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Immunizations and Quality Improvement

Immunizations and Quality Improvement. Quality Improvement. Quality Improvement (QI) A method for analyzing a particular clinical practice, implementing change in that practice and assessing the effects of changes QI is prospective and retrospective in its approach

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Immunizations and Quality Improvement

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  1. Immunizations and Quality Improvement

  2. Quality Improvement • Quality Improvement (QI) • A method for analyzing a particular clinical practice, implementing change in that practice and assessing the effects of changes • QI is prospective and retrospective in its approach • Looks at where something is in the present and aims to help in improving it in the future

  3. Quality Improvement ACGME Program Requirement on Practice Based Learning and Improvement states, “systematically analyze practice using quality improvement methods, and implement changes with the goal of practice improvement- Residents are expected to participate in a quality improvement project.”

  4. Quality Improvement • Quality can be defined in multiple ways • Consistent value or safety of a product, service, job, benefit, etc • In reference to immunizations, it could be the “quality” of the actual immunization, its delivery, or the number of patients in a practice immunized

  5. Quality Improvement • The stakeholders in Pediatric QI include: • Patients and their parents (or families) • Health care providers • Office staff • Parent’s employers • Payors

  6. Quality Improvement • Getting started • Select a small problem and measurewhere the practice or service stands • Narrow the focus • Track and study the focus looking for target areas to improve

  7. QI ProjectImmunization Rates • QI projects focused on improving immunization rates can target • Particular vaccine (eg, influenza) • Target population (eg, 2-24 month olds) • Entire population served

  8. QI ProjectImmunization Rates • An example of how to do QI for immunization rates comes from TIDE – Teaching Immunization Delivery and Evaluation

  9. Designing QI – Step 1 • Assess Immunization Rates (“Plan”) • Assessment methods: • Chart method • Active method • Consecutive method • Record the assessment data collected • There is a sample to download

  10. This is an example of an Individual Encounter Record, which can be used to record vaccination data for each patient. You can find this form at the following site:www2.edserv.musc.edu/tide/moduleb/ier/ier.pdf

  11. Designing QI – Step 2 • Implement Change (“Do”) • Describe and analyze key office routines related to immunizations using an office immunization practices questionnaire • There is a sample to download • Based on findings… • Select an intervention likely to improve immunization rates • Focus on the “vital few” interventions (or even one)rather than the “useful many”

  12. Office Immunization Practices Questionnaire

  13. Designing QI – Step 3 • Assess the Effects of Change (“Study”) • Assess the immunization rates again (after a set period of time) • Continue to improve your effort after noting barriers / set-backs • Celebrate successes • Continue to re-measure at periodic intervals

  14. Designing QI – Key Points • It is important that the key players buy into the project – incentives help! • More detailed information and forms such as the Standardized Encounter Form and the Immunization Practices Questionnaire can be found on Modules A, B, and C of the TIDE (Teaching Immunization Delivery and Evaluation) website • http://www2.edserv.musc.edu/tide/reg/main.las

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