[AVBC 2025] Improving Influenza Vaccination Rates in Patients with Acute Coronary Syndrome (ACS)
Care Process & Redesign
Workforce Transformation
Appropriate & Value-based Care Conference
SingHealth
19 November 2025
This study evaluates the effectiveness of a multidisciplinary Post-ACS clinic integrating Cardiac Care Specialty Nurses. Integrating dedicated post-discharge clinics into routine cardiac care can optimize preventive health outcomes and support national.
Year Submitted: 2025
Published Date: 19 November 2025
Tags: Workflow Redesign, Quality Improvement, Care Process ＆ Redesign, Multi-Disciplinary, Job Redesign, Workforce Transformation, Allocative Value, Value Based Care, Discharge Planning
About this Content
Aims
This study evaluates the effectiveness of a multidisciplinary Post-ACS clinic integrating Cardiac Care Specialty Nurses (CCSNs) and Cardiologists at Sengkang General Hospital (SKH) in improving vaccination rates, aligning with MOH's preventive care targets.
Background
Acute coronary syndrome (ACS) patients face high risks of recurrent cardiovascular events. Influenza vaccination has been shown to reduce major adverse cardiovascular events by 45% (2023 meta-analysis). Despite these benefits, uptake remains suboptimal due to vaccine hesitancy and poor follow-up care.
Methods
A comparative cohort study was conducted at SKH involving ACS patients (January - December 2024). A standardized workflow was implemented in two settings: during hospital admission and at Post-ACS clinic visits. Patients received follow-up through either Post-ACS clinic with personalized education, structured follow-up scheduling, and CCNS-led counselling using HPB NAIS booklet and SKH educational pamphlet, or standard care pathway with routine follow-up without targeted interventions. Vaccination rates were compared between groups at both admission and post-discharge.
Results
A total of 145 ACS patients were enrolled: 104 in the Post-ACS clinic group and 41 in standard care. Following workflow implementation, vaccination rates during admission increased from 21% to 73%. Post-discharge vaccination rates were significantly higher in the Post-ACS clinic group compared to standard care (29% vs 5%, p0.05). Final unvaccinated rates were significantly lower in Post-ACS clinic group (16% vs 44%, p0.05).
Conclusion
Integrating dedicated post-discharge clinics into routine cardiac care can optimize preventive health outcomes and support national MOH targets. The standardized workflow substantially improved influenza vaccination rates during hospitalisation. The Post-ACS clinic's multidisciplinary approach, combining CCSN-led education with personalized follow-up, further increased uptake in the post-discharge phase.
Lessons Learnt
Multidisciplinary collaboration during hospital admission and follow-up significantly improved vaccination uptake among ACS patients. The Post-ACS clinics structured approach with CCSN-led education, personalized follow-up and targeted counselling was particularly effective in sustaining post-discharge vaccination rates.
Additional Information
Acknowledgements: We extend our sincere gratitude to Dr. Zhang Di, Ms. Gan Pei Ying, Mr. Marcus Ang Kwang Hwee, Ms. Cai Huimei and Ms. Chen Ling Jun for their invaluable guidance and support towards this project. Reference: Modin D et al. Influenza vaccination and cardiovascular events in patients with ischaemic heart disease and heart failure: A meta-analysis. Eur J Heart Fail. 2023;25(9):1685-1692.
Keywords
Vaccination, Acute Coronary Syndrome
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | SingHealth |
Organization(s) Involved | National Heart Centre Singapore, Sengkang General Hospital |
Platform(s) | Appropriate & Value-based Care Conference |
Healthcare Professional Group(s) | Nursing, Medical |
Applicable Specialty or Discipline | Cardiology |
Project Lead(s) | Joan Kirana Nurjono |
Project Member(s) | Evin Tay Geok Ling |
Connect with this contributor!
Joan Kirana Nurjono - joan.kirana.nurjono@skh.com.sg