Improving Pneumococcal Vaccination Rates in Older Adults Through Enhanced Academic Detailing: Medicine, Nursing and Pharmacy Partnerships

Vaccines are a low-cost high-impact intervention that effectively and efficiently reduce the burden of infectious diseases. Yet many populations, especially in rural areas, have vaccination rates well under nationally recommended levels. Integrating adult vaccination screening, education, administration, and billing into older adults’ visits is proving to be challenging because of competing priorities. This quality improvement project will develop a replicable model of enhanced academic detailing to increase vaccine utilization. Academic detailing is an evidence-based approach to change clinical practice, where tailored material is shared colleague-to-colleague to improve decision-making. Enhanced academic detailing is conceptualized as a comprehensive approach that includes identification of healthcare provider and system barriers, builds an infrastructure for adult vaccinations, and is delivered by an interdisciplinary team.

Our project will be phased over 30-months and starts with training a team of pharmacy, nursing, and medical researchers and students in the academic detailing approach. Then, interested community-based medical clinics and rural pharmacies in Whitman County, Washington will be recruited to pilot this approach. Our goal is to facilitate sustainable practice change in order to increase pneumococcal vaccination rates among older adults in rural Eastern Washington. We intend to demonstrate that a model for enhanced academic detailing can be developed that will consistently increase pneumococcal vaccination rates in rural-dwelling older adults in comparison to usual care. We plan to achieve our goal by pursuing three objectives: assess vaccination barriers, develop an enhanced academic-detailing model, and change healthcare providers’ vaccination practices. We anticipate expected outcomes of decreased vaccination barriers and increased vaccination rates.