How to Increase Staff COVID-19 Vaccination: Focus on the Letter “I”

Skilled Nursing News recently reported on a study that revealed there has been a decrease in new positive resident and staff COVID-19 cases since vaccination clinics began in long-term care communities. According to the report from The Center for Health Policy Evaluation in Long-Term Care (HPE):

Vaccinated nursing homes experienced a 48% decline in new resident cases three weeks after the first clinic, compared to a 21% decline among non-vaccinated nursing homes located in the same county….Similarly, new staff cases declined by 33% in vaccinated nursing homes compared to 18% in non-vaccinated facilities.

This is welcome news for post-acute and senior living care providers. We have all been personally and professionally impacted by COVID-19 and its devastating effects to older adults and those who care for them.

Indeed, most senior care and living management teams agree that vaccination is key to propelling our infection prevention and response action plans as well as providing much-needed hope to our profession and the communities we serve.

As most of us quickly move to a second vaccination clinic and look beyond to our third, it’s important that we keep our foot on the gas pedal. A recent report from the Centers for Disease Control and Prevention (CDC) indicated that so far, 80% of residents and 37% of staff members in our industry have chosen to be vaccinated. So how do we as leaders continue to champion the vaccine?

We focus on the letter “I.”

Inspiration

Any of us with children or pets know that using a carrot instead of a stick is most effective. A recent article in NPR legitimately pointed out that people need time and empathy—not judgment. We are people first. We all have personal reasons for choosing or not choosing to take the vaccine. As we all work to increase vaccination in staff, we are better served to listen to personal reasons and seek to understand them rather than pressure or guilt people into compliance. This inspiration might come in a variety of ways. For example, many of Health Dimensions Group’s managed communities have encouraged those being vaccinated to answer the question, “Why are you choosing to be vaccinated?” The reasons are as multifaceted and as individual as the people who stated them. They include “keeping my residents safe,” “keeping my own family safe,” “being able to return to church choir,” “returning back to the normal we had in a not so distant past,” along with many others. Support—not shame—is the key here. “You catch more flies with honey than vinegar,” as my grandma said.

Insight

Information and education continue to be a key to influencing the number of people who choose to be vaccinated for COVID-19. In providing these materials, you really need to reach people where they are. There is an old marketing adage, “consider your audience.” In speaking to some of our executive directors, I received feedback that our messaging needs to be easy to understand. While it might be necessary for some to hear the scientific facts, others may need information that’s easier to digest. We have used resources provided by the CDC as well as our professional associations. We have also created our own educational tools, with a goal to be as concise and insightful as possible.

Your medical director, if you have one, plays an important role here. In some of our managed communities, the medical directors have offered or agreed to author a letter to residents, families, and staff. Our communications team provided a template that the physicians could edit as they saw fit. A couple of medical directors offered to record a video message for use in email marketing and social media, which included Chris Jensen Health & Rehabilitation Center in Duluth, Minnesota. Initially we thought the medical directors’ support in messaging would be a big influence on just families and residents; however, we quickly learned that our staff wanted to hear from the medical director as well. Many staff members do not have a primary care physician or other trusted health care provider or professional with whom they can share their concerns. Speaking directly to the community’s medical director, director of nursing, or other nursing staff member provides a trusted resource on the health and medical benefits of COVID-19 vaccination.

Individual

We are all busy leading our teams and taking care of the residents in our communities, so it is easy to defer and utilize mass communication techniques. Whether this is through voice messaging, email campaigns, posters, flyers, or handouts, we might all be guilty of trying to “reach the masses quickly.” While this may work to influence some people, other people may need a more personal touch. One of our executive directors in Ely, Minnesota made it a personal mission to call or talk to every single staff member. This gave him an opportunity to hear firsthand about the concerns and customize messaging as appropriate. The reason this works, of course, is that this executive director already has trusted relationships with his team. If the only time the staff hears from leadership is to ask them to do something, it won’t work. The key here is relationships—one-to-one relationships. It is important to match informal and formal leaders with their friends and trusted colleagues. One size does not fit all, so don’t leave this to chance. Make a list and a strategy for reaching and talking to each community staff member and resident personally.

Incentive

When we first started rolling out the vaccines, many senior care and living leaders wrestled with whether we should pay or otherwise incent staff to get vaccinated. Health Dimensions Group has a company value of Integrity, so it felt wrong to pay people to be vaccinated. After all, do we pay people to get a flu shot? Do we pay our kids to get their annual vaccinations? However, we quickly learned that many organizations nationwide were providing some sort of financial incentives to their staff. And guess what? It works for some. At Health Dimensions Group, we are paying managed community employees four hours of time to be fully vaccinated. We believe this is appropriate given we are paying for people to research and learn more about the vaccine as well as the time it takes to get vaccinated. We also set up a friendly competition between our managed communities. The managed community with the highest percentage of staff members fully vaccinated will be awarded a $3,000 stipend to remodel their break room. We also have financial incentives for second and third place. One of our executive directors in Chippewa Falls, Wisconsin, emailed me today and said, “Game on.” Competition and incentives work.

Innovation

Innovation has been key to high staff member and resident COVID-19 vaccine participation and can take a variety of forms. Our managed community in Frazee, Minnesota, took a creative approach and selected the theme “poke-a-bowl,” which was a play on Super Bowl Sunday. They had football game themed snacks and decorations. We have also created videos capturing the optimism and hope surrounding the vaccine An Exciting Day at Traverse Care Center and Prairieview Place and An Exciting Day at Terova Senior Living. Be sure to ask your staff, “What would be a fun theme to get our community members energized?” After nearly a year of a pandemic that challenged the mental health of each of us, having something to celebrate and an opportunity to do something creative feeds our souls.

Integrity

Health Dimensions Group, as noted earlier, has a company value of Integrity, which has played out as we have worked to increase the percentage of staff and residents who have received the COVID-19 vaccination. We have shared all information we have about the vaccination, as well as relied on official resources through the CDC and various state health departments. We answer questions openly and honestly. For our organization, Integrity also means “the right thing to do.” This message appeals to those employees who feel it is their personal obligation to get vaccinated to protect those they serve and care for, as well as those in the broader community.

Intensity

In many areas of the country, we have finished our second vaccination clinic and are moving to our third. Information has been slow in coming as to the national or statewide strategy for vaccinating residents and staff who chose not to be vaccinated earlier on. It would be easy to become complacent. Medical leaders and scientists have been moving the bar on the number of people who must be vaccinated to achieve herd immunity. It’s important to keep working on vaccination compliance. This intensity and continued diligence will allow us to increase the percentage of staff and residents who are ultimately vaccinated for COVID-19.

The residents and team members we serve in senior care and living are very diverse. To be effective in vaccination compliance efforts, we need to be as Inventive as we can. A focus on the “I” in vaccInation will be key to our success.