Improving Adult Vaccination Practices

This initiative aims to provide healthcare professionals with education and tools to increase pneumococcal and influenza vaccination rates, thereby reducing the risk of outbreaks, serious illness, hospitalization, and death, as well as reducing direct medical costs of adult patients seen in Cleveland Clinic community Physician Partnership Quality Alliance employee and affiliated primary care practices.

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Overview

This initiative aims to provide healthcare professionals with education and tools to increase pneumococcal and influenza vaccination rates, thereby reducing the risk of outbreaks, serious illness, hospitalization, and death, as well as reducing direct medical costs of adult patients seen within Cleveland Clinic and the Physician Community Partnership Quality Alliance employee and affiliated primary care practices.

About PI CME

Performance Improvement Continuing Medical Education (PI CME) is a structured, long-term process by which a physician or group of physicians learn about specific performance measures, assess their practice using selected measures, implement interventions to improve their practice, and then reassess their practice after an interval of time.

PI CME has been recognized as an important component of continuing professional development and may answer multiple credentialing and reporting needs. Physicians can earn 5 AMA PRA Category 1 Credits™ for completion of each stage of a PI CME activity, or a maximum of 20 AMA PRA Category 1 Credits™ for completion of all three stages.

FACULTY AND STEERING COMMITTEE

Activity Director:

Tarek Elsawy, MD, FACP

Chief Medical Officer
Cleveland Clinic Community Physician Partnership and the Quality Alliance
Cleveland Clinic
Cleveland, OH

Faculty:

Susan Rehm, MD

Vice Chair, Department of Infectious Disease
Executive Director, Physician Health
Cleveland Clinic
Cleveland, OH

Faculty

William Schaffner, MD

Chairman, Department of Preventive Medicine
Vanderbilt University
Nashville, TN

Additional Planning Committee Members

Disclosure

  • Tarek Elsawy, MD, FACP (Activity Director) Type of financial relationship(s):
    • Membership on advisory committee or review panels: SS & G Healthcare Services LLC
    • Teaching and Speaking: Greeley Company
  • William Schaffner, MD (Faculty) Type of financial relationship(s):
    • Teaching and Speaking: Sanofi Pasteur SA
    • Membership on data safety monitoring board for experimental vaccine trials: Merck & Co., Inc.
  • Susan Rehm, MD (Faculty) Type of financial relationship(s):
    • Membership on advisory committee or review panels: Pfizer, Inc., Merck & Co., Inc.

The Cleveland Clinic Foundation Center for Continuing Education, the Physician Community Partnership Quality Alliance, and the Academy for Continued Healthcare Learning staff members and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

CME/CE

Statement of Need

Pneumonia, a vaccine-preventable disease, remains a substantial cause of morbidity and mortality, yet approximately one-third of adults aged 65 years and older have not received the pneumococcal vaccine. Seasonal influenza vaccination coverage is also suboptimal in older adults. Data indicate that pneumococcal and influenza vaccination rates in another high-risk group, adults with an immunocompromising or chronic condition, also fall short of national goals. This initiative aims to provide healthcare professionals with education and tools to increase pneumococcal and influenza vaccination rates, thereby reducing the risk of outbreaks, serious illness, hospitalization, and death, as well as reducing direct medical costs of adults and high-risk patients seen in Cleveland Clinic Community Physician Partnership Quality Alliance employee and affiliated primary care practices.

Target Audience

This activity is designed for physicians and other healthcare providers of the Cleveland Clinic Community Physician Partnership Quality Alliance.

Learning Objectives

Upon completion of this activity, participants will be able to:

  • Discuss the morbidity and mortality of invasive pneumococcal disease and influenza in at-risk adults
  • Outline the immunocompromising and chronic conditions that increase patients’ risk of influenza and pneumococcal disease
  • Review recommendations and schedules for pneumococcal and influenza vaccination in older and high-risk adults
  • Discuss patient- and practice-related barriers to achieving national standards for adult vaccinations
  • Improve vaccination coverage rates for pneumococcal and influenza by implementing practice- and system-based tools to identify and immunize older and high-risk adults

Support

The Cleveland Clinic Foundation Center for Continuing Education, the Physician Community Partnership Quality Alliance, and the Academy for Continued Healthcare Learning acknowledge an educational grant for support of this activity from: Pfizer, Inc.

