Increasing Pneumococcal Vaccination Rates Using Previsit Planning in Patients Age 65 and Older.

Abstract: Although pneumococcal vaccination decreases the rate of pneumonia-associated hospitalization and mortality, rates of pneumococcal vaccination among adults aged 65 years and older remained relatively unchanged during the period of 2019-2022. To improve the rate of pneumococcal vaccine coverage among patients aged 65 years and older in our academic internal medicine clinic, we conducted a quality improvement project centered on previsit planning as the intervention. Previsit planning was implemented in a phased approach, divided into three intervention periods, each involving an increasing number of medical teams. The previsit planning intervention was performed by medical assistants who reviewed vaccination status of patients scheduled for the following day and pended vaccination orders when indicated. When compared with baseline vaccination rates, rates increased in each of the three interventions (7.5%-33.3% [p < .05], 8.9%-39.6% [p < .05], 27.8%-38.9% [p < .05], respectively). Previsit planning can improve pneumococcal vaccination uptake in the ambulatory setting by distributing responsibilities for addressing care gaps across multiple team members, with potential benefits also including reduced provider burnout, improved clinic flow, and improvement of team members' preparation for patient visits.