Organizational factors associated with Health Care Provider (HCP) influenza campaigns in the Veterans health care system: A qualitative study

Zayd Razouki*, Troy Knighton, Richard A. Martinello, Pamela R. Hirsch, Kathleen M. McPhaul, Adam J. Rose, Megan McCullough

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Background: It is an important goal to vaccinate a high proportion of health care providers (HCPs) against influenza, to prevent transmission to patients. Different aspects of how a HCP vaccination campaign is conducted may be linked to different vaccination rates. We sought to characterize organizational factors and practices that were associated with vaccination campaign success among six sites within the Veterans Health Administration, where receipt of flu-vaccination is voluntary. Method: We conducted a total of 31 telephone interviews with key informants who were involved with HCP flu vaccination campaigns at three sites with high-vaccination rates and three sites with low-vaccination rates. We compared the organization and management of the six sites' campaigns using constant comparison methods, characterzing themes and analyzing data iteratively. Results: Three factors distinguished sites with high flu vaccination rates from those with low vaccination rates. 1) High levels of executive leadership involvement: demonstrating visible support, fostering new ideas, facilitating resources, and empowering flu team members; 2) Positive flu team characteristics: high levels of collaboration, sense of campaign ownership, sense of empowerment to meet challenges, and adequate time and staffing dedicated to the campaign; and 3) Several concrete strong practices emerged: advance planning, easy access to the vaccine, ability to track employee vaccination status, use of innovative methods to educate staff, and use of audit and feedback to promote targeted efforts to reach unvaccinated employees. Conclusion: Successful HCP flu campaigns shared several recognizable characteristics, many of which are amenable to adoption or emulation by programs hoping to improve their vaccination rates.

Original languageAmerican English
Article number211
JournalBMC Health Services Research
Issue number1
StatePublished - 2016
Externally publishedYes

Bibliographical note

Funding Information:
This study was funded by the VHA Office of Public Health. Dr. Razouki is an awardee of the OAA MD Postdoctoral Training Program in Health Services Research, Durham Center (TPM 21-026). The authors would like to thank Beth Ann Petrakis for her help collecting the data. The authors thank the Preventive Medicine residency program at Boston University for supporting this effort. The authors would also like to thank all staff that we interviewed for sharing their time with us. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.

Publisher Copyright:
© 2016 The Author(s).


  • Health care provider
  • Influenza vaccine
  • Organizational factors
  • Positive deviance method
  • Qualitative study


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