COMBATING COVID-19 IN PARTICULARLY VULNERABLE COMMUNITY: A RESIDENT QUALITY IMPROVEMENT PROJECT

ABSTRACT

BACKGROUND: At the beginning of 2021, the FDA officially issued the first emergency use authorization of COVID-19 vaccines. Vaccination hesitancy has been an ongoing issue over the years but is now an even more serious problem ever since the newly developed COVID-19 vaccine was released for emergency use. Due to the rapid event of COVID-19, community clinics have been unable to develop effective methods to inform patients about the vaccines, thus the vaccination rates have been low. Our goal is to increase vaccination uptake in our ethnically diverse community in Trenton, New Jersey. METHODS: The study was conducted between January 1-December 31, 2021. The QI team includes faculty and resident physicians, nurses, and medical assistants. The charts of unvaccinated patients were isolated. The team intervened in two PDSA cycles in order to systematically assess our performance and track improvements in vaccination rates. A standardized educational flyer was created and incorporated in EMR in multiple languages. Thereafter, the team added informational visits during each encounter. RESULTS: A total of 2,374 patients were listed, of which 63% were female. Most of our population is Hispanic with 73.8%, followed by Black by 9.7%. At the end of our study, a total of 52.6% of the patients were vaccinated. Among the vaccinated population, 75.7% of the patients were fully vaccinated. The highest monthly vaccination rate was reached inMay 2021 (29.6%) (Figure 1). The most commonly utilized vaccine was Moderna with 48.3% followed by the Pfizer-Biontech vaccine (35.2%). The vaccination rate was significantly positively associated with age, female gender, and Hispanic race ( all p values< 0.05). CONCLUSIONS: Our project demonstrates the importance of patient and staff education, close follow-up, and a systematic PDSA model process. Our patients have low health literacy and lack of knowledge about vaccines' safety and efficacy. Additionally, social media is broadcasting conspiracy theories and misperceptions about the COVID-19 vaccines, thus creating fear in patients. Unfortunately, COVID-19 will not be eliminated anytime soon due to the new variants coming as a threat to the world. Our QI team recommends others collect all the necessary data to move forward in similar projects like ours.