Raise your clinic's adult immunization rates
How Standing Orders Can Help
Standing orders streamline the delivery of adult immunizations by simplifying the process of identifying and vaccinating appropriate patients in your practice. By putting in place a routine, standardized process, such as a standing order, you empower your staff to assess and vaccinate patients according to current CDC recommendations, while you maintain overall control of the process.
Using standing orders (1) improves efficiency in delivering adult immunizations, and (2) increases overall adult immunization coverage rates, leading to improved patient health.
The Need For Standing Orders
Immunization rates for adults in the United States are unacceptably low: Influenza (49%), Tdap (17%), Zoster (24%).
As a result, more morbidity and mortality are associated with adult vaccine-preventable diseases (VPDs) than with pediatric VPDs, where stronger immunization efforts exist.
In a busy adult practice covering a broad range of services, delivery of adult immunizations can become an overlooked preventive intervention, despite the fact that full insurance coverage for patients up to 65 years of age is available under the Affordable Care Act.
Medical practices can help remedy this situation by implementing standing orders. These key practice components have been demonstrated to:
- Streamline assessment of the need for and the administration of vaccines
- Improve vaccine coverage rates in the practice
- Improve patient care
Despite the endorsement of the use of standing orders by multiple major medical and public health organizations, these simple tools are not being implemented in many adult practices, leading to multiple missed opportunities to vaccinate patients and to prevent unnecessary disease and death.
What Immunization Leaders Say About Standing Orders
“At UnitedHealthcare, we encourage medical practices to implement standing orders because we know they increase vaccination rates.”
National Medical Director, UnitedHealthcare
“Using standing orders for all routine vaccines is the key to improving immunization rates in a medical practice. Assessment of the vaccination status should be a part of the vital sign process for all patients. A clinic vaccine champion can manage unusual situations and ensure the correct application of all standing orders. Standing orders enable us to Vaccinate Today!”
Professor of Family Medicine, University of Pittsburgh Medical Center St. Margaret
“Standing orders take the guesswork out of a crowded vaccine schedule. For a busy clinician, they can be the perfect failsafe.”
Chief of the Division of Infectious Diseases and Director of the Vaccine Education Center at the Children’s Hospital of Philadelphia
“Implementing standing orders in our practice helped eliminate the uncertainty that the clinical staff felt as to which vaccines should be given to which patients. Now clinical staff members are empowered to discuss vaccine status with patients and to administer the appropriate vaccines without delay or hesitation. This has allowed the entire office to play an integral part in increasing the number of adult patients who receive needed immunizations.”
Practice Manager, Gordon Gold MD & Associates University of Pittsburgh Medical Center
“Standing orders help to improve practice efficiency and enable standardization in vaccinating adult patients. The National Foundation for Infectious Diseases (NFID) supports the use of standing orders to increase vaccination rates among adults.”
NFID Medical Director
“Immunization of adults is a complex process, but attention and standardization of procedures via the use of standing orders in medical practices have demonstrated major impact on patient care. Using standing orders ensures that each patient will receive the best preventive care at every visit. Not by chance, but by design.”
Clinical Director, Vaccine and International Health and Travel Clinics
“The American Academy of Physician Assistants is deeply committed to increasing adult immunization rates and strongly supports the use of standing orders to administer vaccines to adults. In short, standing orders help PAs deploy their full skill set efficiently and effectively by reducing unneeded steps in clinic operations and capturing often missed opportunities to vaccinate.”
Director, Clinical Education, American Academy of Physician Assistants (AAPA)
“Standing orders are one of the most effective and cost-effective methods to raise immunization rates. For standing orders to be most effective, a routine trigger is needed, such as vaccination as a vital sign.”
Professor, Department of Family Medicine, University of Pittsburgh
American College of Physicians
American Academy of Family Physicians
American Association of Nurse Practitioners
Association of Immunization Managers
Association of State and Territorial Health Officials
Gerontological Society of America
National Association of County and City Health Officials
National Foundation for Infectious Diseases (NFID)
Public Health Foundation
Society of Teachers of Family Medicine – Group on Immunization Education
Vaccine Education Center, Children’s Hospital of Philadelphia