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HPV Call-to-ActionSEPTEMBER 13, 2017

Agenda

• Welcome & Housekeeping

• Speaker Introductions

• Increasing HPV Rates in South Dakota- Lexi Pugsley, RN, BSN

• Sanford Health Comprehensive Cancer HPV Vaccination Grant- Andrea Polkinghorn, BSN, RN

• CDC Resources & Messaging for the release of the 2016 NIS-Teen Data- Ian Branam

• Q&A

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Discussion

Lexi Pugsley is a registered nurse and the Comprehensive

Cancer Control Program Coordinator for the South Dakota

Department of Health, Office of Chronic Disease Prevention

and Health Promotion. The SD Comprehensive Cancer Control

Program is a statewide partnership of organizations united in

the vision to reduce the burden of cancer on South Dakotans

through the promotion and support of collaborative programs

and policies for cancer prevention and control.

Andrea Polkinghorn works as a Clinical Services Manager for

Sanford Health. She graduated with her bachelors of science

in nursing from South Dakota State University in 2007. Her

background includes Neonatal Intensive Care, Family

Medicine, as well as Health Coaching. Through her current

role Andrea is able to educate and support 100 clinics in

eastern South Dakota, Northwest Iowa, and southwest

Minnesota. She serves as the chair of Sanford’s Sioux Falls

Region Immunization Workgroup and Vice Chair for the Sioux

Falls Area Immunization Coalition in South Dakota.

Ian Branam is a health communication specialist in the National

Center for Immunization and Respiratory Diseases (NCIRD) at

the Centers for Disease Control and Prevention. Ian has been

supporting health communication activities in NCIRD since

2014 and currently works on NCIRD’s public affairs team. Ian

recently coordinated communication activities around the

latest National Immunization Survey-Teen report. Ian earned

his master’s in journalism and mass communication from the

University of Georgia in 2014. Prior to coming to CDC, Ian

worked as a freelance health and science writer.

Efforts to Increase HPV Vaccination Coverage Rates in SD

Problem: Low HPV Vaccination Coverage Rates Among Adolescents in SD

Solution: Target health systems to implement evidence-based interventions to

increase vaccination rates

Three-dose HPV vaccine series

completion (NIS-Teen)

2013

(revised)2014 2015

Males ages13-17 7.7% 23.5% 22.0%

Females ages 13-17 40.9% 33.1% 32.4%

Increasing HPV Vaccination Rates in South Dakota

Approach: Develop a structured Request for Application process to select health system

partners to collaborate on HPV vaccination interventions

Partners: SD Cancer Prevention and Control Program, SD Cancer Coalition, SD Breast and

Cervical Early Detection Program (All Women Count!), and the SD Immunization Program

Award Requirements:

-Systems level change approach that impacts the permanent organizational culture around

HPV vaccination

-Demonstrate potential for sustained efforts and lasting impact

-Quality improvement team

-Funds could not cover vaccine or vaccine administration fees

-Monthly and Quarterly Data and Progress Reporting Requirements

Evidence-based Intervention Options:

-Client Reminder and Recall Systems

-Provider Assessment and Feedback

-Provider Reminders

-Standing Orders

-Reducing Structural Barriers

-Community Based Interventions (Implemented in Combination)

-Someone You Love Screening

-Professional Education

SD DOH Support:

-Funding, practice coach, evaluation support, data feedback

Partner Recruitment

Round One: July 1, 2015 - June 30, 2016

▪ 1 Applicant: Sanford Health - 7 clinic sites

Round Two: July 1, 2016 - June 30, 2017

▪ Continuation Application: Sanford Health – 39 clinic sites

Round Three: March 1, 2017 - February 28, 2018

▪ 2 Applicants: Avera Health and Community Health Care Association of the Black Hills

Round Four: (applications closed 9/7/17) October 1, 2017 - September 30, 2018

▪ Expanded eligibility to also include QI orgs, professional orgs, health plans, schools

Lessons Learned:

▪ Collaborative Partnership

▪ Team Approach

▪ Data

▪ Flexibility

Contact Information:

Lexi Pugsley, RN, BSN

SD Comprehensive Cancer Control Program Coordinator

South Dakota Department of Health

P: 605.626.2660

[email protected]

SD Cancer Coalition Website: cancersd.com

mailto:[email protected]

http://www.cancersd.com/

Sanford Health Comprehensive CancerHPV Vaccination Grant

Andrea Polkinghorn, BSN, RN

Clinical Services Manager

Our organization is a large integrated healthcare delivery system that provides healthcare in nine states and three countries. As an enterprise we have 43 medical centers, 289 clinics, 22 long-term care facilities, 27,000 employees and 1,400 physicians who offer expertise in 80 specialties.

