SAT-821 Improving pneumonia vaccination rates among patients with diabetes through modification of the clinic workflow

Abstract Disclosure: K. Mercado: None. N. Delcid: None. K.E. Izuora: None. Introduction: Vaccine preventable illnesses are more severe among patients with diabetes, yet the vaccination rate in this population is low. The purpose of this quality improvement project was to improve the process for pneumococcal vaccination assessment for patients with diabetes at our clinic. Methods: Following a root cause analysis, we identified inconsistent assessment of vaccination status of our patients during clinic visits as a key reason for low vaccination rates documented in the electronic medical record (EMR). We conducted a workflow analysis and identified several potential areas of modification. We implemented a specific modification that incorporated vaccine assessment into the medical assistant rooming workflow. This involved creation of a customized EMR assessment module that is based on CDC Standards for Adult Immunization Practice. Following assessment, if a patient is unvaccinated, a recommendation is made with administration or referral if patient is agreeable to receive the vaccine. Our outcome measures included successful implementation of the modified workflow and improvement of our pneumonia vaccination rates. Results: The modification to our clinic workflow was well received by our clinic staff and did not result in significant delays during actual patient encounters. We observed that the time spent conducting the vaccine assessment was usually the time patients spent waiting in the exam room before the encounter. Compared to our baseline vaccination rate of 5.7% (61/1066), so far, we have observed an increase to 8.7% after 5 months of modifying the workflow. One limitation we observed was the lack of automated communication between the EMR and the state Immunization Information System (IIS) to update vaccine information from outside our system. Conclusion: Implementation of a modification to the clinic workflow was feasible and resulted in minimal delays during the visit. The modest improvement in our vaccination rates suggests continued effort is necessary to sustain the implementation of our modifications and efforts should be directed towards improving communication between the EMR and IIS. Presentation: Saturday, July 12, 2025