Splenectomy as a Destination: Improving Quality of Care Among Asplenic Veterans Through a Travel Clinic.
dc.contributor.author | Boggan, J | |
dc.contributor.author | mitchell, AP | |
dc.contributor.author | lau, K | |
dc.contributor.author | simel, DL | |
dc.coverage.spatial | United States | |
dc.date.accessioned | 2017-05-27T18:26:06Z | |
dc.date.available | 2017-05-27T18:26:06Z | |
dc.date.issued | 2017-02-14 | |
dc.description.abstract | BACKGROUND: Asplenic patients are at risk for severe infections, but adherence to recommended preventive education and vaccination is poor. The goal of this study was to demonstrate that a targeted intervention can improve vaccination rates in a population of asplenic veterans. METHODS: Surgically asplenic patients actively receiving care in our health care system were identified via a database search. Patients were contacted via mailed letters and encouraged to attend an existing travel clinic with a new process designed for asplenic patients. In the clinic, patients were educated on the risks of asplenia and proper preventive precautions, a vaccination history was taken, and patients were administered any additional indicated vaccines. RESULTS: The database search yielded 113 patients; an additional 14 asplenic patients were identified and referred to the clinic by providers, and 2 were referred prior to planned splenectomy. Among all asplenic patients, the first-year referral rate to clinic was 38/129 (29%). During the first year of the intervention, there were increases in the rates of 3 of 4 recommended vaccinations: pneumococcal conjugate, 19% to 55% (P <.001); Haemophilus influenzae type B, 19% to 35% (P = .007); and meningococcal vaccine, 24% to 43% (P = .002). The pneumococcal polysaccharide vaccination rate increased from 91% to 93% (P = .62). CONCLUSIONS: Targeted interventions can improve guideline-based care for asplenic patients. The creation of a clinic designed for asplenic patients led to increases in 3 of 4 recommended vaccinations. This strategy may be applicable to other health care systems with similar numbers of asplenic patients. | |
dc.identifier | ||
dc.identifier | S0002-9343(17)30131-6 | |
dc.identifier.eissn | 1555-7162 | |
dc.identifier.uri | ||
dc.language | eng | |
dc.publisher | Elsevier | |
dc.relation.ispartof | Am J Med | |
dc.relation.isversionof | 10.1016/j.amjmed.2017.01.024 | |
dc.subject | Asplenic | |
dc.subject | Preventive medicine | |
dc.subject | Quality improvement | |
dc.subject | Splenectomy | |
dc.subject | Vaccines | |
dc.title | Splenectomy as a Destination: Improving Quality of Care Among Asplenic Veterans Through a Travel Clinic. | |
dc.type | Journal article | |
duke.contributor.orcid | Boggan, J|0000-0003-3564-2807 | |
pubs.author-url | ||
pubs.organisational-group | Clinical Science Departments | |
pubs.organisational-group | Duke | |
pubs.organisational-group | Medicine | |
pubs.organisational-group | Medicine, General Internal Medicine | |
pubs.organisational-group | School of Medicine | |
pubs.publication-status | Published online |
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