Our organization’s mission is “dedicated to the work of health and healing.” Our vision is to “improve the human condition through exceptional care, innovation and discovery.” Every day, we show that commitment by delivering the highest quality of care to the communities we serve.

Educate

Year One

• June 2015-Mandatory education for allproviders and nurses in each Family Medicine Clinic.

• February 2016 - Second round of education to providers and nursing

Year Two

• June 2016- Mandatory education for providers and nurses at the additional SF region clinics.

Merck assisted with vaccine and disease education, framing of the conversation, and supplied reminder resources such as magnets (year 1 only) and a texting program

Provider Feedback

• Reports created to showindividual provider and clinic vaccination rates for Tdap, Meningococcal, and HPV• Healthy People 2020 goals

were shared at each education session and with monthly data

HPV- Percentage of Completed Series

Increased by 8%

Increased by 18%Increased by 16%

Adolescent Immunizations Clinic Rates

Decreased by 24%

Increased by 16%

Increased by 10% Increased by 17%

Increased by 8%

Client Reminder System

• Year 1: • 1st Reminder: automated

phone call and mailer

• 2nd Reminder: automated call

• 3rd Reminder: mailer

• Year 2:

• Combination of automated phone calls and mailer reminders

• Series Completion Reminders: Calls by Nursing Staff and Mailed Reminders

9400

9600

9800

10000

10200

10400

10600

10800

11000

Girls Boys Girls Boys

TeleVox Reminders Mailed Reminders

9952

10919

10126

10579

Client Reminders

Year 1

Over 41,500 client reminders

disseminated

108809240

21377

17809

2769920

0

5000

10000

15000

20000

25000

Girls Boys Girls Boys

TeleVox Reminders Mailed Reminders Nursing StaffCalls forSeries

Completion

MailedReminder for

SeriesCompletion

Year 2

62,995 client reminders

disseminated

Client Reminders

45%

19%

37%

Reminder Phone calls via Nursing Staff-Patients ages 11-17 due for 2nd or 3rd HPV

dose

Patients who presented for their next HPV dose

Patient's who moved away/disconnected phonenumber/refused additional doses

Patient's who've been contacted but remain due

N=546

Nursing Telephone Call Results: Patients 18-26 Years of Age

74%

6%

20%

Left Message or Patient States They Will Come in For Their Next Dose

Up-to-Date

Refused or Contraindicated

N=1,403

No Missed Opportunities Culture

• “Every patient, everytime”

• “Same Way, Same Day”

• Missed Opportunitiesreport created

• Chart audits for any “missed opportunities” and feedback provided to clinic providers, nursing, supervisor and director

