Improving Pediatric Immunization Rates In Children Under the Age of 3 in Two University Community Clinics Chad Alan Spain, MD Kyle Bradford Jones, MD University of Utah Department of Family and Preventive Medicine Introduction Methods Results Discussion OBJECTIVE Achieve the Healthy People 2020 goal of 90% immunization rate for each vaccine and 80% combined immunization rates in children under 3 years of age by: Decreasing missed opportunities Providing outreach to patients not in clinic DESIGN A continuous quality improvement (CQI) project using Plan-Do-Study-Act (PDSA), team-based methodology INCLUSION Patients 0-35 months of age seen within the last 12 months at Madsen or Sugarhouse clinics CLINICAL PROCESS Immunization records were printed daily for scheduled pediatric patients from the Utah Statewide Immunization Information System (USIIS) and distributed to providers *While already occurring at MHC, this process was new to SHC Clinic wide immunization reports were generated for patient outreach intervention INTERVENTION A letter was sent to each newly identified deficient patient informing of overdue immunization After 6 weeks, a phone call was made to each deficient patient who had not yet come in for immunization MHC After filtering for those who were truly deficient and were still a member of clinic 40 patients received a letter 21 of these patients eventually needed and received a phone call SHC After filtering for those who were truly deficient and were still a member of clinic 55 patients received a letter 33 of these patients eventually needed and received a phone call BACKGROUND Goal of Healthy People 2020 is to obtain 90% immunization rate for each vaccine and 80% combined immunization rates in children under 3 years of age (4:3:1:3:3:1 [4DTaP, 3Polio, 1MMR, 3HIB, 3HepB, 1Var] series) Nationally 44% of children aged 19 to 35 months in 2009 received the recommended doses of DTaP, polio, MMR, Hib, Hepatitis B, Varicella, and PCV Each annual birth cohort vaccinated with the routine immunization schedule will ultimately: Save 33,000 lives Prevent 14 million cases of disease Reduce direct health care costs by $9.9 billion Save $33.4 billion in indirect costs Madsen Family Health Center (MHC) immunized only 66% (n=188) of children under 3 years old as of November 2012 (4:3:1:3:3:1:3 series, this includes PCV ) Sugarhouse Family Health Center (SHC) immunized only 58% (n=319) of children under 3 years old as of November 2012 In 2011-2012 a CQI project at MHC improved immunization rates in children under 2 years from 66% to 92% (n=91) via printing and distribution of daily immunization records of all children scheduled that day Printing of daily immunization records with distribution to providers provides a sustainable method to improve immunization rates without alteration of work flow Intervention allowed identification and targeting of deficient patients. Our intervention contributed to 20+% increased in combined immunization rates in both clinics LIMITATIONS Identification of patients who were no longer associated with the clinic came only after phone calls were made, potentially altering our overall ‘n’ USIIS is not currently integrated with our EMR. If immunizations were performed outside our clinics or were not entered into the database our data could be inappropriately low Sustainability of outreach intervention would require additional staff hours Significant improvement of pediatric immunization rates was accomplished with printing of daily immunization records for scheduled patients and intervention involving outreach to deficient patients Presentation of this study was supported (in part) by the Dr. George D. Gross and Dr. Esther S. Gross Educational Endowment Fund in Family Medicine, Department of Family & Preventive Medicine, Division of Family Medicine, University of Utah. MHC and SHC CQI Team: Jen Aoki (MA), Kay Haley (RN), Crystal Jones (MA), Luis, Linan (MA), Perlita Mendoza (MA), Mathew Percy (MD PGY-2) Advisor: Susan Pohl MD Printing of Conclusions Conclusions Acknowledgements Acknowledgements Dr. George D. Gross and Dr. Esther S. Gross Endowment Fund in Family Medicine, Department of Family and Preventive Medicine, Division of Family Medicine, University of Utah.