Sponsors

This activity is sponsored by Cleveland Clinic Community Physician Partnership Quality Alliance, Cleveland Clinic Foundation Center for Continuing Education, and the Academy for Continued Healthcare Learning.

Accreditation

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint providership of the Cleveland Clinic Foundation Center for Continuing Education and the Physician Community Partnership Quality Alliance. The Cleveland Clinic Foundation Center for Continuing Education is accredited by the ACCME to provide continuing medical education for physicians.

The Cleveland Clinic Foundation Center for Continuing Education designates this performance improvement activity for a maximum of 20 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Maintenance of Certification

This activity fulfills program requirements for ABFM and ABIM MOC Part IV credit through the Cleveland Clinics Portfolio program.

FAQs

?
Whom do I contact if I have technical difficulties with this online portal?
Ans.
Please contact Vanessa Senatore, Associate Program Director, with ACHL. Email: vsenatore@achlcme.org or Phone: (773) 714-0705 x 189
?
What type of data will be collected ?
Ans.
Data Collected
The following data was securely extracted for use in this performance improvement activity. No patient identifiers have been extracted.

Date of Birth
Gender
Race
Type of pneumococcal vaccine administered (PPSV23 or PCV13) and influenza vaccine administered (live or attenuated)
Date pneumococcal vaccine administered and most recent influenza vaccine administered
Diagnosis of a chronic condition*

*Chronic condition defined as:
Coronary heart disease-congestive heart failure, cardiomyopathy, myocardial infarction, angina, arrhythmia
Chronic lung disease- chronic obstructive pulmonary disease, chronic bronchitis, emphysema, asthma
Diabetes mellitus (Exclusions: gestational and steroid induced)
Liver disease- chronic liver disease, cirrhosis, hepatitis B, hepatitis C
Human immunodeficiency virus infection
Renal disease- chronic kidney disease, moderate-to-severe renal disease
(Exclusions: Contraindication)

Methodology for Performance Measure Calculation
Patient data was included if they had an office visit within previous two years.

Pneumonia Vaccination Status for Older Adults
Of patients in population aged 65 as of August 31, 2014, those that have documentation of ever receiving the pneumonia vaccine. Excluded if contraindication indicated.

Pneumonia Vaccination Status for High-risk Patients
Of patients in population aged 18-64 as of August 31, 2014 that are high risk, those that have documentation of ever receiving the pneumonia vaccine. Excluded if contraindication of steroid induced diabetes or gestational diabetes.

Flu Vaccinations for Adults Ages 65 and Older
Of patients in population aged 65 as of August 31, 2014, those that have documentation of receiving previous season’s influenza vaccine between September 1, 2013 – August 31, 2014. Excluded if contraindication indicated.

Flu Vaccinations for High-risk Patients
Of patients in population aged 18-64 as of August 31, 2014 that are high risk, those that have documentation of receiving previous season’s influenza vaccine, between September 1, 2013 – August 31, 2014. Excluded if contraindication of steroid induced diabetes or gestational diabetes.
?
I am a nurse or a physician’s assistant – can I also complete this activity?
Ans.
Yes, the full healthcare team is encouraged to participate! However, the full PI activity is only certified for physicians.

Contact Us

If you have questions about this initiative or need assistance with the online portal, please contact:

Vanessa Senatore
Associate Program Director, ACHL
Phone: 773-714-0705 x189
Email: vsenatore@achlcme.org

T Nadas
Project Manager, Clinical Integration, Cleveland Clinic
Phone: 216-445-5564
Email: NADAST@ccf.org

Molly Mooney
Accreditation Manager, Cleveland Clinic Center for Continuing Education, Cleveland Clinic
Phone: 216-444-0459
Email: mooneym2@ccf.org

Copyright © 2014 ACHL PI CME
The information included in this educational activity is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition. The viewpoints expressed in this PI CME activity are those of the authors/faculty. They do not represent an endorsement by The Cleveland Clinic Foundation, the Physician Community Partnership Quality Alliance, or the Academy for Continued Healthcare Learning. In no event will The Cleveland Clinic Foundation, the Physician Community Partnership Quality Alliance, or the Academy for Continued Healthcare Learning be liable for any decision made or action taken in reliance upon the information provided through this PI CME activity.