2005  March 2006 Larger hospital assessed 24/7 Smaller hospital assessed 10 A to 10 P Physicians signed standard orders Nurses vaccinated"@(Px(-B/Racial Disparities F0ZInfluenza Vaccination, Patients in ACIP Risk Groups by Race, Hospital A ED, Dec. 5-Feb. 16[[G1ZInfluenza Vaccination, Patients in ACIP Risk Groups by Race, Hospital A ED, Dec. 5-Feb. 16[[ S>Question| Are reasons for decreased late season flu immunization different from reasons for decreased early season flu immunization. }}P9Late Season ImmunizationP No significant decrease in late and early season acceptance of flu immunizationQPQK5#Patient Reasons to be Un-Vaccinated6$$$$ $Inadequate Knowledge, Attitudes & Practices (KAP) Direct and Indirect  Costs 430s2} E"Overall ConclusionsPara-professionals in EDs can increase patient s KAP towards flu vaccination Eliminating patient s direct & indirect cost increases immunization rates ED immunization decreases disparities Providers: Role is problematic ps-- Conclusions of Phase 4bLate flu season immunization is feasible and accepted by patients. Patient issues with late flu immunization are the same as early season issues Provider issues may be importantPsKz6T=OutlineQuestion Reasons for low immunization rates Phases of  Baton Rouge Effort Isolating variables Results Conclusions<K 7 7 7K   ``0(  `x ` c $4c? `}  ? x ` c $X)? ` ? 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