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QI project helps practices increase immunization rates

June 1, 2022
from the AAP Department of Chapter, District and Member Engagement

Two chapters participating in a quality improvement (QI) project were able to increase immunization rates despite COVID-19 challenges and staffing shortages.

The Florida and Texas chapters recruited 35 physicians in 14 practices to participate in the Improving Childhood Immunization Rates Project, a collaborative supported by the AAP Chapter Quality Network. The collaborative gave the practice teams the opportunity to showcase strategies and interventions used to make improvements, share ideas for tests of change and discuss common barriers.

From December 2020 to December 2021, practices saw steady improvement across all project measures, including:

  • the percent of patients up to date on four doses of diphtheria, tetanus and acellular pertussis vaccine; three doses of inactivated poliovirus vaccine; one dose of measles, mumps and rubella vaccine; three doses of Haemophilus influenzae type B vaccine; three doses of hepatitis B vaccine; one dose of varicella-zoster virus vaccine; and four doses of pneumococcal conjugate vaccine.
  • the percent of patients up to date on the individual vaccines listed above; and
  • the number of missed opportunities to administer eligible vaccines when patients were seen for an office visit.

El Paso Pediatrics in Texas implemented a strategy to educate families and reduce missed opportunities for vaccination. The practice team created a QR code that linked to the childhood immunization schedule, and cards with the code were posted in each exam room. Families could scan the code while waiting for the pediatrician, giving them time to prepare for immunization conversations. Additionally, the QR code drove traffic to the practice website, where families could access the immunization schedule and practice resources.

El Paso Pediatrics practice manager Roger Hovis said collaborating with other participants helped drive change in the practice.

“We were supported with genuinely new ideas, and the monthly practice meetings allowed the individual practices to brainstorm and collectively support each other,” he said.

Brandon Chatani, M.D., FAAP, who was on the Florida Chapter’s leadership team, commended practice teams for their perseverance and dedication.

“I met pediatricians and medical personnel that not only were dedicated to the health of children but also driven to optimize their immunization practices,” Dr. Chatani said.

In one of the project surveys, 75% of participants indicated that they were confident they can use QI methods to improve immunization-related care.

“This confidence came from small trials of change and learning from across the collaborative how the process works,” Dr. Chatani said. “I cannot wait to see how all our involved pediatricians take this newfound confidence and apply it to their immunization practices and beyond.”

The practices’ knowledge and confidence are reflected in the final project run charts. Practices collected patient visit data for 12 cycles, and the aggregate data show the collaborative saw improvement on all project measures.

Notably, participating practices achieved significant improvement in the percent of their total patient population that was up to date on all vaccines. The rate increased from 77.8% at baseline to 86.6% at the close of the project.

“I think the more that practices are aware of the success and ease of such projects are with the support of the chapter and national organization, they can put aside the concern of overcommitting and rather enjoy the success and satisfaction of the project,” Dr. Chatani said.

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