# Evaluating a Tailored Quality Improvement Intervention to Improve Vaccination Coverage in Sydney Residential Aged Care Facilities

## TL;DR

A tailored quality improvement program increased vaccination rates in aged care residents in Sydney, with notable improvements in shingles, pneumococcal, and influenza vaccines.

## Contribution

The study demonstrates the effectiveness of tailored interventions in improving vaccination coverage in aged care facilities.

## Key findings

- Shingles vaccination coverage increased by 23.4%, pneumococcal by 14.2%, and influenza by 10.9%.
- Interventions like consent templates and vaccination trackers were found useful by staff.
- Discrepancies were found between official records and internal data, suggesting underreporting by external providers.

## Abstract

Background/Objectives: Aged care residents are highly vulnerable to vaccine-preventable diseases. Despite recommendations and funding under Australian programs, vaccination rates among residents for COVID-19, influenza, pneumococcal and shingles remain sub-optimal. The aim of this work was to assess if tailored quality improvement interventions would improve vaccination coverage in aged care residents. Methods: This was a quality improvement initiative evaluated using a quasi-experimental pre–post design. Building on previously identified barriers and enablers, a package of interventions and resources was developed to support consent processes, vaccination planning, and tracking. Pre- and post-intervention vaccination coverage was assessed using resident lists from participating aged care facilities and data extracted from the Australian Immunisation Register (AIR) at two time points, 14 months apart. A process evaluation survey was distributed to RACF staff. Results: Of the 6964 residents listed, 5153 (74%) remained registered in AIR when data was extracted post-intervention. Shingles showed the greatest improvement in absolute difference (+23.4%), followed by pneumococcal (+14.2%) and influenza (+10.9%), despite a high baseline of 68.5%. COVID-19 coverage declined by 7.4% when applying a 6-month reporting interval. Twenty-five staff completed the process evaluation survey; 45% of respondents identified discrepancies between AIR data and internal records, indicating underreporting by external providers. Interventions including the consent template and vaccination tracker were reported as useful and were used to support local vaccination. Conclusions: This quality improvement initiative improved coverage for three of the four recommended and funded vaccines for RACF residents and demonstrated the value of tailored interventions informed by consumer and provider feedback. The approach potentially offers a scalable model for improving vaccination rates in aged care across Australia.