Tran Maurice N, Bacci Jennifer L, Dillon-Sumner Laurel, Odegard Peggy
J Am Pharm Assoc (2003). 2021 Jan-Feb;61(1):e19-e25. doi: 10.1016/j.japh.2020.08.036. Epub 2020 Oct 16.
Project VACCINATE was a 1-year demonstration project conducted in 70 community pharmacies in Washington from September 1, 2016 to August 31, 2017 aimed at increasing adult vaccination and documentation in the state immunization information system (IIS). Key intervention features aligned with the Standards for Adult Immunization Practices and included incorporation of an immunization interface to facilitate proactive immunization screenings, patient engagement regarding vaccine needs, and vaccine documentation in the IIS as enhancements to the vaccination workflow.
The objective of this qualitative study, a subanalysis of Project VACCINATE, was to identify community pharmacy staff members' perceptions of work system factors that influenced the implementation of key intervention features.
Pharmacy staff at all Project VACCINATE locations were eligible to participate and were recruited by e-mail. Key informant interviews lasting 15-30 minutes were conducted by telephone using a semistructured interview guide. Interview transcripts were thematically analyzed using the Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 model of work systems.
A total of 7 interviews were conducted with pharmacists from different pharmacy locations from September to December 2017. Nine factors emerged across all domains of the SEIPS 2.0 model regarding the implementation of the key intervention features. These factors were pharmacist-patient relationships, team culture, individualized patient education, technician involvement, electronic access to vaccine records, pharmacy layout, staff training, immunization documentation in other care settings, and insurance coverage.
Several key factors were identified that, when addressed, can enable the incorporation of proactive immunization screenings, patient engagement, and vaccine documentation as enhancements to the community pharmacy-based vaccination process. Community pharmacy organizations should consider incorporating the described factors into existing immunization programs when assessing the unique dynamics of their work system.
“疫苗接种计划”（Project VACCINATE）是一项为期1年的示范项目，于2016年9月1日至2017年8月31日在华盛顿州的70家社区药房开展，旨在增加该州免疫信息系统（IIS）中成人疫苗接种及记录情况。关键干预措施符合成人免疫接种实践标准，包括引入免疫接种接口，以促进主动免疫筛查、就疫苗需求与患者互动，以及在免疫信息系统中进行疫苗记录，作为疫苗接种工作流程的改进措施。
本定性研究作为“疫苗接种计划”的子分析，旨在确定社区药房工作人员对影响关键干预措施实施的工作系统因素的看法。
“疫苗接种计划”所有地点的药房工作人员均有资格参与，并通过电子邮件招募。使用半结构化访谈指南通过电话进行持续15 - 30分钟的关键信息提供者访谈。访谈记录采用患者安全系统工程倡议（SEIPS）2.0工作系统模型进行主题分析。
2017年9月至12月，共对来自不同药房地点的药剂师进行了7次访谈。在SEIPS 2.0模型的所有领域中，出现了9个与关键干预措施实施相关的因素。这些因素是药剂师与患者的关系、团队文化、个性化患者教育、技术人员参与、电子获取疫苗记录、药房布局、员工培训、其他护理环境中的免疫接种记录以及保险覆盖范围。
确定了几个关键因素，解决这些因素可以将主动免疫筛查、患者互动和疫苗记录纳入社区药房疫苗接种流程的改进措施中。社区药房组织在评估其工作系统的独特动态时，应考虑将所述因素纳入现有免疫计划中。
