Improving Pneumococcal Vaccination Rates during Hospitalization via Resident Education Intervention: A Hospital-based Quality Improvement Project in a Teaching Community Hospital

Background: Pneumococcal vaccination coverage among eligible adults in Japan remains suboptimal. This gap may be partly attributable to insufficient physician and patient education, as well as limited coordination in delivery of preventive care. Therefore, we conducted a hospital-based quality improvement project combining resident education with system-level workflow modifications to enhance pneumococcal vaccination rates. Methods: A single-center quality improvement study was conducted at a teaching community hospital in Japan, comparing outcomes between pre-intervention and intervention periods. The intervention included resident education, patient educational materials, integration of vaccination status into admission documentation, discharge checklists, and weekly reminders. The primary outcome was the proportion of eligible patients vaccinated during hospitalization, while secondary outcomes included overall vaccination rates at discharge. Process measures assessed residents’ knowledge and confidence before and after the educational session. Results: During the pre-intervention period, 40 eligible patients were identified, and none were vaccinated (0%). During the intervention period, 36 eligible patients were identified, of whom 29 (80.6%) were vaccinated. Overall vaccination rates at discharge increased from 22.4% (22/98) to 59.5% (50/84). Among 15 residents, mean knowledge scores improved from 57% to 92%, and confidence in counseling increased from 2.0 to 4.4 on a 5-point Likert scale. Conclusions: A resident-led, hospital-based quality improvement intervention substantially increased pneumococcal vaccination rates among eligible hospitalized patients. Educational initiatives combined with system-level workflow modifications represent a practical strategy to improve adult vaccination coverage in inpatient settings.