Health Assessment Resources – Flu Vaccination
When beginning a DRIVE program, it is critical to first identify the issue(s) that need to be improved upon, as well as any significant gaps in performance.
In order to do so, data from different areas of a practice or health system are to be collected and assessed to pinpoint the quality improvement (QI) activities that need to be focused on.
To facilitate this objective, the DRIVE resources highlighted in this phase can help structure the right focus, while shaping and understanding baseline needs. This, in turn, will help inform the pathway to take for the DRIVE program.
Three Main Resource Categories
Below are the 3 main resource categories in the DRIVE program that provide different tools and methods to help identify gaps, needs, and/or issues to best target improvement efforts:
| Resource Category | Examples of Health Areas Addressed |
| Community Health |
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| Health System and Clinic |
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| Practice Organization and Workflow |
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Understanding the baseline population health needs can come from community resources, the own health system (eg, EHR data) and by examining what is happening in a practice (eg, by filling out a practice assessment survey and workflow analysis worksheets).
Tips for Collecting Data
During the Assess and Understand phase, it is crucial to collect a variety of data that is pertinent for this QI activity. Here are some recommendations on collecting data effectively:
- One individual in a practice can complete the practice assessment survey (ie, Practice Organization and Workflow section)
- Teams are best for a deeper dive, such as root cause analyses
- Community leaders can help identify external information about the health needs of the population
A planning meeting with all participants can be used to develop a strategy for collecting and/or reviewing baseline data and health care gaps in a consistent way
Applying the “Assess and Understand” phase in-practice
Below are two examples showcasing how the tools and resources in this phase can begin to help address specific needs.
Example 1
Example 1A physician could be reading scientific literature that more Blacks are being affected by COVID-19 and that there are concerns that the flu and COVID-19 could dangerously exacerbate health problems in the upcoming Fall season. The physician recognizes this potential issue and wants to assess if their practice needs to increase flu vaccination rates. By understanding the current situation with the different resources and tools outlined below, the physician can identify how to best move forward to focusing their energy on improving flu vaccination performance.
The physician could explore the following resources and tools:
- Visit the geo map to identify vaccination rates in specific zip codes throughout the United States
- View flu vaccination rates from EHR system
View the Health System and Clinic Resources
- Inquire about flu metrics, such as the current flu vaccination rates in their system or practice, and who administers the vaccines?
View the Practice Assessment Survey in the Practice Organization and Workflow Resources
The physician might now ponder about how they administer flu shots, and how that will look in the Fall, when/if there is still a risk of COVID-19.
Example 2
A church group leader in Brooklyn, NY recognizes that there has been a rise in COVID-19 cases across a large diverse local population. The church leader wants to understand the issues better in order to improve health conditions in the community. They can start by looking at the geo map resource Mypalc.org to see what the flu vaccination rates have been in the zip codes of their congregation and community. This could lay the groundwork to present a case to their health system, providing proof that health interventions need to be activated.
Community Health Resources
Identify Local Health Disparities
PALC is a community of patient advocacy-led online learning networks joined together to amplify the patient voice in the digital age
Access big data analytics to help accelerate knowledge for a specific condition or therapy
National Minority Quality Forum: Patient Advocacy Learning Communities
Access information on racial disparities in flu vaccination that can be translated to COVID-19 vaccination efforts. Kaiser Family Foundation:
Racial Disparities in Flu Vaccination: Implications for COVID-19 Vaccination Efforts
Access information from the CDC on flu hospitalization data among racial and ethnic minority groups. CDC:
Review a study of flu vaccine uptake disparities among racial and ethnic minority Medicare beneficiaries. The Lancet/NMQF:
Assess Community Health Needs
Assess the health needs of the local community
CDC’s Community Health Assessments and Health Improvement Planning
Measure public health in local region with NACCHO Community Health Assessment and Improvement Planning
National Association of County and City Health Officials (NACCHO)
Better understand patients’ social determinants of health with the PRAPARE Protocol
PRAPARE: Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences
FluView Interactive depicts data from two of the CDC’s influenza like illness surveillance systems. It details epidemiologic surveillance, hospitalizations, pediatric mortality, geographic spread, and other influenza like illness indicators
This microsite details the estimated influenza illnesses, medical visits, and hospitalizations averted by vaccination
Flu Prevention Education
Understand the risk of flu complications for individuals living with chronic illnesses
Health System and Clinic Performance Resources
Uncover Flu Measures at Health System and Clinics
The following illustrates different approaches for stakeholders to generate, assess, and utilize pertinent data about their QI performance.
- Health system, clinic, and/or provider level performance data to consider
- How to obtain performance data and which factors need to be considered when acquiring this data
- Data access from Electronic Health Reports (EHRs) or manual chart sampling
- Common performance reports generated in clinic or health system (if possible)
- Performance assessment by demographic group or co-morbidity
- For example, individuals with chronic health conditions are more prone to negative health outcomes with the flu; as a result, a potential population to focus on could be people with diabetes
- Data and insights identify areas for improvement and set the baseline for improvement projects and measurement
- Once the type of data to be utilized is established for a particular population, then the gap to focus on can be revealed
- Regular reporting set up to track improvement moving forward
Please note that a performance rate is only as good as the data entered into system. Consequently, make sure to carefully review sources and processes for assessing QI projects that can be activated separately and on their own.
Practice Organization and Workflow Resources
Assess Practice Facility
- Provides a snapshot of staffing resources, patient population, QI resources, experience and goals
- Compares clinical practice to guideline-based recommendations
- Helps visualize opportunities for efficiency and optimal staff utilization
Root Causes of Practice Challenges
- Helps determine internal and external barriers to optimal health care practice using a fishbone diagram