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Project Charter

• Project: The Establishment of a National Pandemic Action Plan for Influenza in the US.

• Organization: Center for Disease Control• Target Completion date: December 2013• Team Members: Mohamed Sidi Haiba and Louai El

Meqbeli• Scope: The project will analyze the flaws of the

existing process and propose alternative solutions to improve it.

Project Charter Cont’d

Stakeholders:

• Physicians

• Patients

• Healthcare Providers

• Employers

• General Population

• Government

Project Charter – Objectives

The Stated Goal: Increasing the supply and capacity of delivery of influenza vaccines

The Strategies Identified:

• Developing an immunization policy to increase the demand for seasonal vaccines by an average rate of 10% a year.

• Increasing influenza vaccine production capacity accordingly.

• Promoting research and development for new influenza vaccines

Project Charter – ObjectivesDeveloping an immunization policy to increase demand for

seasonal vaccines

• Map the landscape• Estimate the disease burden

• Develop regional plans of action and mobilize resources• Encourage international coordination between between

countries and regions of the world

Project Charter – ObjectivesIncreasing influenza vaccine production capacity

The three most valuable options identified by WHO experts

Include:

1.continuing to promote seasonal influenza vaccine programmers,

1. supporting the industry to sustain production capacity beyond seasonal demand and

2. enabling some vaccine production facilities to change, at the onset of a pandemic, from producing inactivated vaccines to live attenuated vaccines.

Project Charter – ObjectivesPromote research and development for new

influenza vaccines

Develop more effective influenza vaccines using new technologies.

The ideal product profile is a vaccine which is:• safe and highly protective, preferably in all target groups, including

infants, the elderly,

pregnant women and immuno-suppressed individuals;• is easily and economically produced on a large scale;• is effective – preferably with a low dose of antigen;• is delivered, ideally, as a single dose

Deployment Model Need Drivers CTQs Requirements

Improving the uptake of the

influenza vaccines in the USA

Seasonal clinic Mobile Staff

Client recall reminder Providers feedback

Media campaign Enhance efficacy of

exiting vaccines and promote research for

new ones

Mapping the existing process • Influenza Vaccine Doses distributed, United States 1964-2004.

• % of persons aged ≥ 65 years who reported receiving Vaccination during the preceding 12 months, by race/ethnicity and survey year- national health interview survey, US 1989-2003.

• % of persons aged 18-64 years who reported receiving influenza vaccination during the preceding 12 months, by race/ethnicity and survey year-national health interview survey, US 1989-2003.

• Cumulative Monthly Influenza Vaccine Distribution for 1999, 2000, 2001, 2002, 2003-04, 2004-05.

• % of influenza Vaccination by month, selected priority US populations, BRFSS 2004-05

Determining the process variation To achieve this objective, one needs first to

• examine the nature of the cause effects we are dealing with.

• Are they common or special?

• Given the data we have so far and the fact that our strategic approach is already known (improvement process), we know in advance that our variation type is stable and our cause effects are common.

Identifying the root causes

Based on the analysis of existing data we

have identified several root causes, but the

most important are:

• Lack of education

• Difficulties to access

• Cost

• Vaccine shortages

• Gaps in R & D

Proposed Solutions • Creating a robust and effective supply and delivery chain.

• Developing a stockpiles of vaccines.

• Resolving policy regulatory and coordination

• Broaden access to vaccination e.g. workplace, community, pharmacies, seasonal clinics.

• Raise the awareness of the public about the importance of vaccination (public information).

• Mandate employers to offer vaccine free of charge or at an affordable cost (on site if possible).

• Extend the requirement to public schools, nursing homes, kindergarten.

Cont’d Solutions

• Enhance demand among vulnerable segments of the population “elderly people, infants, pregnant women, children etc…”

• Extend the critical period of coverage beyond December.

• Link Influenza vaccination with the delivery of other vaccination among adolescents.

Enhancement Strategies

year 1 year 2 year 3 year 4

Client reminder/recall10% 20% 30% 40%

Multicomponent education15% 30% 45% 60%

Cost reduction 10% 20% 30% 40%

Reducing difficulty to access 20% 40% 60% 80%

Provider reminder /recall10% 20% 30% 40%

Implementation Process

Summary The availability of data is a crucial step in statistical analysis. Although, we

Were unable to obtain/collect all the data we needed, we had enough to kick start

our mapping process and devise some of our proposed solutions. The three

most valuable proposals identified by WHO experts include:

1. continuing to promote seasonal influenza vaccine programmers,

2. supporting the industry to sustain production capacity beyond seasonal demand and

3. enabling some vaccine production facilities to change, at the onset of a pandemic, from producing inactivated vaccines to live attenuated vaccines. Finally, in order for the process to be efficiently implemented and to take root

In the long run, the improvements achieved need to be maintained and

Ultimately institutionalized. In this regard the institution of a process control

level is of great importance.

Critique of the sources:

• Statistical Thinking (improving business performance) by R. Hoerl and R Snee

• Department of Health & Human Services HHS

• www.who.org

• Http://www.isixsigma.com/library/content/c001211a.asp .

• www.dtic.mil/ndia/2003CMMI/Facemire.ppt

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