SOP Toolkit in Diverse Practices Implemented & Tested With RE-AIM
SOP Toolkit in Diverse Practices Implemented & Tested With RE-AIM
The purpose of this study is to test whether or not the 4 Pillars Toolkit increases adult
 Influenza, pneumococcal polysaccharide vaccine (PPSV), tetanus, adult diphtheria and
 acellular pertussis vaccine (Tdap/Td) vaccination rates. The vaccines are all FDA licensed
 vaccines and to be used according to national guidelines. The investigators will conduct a
 randomized cluster trial of this toolkit in diverse primary care practice with electronic
 medical records (EMRs).
This intervention is a two-region, two-year, stratified randomized cluster trial in 24
 primary care practices with EMRs. These practices will be randomly assigned to be
 intervention or control sites to test this 4 Pillars Toolkit intervention package of
 evidence-based techniques tailored to their practice structure and culture; one set of
 practices randomized to intervention in year 1 and the other to control. In year 2, the other
 set of practices will receive the intervention and community controls may be sought.

 These diverse practices consist of: 18 diverse practices from UPMC in western Pennsylvania
 and 6 diverse practices from large community health centers in a PBRN in Texas.
Practice staff and adults in enrolled clinical sites

 Inclusion Criteria:

 Site inclusion criteria:

 -  1) an appropriate adult population: e.g., adults aged 50 years and older;

 -  2) currently using an EMR that has prompt ability, such as EpicCare;

 -  3) having and keeping immunization data within this EMR

 Patient-level inclusion criteria:

 -  1) Adults (18 years and above) who are active patients of the enrolled practices
 (e.g., active patients are those with a visit within the last 12 months)

 -  2) All unvaccinated adults without a contraindication are eligible to receive Td/Tdap
 and influenza, regardless of age and at age 65 years or older are eligible for PPSV.

 Exclusion Criteria:

 Site exclusion criteria:

 -  1) consistent SOP use for the 3 vaccines being studied or high vaccination rates
 (e.g., 80%)

 Patient-level exclusion criteria:

 -  1) those with a true contraindication, following the CDC's Guide to Contraindications
 (attached with the US Recommended Adult Immunization Schedule), such as prior vaccine
 anaphylaxis.