During AAP district meetings over the summer, chapter and district leaders discussed how to build state and regional capacity to engage in quality improvement (QI) initiatives to improve HPV vaccination rates.
With funding from the Centers for Disease Control and Prevention, AAP districts hosted a training in QI methodology focused on building and enhancing the capacity of pediatricians and pediatric subspecialists to engage in improvement work in their practices and institutions. Districts also implemented a chapter-led QI project to improve HPV vaccination rates.
The districts are in varying stages of their QI training. Districts IV, VI, VII and X were trained in summer 2015 and are completing their project. Districts I, II, III, V, VIII and IX were trained in summer and fall 2016.
During the district meetings, chapters that completed their projects shared lessons learned and highlighted several unexpected opportunities that developed through their involvement in this program.
Chapters in Districts IV and VI conducted a survey to learn about successes, challenges and whether chapters planned to expand HPV QI work based on their experiences.
Provider education and participation ranked highest in the category of what worked well.
“The HPV project was a valuable tool to increase the QI abilities for all the chapters in the district since there was a wide variation of the knowledge and ability to provide QI for members,” said AAP District VI Chairperson Pamela K. Shaw, M.D., FAAP. “It was a wonderful way for the district to work together on a project, and the added value was that the partnerships between the chapters is growing and expanding.”
Chapters reported increased member participation and engagement as a result of involving multiple practices in a state effort to communicate a strong provider recommendation for HPV. Pediatricians are sharing tips to educate families, working to get more patients in for well visits, providing education on messaging and encouraging increased collaboration with office staff.
The Illinois Chapter worked with four pediatric residency programs, reaching more than 190 residents.
Partnerships with other organizations also have been formed. Chapters are reaching out to academic medical centers and are selecting regional champions to work in different areas of the state.
As part of its program, the Minnesota Chapter has developed a virtual learning collaborative of pediatricians in the state and surrounding areas.
The importance of developing a timeline was the main lesson learned from their work on the HPV QI project, according to survey respondents in Districts IV and VI. Knowing when items are due as well as ensuring that data are collected in a timely fashion were noted by both the Kansas and Wisconsin Chapters.
The South Carolina Chapter reported that it was a challenge to track whether patients received all three doses of HPV vaccine over the short time it had to complete the project. The Virginia Chapter indicated that office staff spent a lot of time on reminder and recall for HPV vaccination.
Despite the challenges they faced, nine of the 11 chapters that responded to the survey plan to expand their HPV QI project based on what they learned.
During district meetings, participants emphasized the role of pediatricians as leaders in immunization. Provider education coupled with utilization of QI methods led to higher HPV vaccination rates.
“Although there was a wide range of QI experience across our five chapters in District IV, the HPV QI project offered significant benefits to each,” said District IV Chairperson Jane M. Foy, M.D., FAAP. “Those with less QI experience learned from those with more. Those with strong QI initiatives already underway in their state had opportunities to strengthen the chapter's organizational capacity to support them. And all gave valuable feedback to the AAP. I think each wave of AAP-sponsored QI initiatives will benefit from the work that has gone before.”
