Using a quality improvement project to enhance the standard vaccination rate for long-term patients in mental health services in Qatar

Abstract

Background: Countries launch vaccination programs to ensure vaccination coverage as part of the global health security. Special populations including patients with severe mental illness are under average vaccination rate. We aimed to improve the percentage of long-term patients in Qatar's mental health services who received their routine vaccination by the end of 2020 from a baseline rate of 10% to 90% from all vaccination types needed. Methods: This was an interrupted time series quality improvement project using two structured Plan-Do-Study-Act cycles to test the success of the outcome and process measures to reach the desired aim. Run charts were utilized to display the monthly vaccination rates as an outcome measure and the rate of vaccination refusals by the patients as a process measure. A multidisciplinary team was assembled. Root cause analysis was performed. Prioritizations for certain types of vaccines to be given were done. Results: We identified 50 eligible patients. Throughout 12 months, we reached a final vaccination rate of 92%. Number need to treat was used to express the effect size and was calculated as 1.2. Refusals to vaccinations by patients dropped from 41% at the start of the project to only 4% by the end. Conclusion: High vaccination rates over a 12-month period can serve as an indication for the success of the intervention. Sustainability of the results can be achieved by multiple strategies. These results may be useful to hospitals considering vaccine implementation or those currently struggling with implementation barriers.