1. Childhood Immunization Rates
Increasing
Childhood Immunization Rates
A Successful Partnership with the WI Department of Health and Family Services
Sue Scholz, Childhood Immunization Initiative Coordinator
Scott McCarten, System Specialist

2. A not-for-profit integrated health care system
Serving 75 communities in 20 counties of Eastern Wisconsin
Consists of:
14 Hospitals
120 Clinics
136 Community Pharmacies

3. National Immunization Survey: Estimated vaccination coverage with the 4:3:1:3* series among children aged months by state: 7/97-6/98
Wisconsin 77%
% of children covered
States
*4 DTP, 3 Polio, 1 MMR, 3 Hib

4. Comparative Data for 2000 State of Wisconsin 77.6%
Milwaukee County %
Aurora baseline results 58.0%

5. Primary Intervention: Use of Automated Registry
Research findings: Public health departments that use an automated registry have demonstrated improved immunization rates.
Conclusion: Use of the DHFS Wisconsin Immunization Registry will allow us to:
track immunization histories
identify children in need of immunizations
track vaccine inventory
generate reminder notices.

6. Wisconsin Immunization Registry
Developed by the DHFS
16,000 users
4.2 million clients
28 million immunizations
1100 providers
2750 schools
5,500 immunizations entered per day via PC
7,000 entered per day via interface

7. Aurora’s Action Steps Gained approval from Quality Council
Set initiative goal
Trained selected staff and piloted WIR in one region in early 2002
Established goals and measurement for organization-wide implementation
Roll-out, organization-wide, in 2003

8. Aurora Health Care’s Childhood Immunization Initiative
Align with Healthy People 2010 goal of 90% immunization rate (primary series) in children up to 24 months of age
Incremental goals established each year
Current goal: 80% immunization rate in children up to 24 months (4:3:1:3:3:1)

9. Strong Working Partnership with DHFS to Support Initiative
Clinic visits by state reps
WIR Help Desk consistently available
State training sessions made available to Aurora staff
Regular updates, presentations to initiative team by WIR Manager

10. Organization-Wide Process Changes to Support Initiative
Vaccine for Children Program made available to every clinic
Training of clinic staff by DHFS
Backup support from IS staff
Interface download of birth dose Hep B into WIR
Pre-visit printouts of WIR immunization histories

11. Organization-Wide Process Changes to Support Initiative (cont’d)
WIR Administrator Infrastructure at clinic, regional, and organizational levels
Clinic specific reports
Ongoing communication through site visits, persistent clinic contact, organization-wide e-newsletters, intranet, WIR WIRe

12. Aurora’s Results to Date

13. Challenges, Barriers Employee ‘buy-in’ Physician ‘buy-in’
Use of inventory function; paper to electronic
Time to ‘clean-up’ reports
Multiple documentation; Cerner and WIR
Physician ‘buy-in’
Gaining trust in the WIR schedule and recommendations

14. Lessons Learned
Aurora’s results further support the use of an automated registry
Partnership with DHFS was integral to success of entire project
Smaller pilot project allowed us to “work out kinks” and learn valuable lessons for organization-wide implementation
Still many opportunities for improvement

15. Opportunities for Future Improvements
Interventions to increase rates in inner
city populations
WIR to Cerner interface
Expand to hospitals, EDs
Expand the initiative to
adolescents and adults

16. Aurora Regional Results

17. Opportunities for Future Improvements
Interventions to increase rates in inner
city populations
WIR to Cerner interface
Expand to hospitals, EDs
Expand the initiative to
adolescents and adults