HPV Vaccine Doses Administered

861693

15541507 1479

2986

0

500

1000

1500

2000

2500

3000

3500

Girls Boys Total

Baseline: July 1, 2014-June 30, 2015

Project Period: July 1, 2015-June 30, 2016

Year 1: 7 Clinic Sites

3453 3430

6883

5049 5185

10234

0

2000

4000

6000

8000

10000

12000

Girls Boys Total

Baseline: July 1, 2015-June 30, 2016

Project Period: July 1, 2016-June 30, 2017


Zero Doses

64%

56%54% 53%

50%

45% 43% 43% 42%

0%

10%

20%

30%

40%

50%

60%

70%

6/30/15: Pt.Denominator

8706


9902


10758


11490


12248


13,347


14,148


15,044


12,248

Years 1 & 2: 7 Primary Care Clinics

% of females and males ages 11-26 with zero doses of the HPV vaccine

22% Decrease in Zero Doses

Series Completion

25%26% 27%

30%32%

34%36%

38%40%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%


8706


9902


10758


11490


12248


13,347


14,148


15,044


12,248

Years 1 & 2: 7 Primary Care Clinics

% of females and males ages 11-26 with series completion of the HPV vaccine

15% Increase in Series Completion

Zero Doses

9% Decrease in Zero Doses

54%

48%46%

54%

45%

0%

10%

20%

30%

40%

50%

60%

6/30/16: Pt. Denominator 35,737

09/30/2016: Pt. Denominator38,794

12/31/16: Pt. Denominator41,743





Series Completion

30%

32%34%

36%38%

0%

5%

10%

15%

20%

25%

30%

35%

40%

6/30/16: Pt. Denominator 35,737

09/30/2016: Pt. Denominator38,794





% of females and males ages 11-26 with series completion of the HPV vaccine

8% Increase in Series Completion

Challenges and Lessons Learned

• Large number of clinics

• Patient populations

• Attribution methodology

Sanford Health HPV Vaccination Implementation Grant Overview

• During the Two Year ProjectPeriod:

• Over 100,000 clientreminders distributed

• 13,220 doses of HPVvaccine administered

• 22% and 9% decrease inadolescents with zero doses of HPV vaccine administered

• 15% and 8% increase in adolescents who have completed the HPV series

• Hosted “Someone You Love: the HPV Epidemic” Documentary Screenings at colleges and for the public

• Conducted provider education

Contact Information:

Andrea Polkinghorn, BSN, RN

Sanford Clinic

Clinical Services Manager

Office: (605) 404-3903

Cell: (605) 261-2402

Fax: (605) 312-7601

[email protected]

mailto:[email protected]

CDC Resources for the Release of the 2016

NIS-Teen Data

Overarching Framing

Clinicians have been working hard to protect children

from HPV cancers ever since the vaccine was first

introduced over 10 years ago, and we are encouraged

about the future trends in HPV vaccination.

HPV vaccination is protecting against cancer-causing infections even better than we expected. Recent recommendations make it simpler for parents and healthcare professionals to protect children at the earliest age possible.This report shows that most U.S. parents are getting the first dose of HPV vaccine for their child.

Main Messages

HPV vaccination prevents cancer. Most U.S. parents are

getting the first dose of HPV vaccine for their child.

Parents of girls AND boys are protecting their children

from cancers caused by HPV infections. The gap in HPV

vaccination rates between boys and girls continues to

narrow.

Although most children are getting their first dose of

HPV vaccine, there continues to be many children who

are not completing the vaccination series.

Main Messages, continued

HPV vaccination coverage is also lower in rural and less

urban areas. Those communities could benefit from

additional efforts to increase coverage.

More states have successfully increased HPV

vaccination through focused efforts since 2013.

Recent changes to HPV vaccine recommendations mean

preventing HPV cancers is easier now than ever before.

CDC recommends 11 to 12 year olds get just two doses of

HPV vaccine to prevent HPV cancers.

Call to Action

Now is the time for parents to protect their children

from HPV cancers. Every year that adolescents aren’t vaccinated is another

year they are left unprotected from

cancer-causing infections.

General Tweets

#DidYouKnow there’s a vaccine that can protect your kids

from cancer? Talk to your child’s doctor about HPV vaccine

at their next appt.

Most parents are choosing to get the first dose of HPV

vaccine to protect their children from cancers caused by

HPV infections. Are your kids protected?

6 in 10 children are getting the 1st dose of #HPVvaccine. See

6 reasons to get HPV vaccine for your child.

TWEET: Reason 1 to get #HPVvaccine for your child: HPV is a common virus that infects men and women.

TWEET: Reason 2 to get #HPVvaccine for your child: HPV vaccination works.

Spe

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https://www.cdc.gov/hpv/hcp/vacc-coverage.html

https://www.cdc.gov/hpv/hcp/vacc-coverage.html

[email protected]

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➢HPV Call-to-Action Webinar: December 13th at 2 PM ET• Featured topic: TBA

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sanford health comprehensive cancer coalition hpv grant...cell phone or land line or ... discussion...

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