Strategic alignment of quality improvement interventions to address barriers to adult vaccination in oncology.

e23285 Background: To address suboptimal vaccination rates in adult patients with cancer, the American Society of Clinical Oncology utilized a multi-year learning collaborative to develop, implement, and sustain clinical workflows to support increased COVID-19, influenza, and other routine vaccinations in adult cancer care centers. Methods: Eight participating health systems identified local barriers to adult vaccination and developed quality improvement (QI) interventions. Barriers were mapped to the SURE (Supporting the Use of Research Evidence) Framework, classifying obstacles into System constraints, Provider limitations, or Patient factors. Proposed and implemented interventions were coded according to the ERIC (Expert Recommendations for Implementing Change) framework clusters. A relational database was constructed to link specific identified barriers to their corresponding QI interventions. A complex, many-to-many relationship between the domains of barrier inputs (SURE) and intervention outputs (ERIC) was subsequently visualized using a Sankey diagram to illustrate the predominant flows to actual strategies used to address identified barriers. Results: The analysis classified distinct barriers across all three SURE domains, with prominent challenges identified in patient knowledge, staff Electronic Medical Record (EMR) proficiency, and System-level workflows and resource availability. Health systems prioritized interventions leveraging technology and optimizing workflows, with six of the eight teams implementing strategies categorized under the "Change Infrastructure" ERIC cluster, often involving integrating vaccination processes directly into the EMR to reduce staff burden and improve data capture. Seven teams implemented interventions to "Train and Educate Stakeholders" to boost staff knowledge and confidence, and four teams implemented strategies to "Engage Consumers" by empowering patients and addressing their concerns. Teams focused on formalizing and improving clinical workflows and addressing physical and logistical barriers to make vaccination more convenient. Conclusions: The strategic alignment of barriers and interventions demonstrates that a tailored, multi-faceted approach supports improved adult vaccination rates in oncology. By addressing specific patient, provider, and system-level challenges with targeted strategies, health systems can effectively overcome barriers to care. The implementation of diverse interventions across multiple cancer centers highlights the importance of context-specific adaptation and a systematic framework for guiding quality improvement initiatives.