Duke general internal medicine Doctors David Simel and Joel Boggan, along with lead author and former Durham VA Chief Resident for Quality and Safety, Dr. Aaron Mitchell, and Karen Lau, MSN, are helping to forward best practice. Their paper about successfully achieving higher vaccination rates for asplenic patients was published online by The American Journal of Medicine on February 14.
Several features of their work are worth emphasizing. First, the approach was novel and collaborative. They built on existing infrastructure of a travel clinic, nurses, primary care physicians, clinical pharmacists, and infectious diseases clinicians. The study took advantage of the well established VA electronic registry to facilitate monitoring and managing this population. The authors designed a new process referring these patients to the travel clinic where a flowsheet of expectations simplified care. The patients received a letter with an information pamphlet.
Altogether, the result in the first year was improvement in 3 of 4 recommended vaccinations. You will want to read this paper to learn about challenges and benefits of this kind of quality improvement effort.
Citation:
Mitchell, AP, Boggan, JC, Lau, K, Simel, DL. Splenectomy as a Destination: Improving Quality of Care Among Asplenic Veterans Through a Travel Clinic. The American Journal of Medicine. February 14, 2017. PMID: 28213046 [Link]