In early 2017, Melinda Jones, a quality improvement specialist with Quality Insights—the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) serving Delaware, Louisiana, New Jersey, Pennsylvania and West Virginia—noticed that only two of the 90 home health agencies in Louisiana were documenting their vaccine administrations in the state immunization registry.
Further, Quality Insights found that only a few were even aware of—or had access to—that database, known as the Louisiana Immunization Network for Kids Statewide, or LINKS, which is operated by the Louisiana Department of Health.
One of the main reasons for this knowledge gap is that health care providers in the state are not required to submit adult vaccination information to the database, even though it can store such information. As a result of inconsistent reporting, some older adults have received multiple doses of the same vaccine while others have received the wrong vaccine—or none at all.
These oversights can have serious consequences for one’s health, especially for older adults. Also, when someone unnecessarily receives multiple doses of the same vaccine, it can add significant costs to a state’s health care system.
To help address the gaps in vaccine reporting at home health agencies, Jones contacted the Louisiana state immunization program manager, and together they developed a plan to introduce agency staff to the LINKS system. Their first step was to recruit a pilot group of five home health agencies and work with them to create internal processes that support staff in consistently entering the data.
“LINKS has helped us identify patients who have had vaccines but who can’t remember if or when they had them. It’s been an invaluable resource for us in our effort to improve the quality of care for residents."
In March 2017, Jones and the state immunization project manager provided the pilot group with training on the LINKS database and a quick reference guide on how to enter their agency’s data. Additionally, the pilot agencies were given region-specific immunization information system contacts for further assistance with enrollment.
Bunkie HomeCare, a small home health agency about an hour and a half northeast of Baton Rouge, was one of the five pilot agencies. Becky Thompson, a registered nurse at the agency, helped lead the project on the ground and quickly found value in the new database.
Explaining how the agency altered its internal processes, Thompson said, “Upon every patient admission or recertification to home health, information is obtained regarding vaccinations the patient has received.”
If the patient or caregiver is unsure of what vaccines were received, home health staff consult LINKS.
“LINKS has helped us identify patients who have had vaccines but who can’t remember if or when they had them. It’s been an invaluable resource for us in our effort to improve the quality of care for residents," said Thompson.
Since then, Quality Insights has worked with more than 25 home health agencies to help them gain access to the LINKS database. This work is helping home health agencies get a jump-start on new state mandates.
During the 2017 legislative session, the Louisiana State Legislature passed a resolution that requires, starting in early 2018, all health care providers who administer vaccines in the state to use the LINKS database to report immunizations for both kids and adults.