Combination pneumococcal vaccination rates in eligible patients with systemic lupus erythematosus (SLE) improved significantly after the implementation of a multifaceted intervention at a rheumatology practice, according to results published in The Journal of Rheumatology.

Physician- and staff-based surveys were used to analyze the underlying barriers in providing vaccination for patients with SLE. The investigators designed a multifaceted quality improvement project, which included previsit planning, day-of-visit planning, weekly review, and monthly feedback, with the objective to improve rates of combination pneumococcal vaccine (pneumococcal polysaccharide vaccine [PPSV23] plus pneumococcal conjugate vaccine [PCV13]) administration in patients with SLE.

The current project is one of a very few studies designed to enhance combination pneumococcal vaccination rates among adult patients with SLE. Baseline PCV13 vaccination rates, PPSV23 vaccination rates, and combination vaccination rates were 2%, 8%, and 10%, respectively, in the preintervention period. Overall, 612 patients with SLE were eligible to receive any vaccine.

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Significant improvements in vaccination rates were observed by the end of the study period. Improvements were observed from 2% to 39.28% in PCV13 vaccine rates, 8% to 56.5% in PPSV23 vaccine rates, and 10% to 59% in combination vaccination immunization rates. The notable rates underscore the role of planning an intervention with an integrated workflow and the importance of sharing performance data, which can lead to high rates of compliance among team members.

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The investigators concluded that their quality design project can serve as a model to be adapted by other specialty clinics to attain higher vaccination standards. The present study highlights that the development of an integrated workflow and the sharing of performance data can dramatically increase combination pneumococcal vaccination rates in adult patients with SLE.

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Garg S, Tsagaris K, Cozmuta R, Lipson A. Improving the combination pneumococcal vaccination rate in systemic lupus erythematosus patients at an adult rheumatology practice [published online September 1, 2018]. J Rheumatol. doi: 10.3899/jrheum.171377