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Quality Improvement Initiative to Improve Time and Adherence to Revaccination after Hematopoietic Cell Transplantation: Implementation of a Revaccination Clinic within the HCT program
Journal article   Open access   Peer reviewed

Quality Improvement Initiative to Improve Time and Adherence to Revaccination after Hematopoietic Cell Transplantation: Implementation of a Revaccination Clinic within the HCT program

C W Elgarten, A Wohlschlaeger, E A Levy, K Tadley, L Wang, M Atkinson, H Roberson, T S Olson, N J Bunin, J Heimall, …
Transplantation and cellular therapy
28 Jul 2023
DOI: https://doi.org/10.1016/j.jtct.2023.07.020
url
https://doi.org/10.1016/j.jtct.2023.07.020View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze),  Open

Abstract

immune reconstitution immunizations quality improvement Pediatrics
•A quality improvement initiative decreased unimmunized time after pediatric HCT. •Establishment of a re-vaccination clinic within the HCT clinic was a key intervention. •Other interventions: immune-based start criteria, audits of primary care administered vaccines. Revaccination after hematopoietic cell transplantation (HCT) is critical to prevent morbidity and mortality from vaccine preventable illnesses. The global aim of our quality improvement initiative was to enhance timely, correct, and effective revaccination after pediatric HCT. The SMART aim of our project was to decrease median unvaccinated time by four months, by decreasing time to vaccine eligibility, time from eligibility to vaccine start and time to completion of vaccine series. A multidisciplinary group performed a cross-sectional quantitative and qualitative evaluation of revaccination practices at our institution, we identified factors associated with delayed, incorrect, or incomplete revaccination. Several plan-do-study-act interventions were implemented to address these drivers including revising immune readiness criteria, increased auditing of primary care administered immunizations and importantly, establishing a dedicated revaccination clinic within the HCT clinic at our center. Time to vaccine eligibility decreased from 12.6 months to 10 months (20% decrease) and time to complete vaccine series decreased from 19.3 months to 15.7 months (19% decrease). With a quality improvement initiative, we addressed the many causes of delayed or incomplete revaccination post-HCT and through a team-based approach successfully decreased time to vaccine start and vaccine completion at our center.

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