Developing a program to increase seasonal influenza vaccination of healthcare workers: lessons from a system of community hospitals

Patient safety is positively influenced by widespread seasonal influenza vaccination of healthcare workers, but yearly vaccination rates have been unacceptably low. As a result, mandatory vaccination programs have been widely discussed as a means of increasing vaccination rates. In the HCA Inc. healthcare system, the multifaceted Influenza Patient Safety Program was designed to encourage the vaccination of over 160,000 employees across the United States. This program included human resources policies, various patient safety strategies, and a vaccination policy featuring the choice of free seasonal influenza vaccination or wearing a mask. With 100% compliance with the policy, the vaccination rate increased from a mean of 58% to over 90% for three consecutive influenza seasons. As healthcare worker vaccination is part of a larger culture of accountability related to quality and infection prevention, this program was resource intense, required a multidisciplinary approach, and was not without challenges to implementation. Essential components included steadfast leadership support, continuous education and communication efforts, and consistent data collection and feedback. This manuscript describes the approach and processes used in this program as well as lessons learned over three seasons in order to aid other providers in developing patient safety programs that include influenza vaccination for healthcare workers.