The National Advisory Committee on Immunization (NACI) recommends that healthcare workers (HCWs) be immunized against influenza because they can transmit this infection to individuals at high risk for related complications. Despite this recommendation, influenza immunization rates across healthcare organizations are suboptimal and inadequate to prevent the spread of disease.  Despite the strength of the evidence supporting a requirement for all healthcare personnel to receive annual influenza immunization, it remains voluntary in most settings in Canada.  In recognition of these overall low HCW immunization rates, the B.C. Leadership Council (composed of health authority CEOs and the Assistant Deputy Ministers from the Ministry of Health) agreed to introduce an influenza prevention policy, known as the B.C. Influenza Prevention Policy, which requires HCWs to either be immunized against influenza or to wear a mask when providing patient care during the influenza season.

The overall objective of this project is to examine the impact of the BC Influenza Prevention Policy on immunization rates among HCW.  Specific study objectives include:

1. Study 1 (S1) uses a qualitative case study approach to identify key factors associated with the policy implementation based on the insights of seven leadership implementation teams and senior leaders. Planned data sources for S1 include documents and people.  Data collection will be done using key informant interviews and focus groups. This study will be conducted between September 2013 and March 2014.
2. Study 2 (S2) uses a quantitative cross-sectional survey design to examine the implementation and enforcement of the policy at the facility level. The survey will be administered in March, 2014.