Transcript Immunizations and Quality Improvement Quality Improvement  Quality Improvement (QI)  A method for analyzing a particular clinical practice, implementing change in that practice and.

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
 Looks at where something is in the present and aims
to help in improving it in the future
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 improvementResidents are expected to
participate in a quality
improvement project.”
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
Quality Improvement
• The stakeholders in Pediatric QI include:
– Patients and their parents (or families)
– Health care providers
– Office staff
– Parent’s employers
– Payors
Quality Improvement
• Getting started
– Select a small problem and measure where
the practice or service stands
– Narrow the focus
– Track and study the focus looking for target
areas to improve
QI Project
Immunization Rates
• QI projects focused on improving
immunization rates can target
– Particular vaccine (eg, influenza)
– Target population (eg, 2-24 month olds)
– Entire population served
QI Project
Immunization Rates
• An example of how to do QI for
immunization rates comes from TIDE –
Teaching Immunization Delivery and
Evaluation
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
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/ti
de/moduleb/ier/ier.pdf
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”
Office Immunization
Practices Questionnaire
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
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