PMID- 31621875
OWN - NLM
STAT- MEDLINE
DCOM- 20200506
LR  - 20200506
IS  - 1535-2900 (Electronic)
IS  - 1079-2082 (Linking)
VI  - 76
IP  - 24
DP  - 2019 Dec 2
TI  - Factors influencing rates of human papillomavirus vaccination.
PG  - 2053-2059
LID - 10.1093/ajhp/zxz246 [doi]
AB  - PURPOSE: Failure modes and effects analysis (FMEA) was used to identify ways in 
      which community clinic practices related to suboptimal human papillomavirus (HPV) 
      vaccination rates could be improved. METHOD: FMEA is a standardized safety method 
      that helps determine where processes fail, the impact of failures, and needed 
      process changes. In a quality improvement initiative conducted at an academic 
      health center-based community clinic, a multidisciplinary team used FMEA to map 
      HPV vaccination processes and identify areas for improvement of vaccination 
      practices. Risk priority numbers (RPNs) were assigned to identified failure modes 
      based on likelihood of occurrence, likelihood of detection, and ability to 
      correct locally. Failure modes with the highest RPNs were targeted for process 
      improvements. RESULTS: High RPN failure modes were related to clinic processes 
      for follow-up, immunization status checks during well-child visits, and 
      vaccination discussions during sick-child visits. New procedures included 
      scheduling follow-up vaccinations and reminders during the initial vaccination 
      appointment. HPV immunization rates improved following implementation of these 
      procedures, indicating that clinic processes focused on patient follow-up can 
      impact vaccination series completion. CONCLUSION: FMEA processes can help health 
      systems identify workflow barriers and locally relevant opportunities for 
      improvement. Team-based approaches to care process improvements can also benefit 
      from standardized problem identification and solving.
CI  - (c) American Society of Health-System Pharmacists 2019. All rights reserved. For 
      permissions, please e-mail: journals.permissions@oup.com.
FAU - Palmer, Kelsey E
AU  - Palmer KE
AD  - Boulder Community Health, Boulder, CO.
FAU - Moorman, Krystal L
AU  - Moorman KL
AD  - University of Utah College of Pharmacy, Salt Lake City, UT.
FAU - Nickman, Nancy A
AU  - Nickman NA
AD  - University of Utah College of Pharmacy, Salt Lake City, UT, and University of 
      Utah Health Pharmacy Services, Salt Lake City, UT.
FAU - Owen, David G
AU  - Owen DG
AD  - South Jordan Health Center, South Jordan, UT.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Am J Health Syst Pharm
JT  - American journal of health-system pharmacy : AJHP : official journal of the 
      American Society of Health-System Pharmacists
JID - 9503023
RN  - 0 (Papillomavirus Vaccines)
SB  - IM
MH  - Community Health Services/*methods/trends
MH  - Humans
MH  - Immunization/*methods/trends
MH  - Papillomavirus Infections/epidemiology/*prevention & control
MH  - Papillomavirus Vaccines/*therapeutic use
MH  - *Workflow
OTO - NOTNLM
OT  - healthcare failure mode and effects analysis
OT  - immunization schedule
OT  - patient care team
OT  - vaccination
EDAT- 2019/10/18 06:00
MHDA- 2020/05/07 06:00
CRDT- 2019/10/18 06:00
PHST- 2019/10/18 06:00 [pubmed]
PHST- 2020/05/07 06:00 [medline]
PHST- 2019/10/18 06:00 [entrez]
AID - 5588838 [pii]
AID - 10.1093/ajhp/zxz246 [doi]
PST - ppublish
SO  - Am J Health Syst Pharm. 2019 Dec 2;76(24):2053-2059. doi: 10.1093/ajhp/zxz246.