A new approach to improving healthcare personnel influenza immunization programs: a randomized controlled trial.

BACKGROUND: Healthcare personnel influenza immunization rates remain sub-optimal. Following multiple studies and expert consultations, the "Successful Influenza Immunization Programs for Healthcare Personnel: A Guide for Program Planners" was produced. This trial assessed the impact of the Guide with facilitation in improving healthcare personnel influenza immunization rates in Canadian healthcare organizations. METHODS: A sample of 26 healthcare organizations across six Canadian provinces (ON, MB, NS, BC, SK, NL) was randomized to Intervention (n=13) or Control groups (n=13). Baseline influenza immunization rates were obtained for 2008-2009; the study groups were followed over two subsequent influenza seasons. The Intervention group received the Guide, facilitation support through workshops for managers and ongoing support. The Control groups conducted programs as usual. The Groups were compared using their reported influenza healthcare personnel influenza immunization rates and scores from a program assessment questionnaire. FINDINGS: Twenty-six organizations agreed to participate. 35% (9/26) of sites were acute care hospitals, 19% (5/26) continuing care, long-term care organizations or nursing homes, and 46% (12/26) were mixed acute care hospitals and long-term care or regional health authorities. The median rate of influenza immunization among healthcare personnel for the Intervention group was 43%, 44%, and 51% at three points in time respectively, and in the CONTROL GROUP: 62%, 57%, and 55% respectively. No significant differences were observed between the groups at the three points in time. However, there was a 7% increase in the median rates between the Baseline Year and Year Two in the Intervention group, and a 6% decrease in the CONTROL GROUP over the same time period, which was statistically significant (0.071 versus -0.058, p < 0.001). INTERPRETATION: This pragmatic randomized trial of the Guide with facilitation of its implementation improved healthcare personnel immunization rates, but these rates continued to be sub-optimal and below rates achievable in programs requiring personnel to be immunized. TRIAL REGISTRATION: ClinicalTrials.gov NCT01207518.

The role of the medical science liaison in industry.

Health care vendors (ie, industry) can be credited with developing products and medications that improve perioperative clinician and patient safety. The role of the medical science liaison in industry is to provide education about these products and facilitate research partnerships between clinicians and industry that can result in new products and innovations.

Descriptive study of shared decision making about lifestyle modifications with individuals who have psychiatric disabilities.

BACKGROUND: Shared decision making (SDM) is a process of active participation by clients with practitioners in weighing the risks and benefits of treatments. It has not been extended to decisions about making lifestyle modifications. OBJECTIVE: Describe how frequently health lifestyle behaviors are addressed in 15- to 20-minute medicine clinic visits with individuals who have psychiatric disabilities and how often SDM is used in reaching decisions. DESIGN: Content analysis of 98 audiotaped transcripts from practitioner and client medicine clinic visits. RESULTS: The most frequently discussed lifestyle behaviors discussed were sleep (89%) and diet (61%). SDM, defined as sharing information and options about behavior by either or both practitioner and client and affirmation of a decision by both, occurred 48 times (44%) when a problem existed. CONCLUSION: Discussion of lifestyle behaviors along with use of SDM in negotiating changes in behavior is feasible in a 15- to 20-minute visit.