37th National Immunization Conference March 18, 2003 Chicago, Illinois Quality Improvement in Immunization Registries from a Satisfaction Survey 37th National Immunization Conference March 18, 2003 Chicago, Illinois

Authors Partners in Health Systems Maureen K. Murphy MPA Katie Reed MPA Susan Maute BA Sheila A. Allard BS Amanda Wilson BA Laurie Kenyon MS

Partners In Health Systems Company contracted to manage, maintain and support regional registries across much of Upstate New York since 1995. Registry Application, “HealthyShot” Currently installed in 36+ counties. Now working as a statewide registry.

Where Healthy Shot is Used NIAGARA MONROE SUFFOLK NASSAU ROCKLAND NEW YORK CITY CHAUTAUQUA CATTARAUGUS ALLEGANY WYOMING GENESEE ORLEANS LIVINGSTON WAYNE ONTARIO YATES SCHUYLER STEUBEN CHEMUNG SENECA TOMPKINS BROOME CORTLAND CAYUGA ONONDAGA OSWEGO LEWIS MADISON CHENANGO OTSEGO DELAWARE HERKIMER FULTON MONTGOMERY SCHOHARIE GREENE COLUMBIA ALBANY RENSSELAER SARATOGA WASHINGTON WARREN HAMILTON SULLIVAN ULSTER DUTCHESS JEFFERSON STLAWRENCE FRANKLIN CLINTON ESSEX ORANGE PUTNAM ONEIDA ERIE TIOGA WESTCHESTER SCHENECTADY Original CNYIR region Statewide Deployment using CNYIR model Potential HealthyShot counties

HealthyShot Non-Mandated, written consent driven registry Model started with the CNY region in 1995. Year 2000, HealthyShot started in FLAIR. Year 2002, HealthyShot deployed throughout Western NY. Year 2002, HealthyShot began deployment Downstate. Currently deployed in nearly 75% of the counties across NYS.

It all began with…. NIC Conference in Denver, the altitude had a strange effect on my better judgement….. It brought to my attention the need to have measurable rates of satisfaction. With that, develop mechanisms to monitor satisfaction, thus providing opportunities to identify needs and applaud successes.

The Survey Was designed as a collaborative effort between PHS, CNY and FLAIR with significant contribution from colleagues at the University of Rochester The sample of 140 consisted of all registry participants The survey was administered by mail, June 2002 Return rate was 69, or 45%

What We Were Assessing We recognized that the greatest value would be an evaluation from soup to nuts of the entire project . This means... Recruitment Software Support And everything else in-between!

Routinely used? “Regular” was defined by user Vast majority using on a regular basis The rate of sending data may speak to maturity of site The rate of sending data may indicate technical issues Use is also linked to staffing

Who enters data? This speaks directly to involving the entire staff in the recruitment and implementation process “Other” was not defined. This will be crucial to define in future endeavors.

With these Results… New Questions What is the definition of “routinely used”? In the recruitment process, are we meeting with all the right personnel? In the training process are we training all those who should be?

Gaining consents? There is some question as to the truth of the responses Our consent and saturation rates should be nearing 95% if this is accurate

Who gains consent? The theme of involving the receptionist and other office staff continues to be illustrated

...And More Questions...

…Hmmmmmmmm If consent is being gained nearly ALWAYS shouldn’t the number of children be growing more significantly ? Hey wait, is the right person answering the survey? What age is being targeted for consent? Have we targeted the proper staff to train in gaining consent?

Overall satisfaction with support The results speak for themselves

Satisfaction with recruitment Encouraging response Should explore how to move from “Good” to “Great”

...And Even More Questions...

….I wonder………. The rates are great but, how can we improve? Where poor or very poor were answered, get to the root. (It was discovered that the survey had landed in the wrong hands).

The Big Discovery It became clear that an unintentional finding was going to have significant bearing…. By making participants comfortable with the process and involving them from the beginning, will give them Ownership.

What Good are Findings Unless You’re Going to do Something With Them?! ….And Then What Good are Findings Unless You’re Going to do Something With Them?!

Tools Created to Enhance Process Implementation Workbook Highlights Registry Champion Who, What Where, When and How Concise description of what to expect from recruitment up to and beyond installation Drawbacks Agreement to participate doesn’t always occur at meeting Workbook is best utilized when an introduction is provided

More Tools Leave Behind Piece In Process: Post installation evaluation One bulleted page to provide staff with an introduction to the Registry. In Process: Post installation evaluation Designed to capture needs and strengths at the earliest time. Thus enabling us to get the participants on track and ensuring they stay there! Consent FAQ’s Sheet A bulleted list of FAQ’s to provide everyone in the office the means for capturing consents .

What do we do now? Use the survey periodically to re-assess the satisfaction of user community. Take our cues from the results. Evaluate the newer tools to be sure they are meeting their intended need. Recognize this is an on-going process. Recognize this is a Quality Assurance measure. Recognize we have a commitment to the User Community to be the best we can be!!

Contact Information Maureen K. Murphy Project Coordinator, FLAIR Partners in Health Systems 5703 Enterprise Parkway Dewitt, NY 13214 585-292-4024 mmurphy@phs-us.com