Clinical quality governance-apractical approach in general practice with the example of influenza vaccination

Abstract

We understand clinical quality governance (CQG) as quality management in the clinical domain. In 2020, presumably due to the coronavirus pandemic, more patients requested to be vaccinated against influenza as compared to previous years so that it became apparent that there would be ashortage for high-risk patients. To meet the problem, we started aCQG process. This article is explicitly not aresearch article but an exemplary description of aCQG process intended as astimulus and for discussion. We initiated the following process: (1) evaluation of the present state, (2)patients who already had requested avaccination were prioritized and vaccinated first, and (3) contacting via telephone and vaccination of high-risk patients not on the list. We chose patients with chronic obstructive pulmonary disease (COPD) older than 60years as an indicator for the group of highest priority. In the beginning only 3(8%) of our 38 patients with COPD were vaccinated against influenza. After prioritization and vaccination of the high-risk collective in the list of those who had requested to be vaccinated, 25 (66%) of our 38 patients with COPD were vaccinated. After aphone call of high-risk patients not on the list, 28 (74%) patients were vaccinated. This represents an increase of vaccination coverage from 8% to 74% which is close to the rate recommended by the World Health Organization (WHO). In times of apandemic, family physicians occasionally have to deal with ascarcity of resources and have to develop strategies for fair resource allocation. Not only in this context is CQG worth the effort. The generation of list queries could be improved by the providers of electronic patient records.