Best and Promising Practices

Successfully using incentives and understanding the role they play is key to working with healthcare systems to improve HPV vaccination practices. Promising practices for using incentives include:

Learn and recognize health systems’ priority areas

Most healthcare systems set QI priorities on a yearly cycle. These priority areas drive the allocation of resources and attention throughout the system. Just because your organization prioritizes HPV vaccination, doesn’t mean that healthcare systems will have the same focus.

Establishing relationships with QI leaders is critical to learning and recognizing systems’ priorities. Once you know a health system’s QI priorities, you can work with leaders to show them how HPV vaccination fits in with their overall strategy.  For example, does a system have the goal to increase pediatric vaccination? Show them how a specific focus on HPV vaccination can impact their HEDIS measures. Does a system have a goal to implement reminder/recall for preventive services? Show leaders how HPV vaccination can fit into that plan. 

Once you’ve helped show QI leaders how HPV vaccination can fit into their priority areas, encourage the system to set goals and incentivize improvements that support them. Healthcare systems can provide many kinds of incentives to drive change. But QI partners can also offer incentives to the system. Offering to support HPV QI projects with incentives for meeting goals can motivate systems to make HPV vaccination a priority area.

“Well, we’ve– again, we prioritize based off of, is there an incentive tied to it, number one, and also are we doing really poorly on it.”

Health system QI leader

Incentives that QI partners may be able to offer:

• Support MOC Part 4 projects by providing materials and templates for reporting requirements
• Offer state-wide recognition and awards for high performing providers or clinics
• Provide regular data reports from your state’s immunization information system (IIS) to track improvements in HPV vaccination rates
• Help clinics update their medical records and work with systems to make the state’s IIS bi-directional with their EHR systems

Help clinics and systems set SMART goals

Many healthcare systems may want to improve their HPV vaccination rates.  But sometimes QI projects fail because clear goals for the project and metrics for success haven’t been established from the start. Work with QI leaders to set SMART HPV vaccine QI goals.

SMART questions to consider before the start of the project:

• Will you focus on HPV vaccine initiation or completion? For what ages? Who will participate in this QI project; all vaccine prescribers, specific clinics, nurses, other clinic staff? (Be Specific)
• Will we track vaccination rates or patient counts? How will people involved in the project get feedback about their progress; on system-wide dashboards, in staff meetings? (Make it Measurable)
• What are HPV vaccination rates at the start of the project? What resources do we have to put behind this project? How much change in HPV vaccination rates are we hoping to achieve; 10%, 15%? (Is it Achievable)
• What is a goal that this system or clinic can reasonably aim for, considering where we’re starting and the resources that we have? (Be Realistic)
• What is the time frame for this project? When will it start? How will we know when it’s over? (Make it Timely)

“When people saw that we developed this division and identified the value of it, we’re suddenly getting people calling us and saying, “Can you do this project for us?”  And we’re having to educate them that really what you need to do is identify what you need, what is your goal, what things do you think might work and let us help you really get a strategy of achieving that goal and developing a technique to get there and help us decide what you would call a success and we’ll see if we can develop some data measurements to help you know if you are succeeding.”

Health system QI leader

Offer your resources

Many healthcare systems want to improve their HPV vaccination rates but lack resources to get projects off the ground. Immunization programs and other QI partners have specific expertise that they can offer to facilitate these projects, and healthcare systems may not know that those resources are available. QI partners can offer educational materials like HPV vaccine consultation slides or an action plan, trainings, data reports, and established QI infrastructure through programs like IQIP. By offering your support and resources, you can empower and motivate providers to improve patient care.

“Sometimes it’s hard to get buy-in from clinics that haven’t really had a lot of experience with [quality improvement]. A lot of times they feel like ‘Oh, it’s just one more thing they’re asking me to do to run this report,’ and so trying to win that relationship over with the clinics is really the hardest piece. Once they realize that we’re there to help, that’s when they start saying ‘Oh, okay. I can use you. You do have value. Come help me with these things.”

Health system QI leader