Date of Graduation

Fall 12-12-2025

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

First Advisor

Robert Patterson, DNP, MSN, RN

Abstract

Objective: This quality improvement project was implemented in an urban community health clinic primarily serving low-income and Latinx patients. Factors such as demographics, socioeconomic status, health, and transportation contribute to low U.S. influenza vaccination rates (Chen et al., 2020), while EHR training can improve provider satisfaction and efficiency (DiAngi et al., 2019). This microsystem faced inconsistent workflow processes, limited EHR training, and documentation errors that contributed to low staff satisfaction rates and influenza vaccination rates. An average of 11.4% of patients received a flu vaccine in October 2023 and 2024. Medical assistants (MAs) completed a pre-intervention survey indicating that 35% were dissatisfied with the flu vaccine rollout process. Contributing factors include competing MA priorities, unclear EHR training, lack of workflow standardization, limited use of EHR tools, poor vaccine signage, and inconsistent vaccine ordering. Aim: A multimodal intervention was designed to address workflow inefficiencies and MA dissatisfaction. Methods: These interventions included (1) integrating the Immunization Clinic function in EPIC to streamline flu vaccine documentation and administration, (2) MA EHR training, and (3) the distribution of workflow tip sheets to standardize EHR use. Collection of data included pre- and post- MA satisfaction surveys and clinic vaccination reports. Trainings sessions involved MAs, nurse managers, and other clinic staff to standardize workflow. Implementation of the Immunization Clinic EHR function began on October 1, 2025, and ended on November 5, 2025. Results: Post-intervention results showed that patient vaccination rates increased from 11.4% to 19.1% and staff satisfaction increased from 65% to 77%. Conclusions: The intervention proved to be successful as patient vaccination rates and staff satisfaction increased. This showcases the importance of staff trainings and having a consistent standardized EHR workflow.

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