KEYWORDS:
Standing orders, physician involvement, immunization promotion/education.

BACKGROUND:
Immunization is an efficient, cost-effective strategy to prevent hospitalization and death from influenza and pneumococcal disease. Strong evidence exists that standing medical orders, clear physician recommendation and organizational-based informational/promotional materials influence whether an individual is immunized.

OBJECTIVE(S):
Increase the statewide influenza and pneumococcal immunization rates using a three-pronged approach: Mailing regarding standing medical orders; an Immunization Tool Kit; and “Presents for Prevention.”

METHOD(S):
- Standing Orders Make a Difference. A spring 2001 mailing went to 7,000 primary care physicians, nurse practitioners and physician assistants in Wisconsin encouraging implementing standing orders for immunizations. It included a sample standing order and implementation tips.
- Immunization Tool Kit. About 8,500 kits were mailed in August to those listed above, public health departments and mass immunizers. The kit provided tools to assist providers, including strategies for raising rates; ACIP recommendations; Wisconsin’s vaccine contingency plan; promotional/educational materials; and reproducible vaccine information.
- “Presents for Prevention” went to clinics and health systems. The kit provided clinics/physician offices with promotional items for their patients and office staff. Contents included: chart stickers, chart flowsheets, posters for exam rooms, and giveaways such as health records, calendars, refrigerator magnets and pins.

RESULT(S):
The standing orders mailing was well received, and many physicians instituted new procedures. A 1999 evaluation of the Immunization Tool Kit indicated physicians liked the recommendation summaries and the promotional materials. More than 130 orders were placed for educational materials. Some 1,100 “Presents for Prevention” kits were mailed to physicians and clinics, with nearly 100 clinics subsequently ordering materials.


CONCLUSIONS(S):
The informational and promotional/patient education materials meet a need – particularly those that can be directly applied to the practice to inform physicians and patients.


LEARNING OBJECTIVES:
If MetaStar used mass mailing to place educational/promotional materials in the hands of providers, would they be used?