PC2187: Use of Educational Modules to Improve Medical Staff Recommendations for Pediatric COVID-19 Immunizations

Purpose/Objectives: The SARS-CoV-2 pandemic has resulted in nearly 13 million U.S. cases of COVID-19 in children, including over 75,000 infections in Department of Defense beneficiaries under 18 years of age. COVID-19 immunizations received initial emergency use authorization (EUA) for children ≥12 years-old in May 2021. Early data demonstrated high levels of vaccine hesitancy with only a minority of families planning to get an authorized COVID-19 immunization. Prior research demonstrated a strong recommendation from a trusted medical team member being a key driver in increasing immunization rates. The Process Improvement to Increase Immunizations for COVID Knowledge via Educational Modules (PI3CKEM) project’s aim is to provide evidence-based practice knowledge focused on increasing medical team members' comfort level, providing a strong recommendation for authorized COVID-19 immunizations for their pediatric patients.

Design/Methods: We employed Lean Six Sigma principles with Plan, Do, Check, Act (PDCA) cycles to develop a process improvement project utilizing virtual educational modules (VEM). The PI3CKEM project was used in the pediatric departments at two military treatment facilities (MTF): Walter Reed National Military Medical Center (WRNMMC) and Brooke Army Medical Center (BAMC). The primary goal was to achieve over 80% self-reported confidence in giving COVID-19 vaccination counseling by medical staff providing care for EUA eligible pediatric beneficiaries. Self-reported confidence was rated categorically and tracked as a percentage of respondents on a run chart. Likert scales were used for pre-module and post-module assessments. WRNMMC pediatric specific vaccination rates were compared to national results as a secondary benchmark.

Results: Three educational modules were developed covering the initial COVID-19 EUA for ≥12 yo, myocarditis reports following COVID-19 vaccination, and expansion of the EUA to include ≥ 5yo. 74 persons to include physicians, medics, and nurses participated in the modules. Initial comfort level was 70% and increased to 100% of respondents over the duration of the intervention (Figure 1). Pre and post-module assessments demonstrated a significant increase in 7 of 8 questions (Figure 2). In March 2022, at least 44.4% of eligible WRNMMC pediatric patients had completed 2 or more doses of an authorized vaccine compared to 41.4% nationally.

Conclusion/Discussion: The PI3CKEM project achieved its primary goal of achieving sustained high-level comfort in making a strong recommendation in support of COVID-19 vaccination amongst medical staff by using VEM developed in response to the evolving COVID-19 immunization landscape. Additionally, pediatric beneficiaries outperformed national immunization rates. Ongoing educational efforts will continue to address knowledge needs, including the immunization of those under 5 years of age.