Challenges and Solutions in Improving Immunization Rates
Historical struggles faced at Grand Ronde Health and Wellness Center in managing immunizations, including lack of standardization and community vaccine hesitancy. Introduction of the AFIX program and steps taken to increase immunization rates through recalls and pediatrician support.
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Presentation Transcript
Grand Ronde Health and Wellness Center: Immunization Rate Amanda Walker, CMA, Immunization Program Coordinator Jennifer Lott, CMA
Historical Immunization Program at Grand Ronde Health and Wellness Difficult to manage immunizations due to having to be charted in 3 different systems NextGen RPMS Oregon Alert Immunizations were not standardized amongst practitioners Although there were standing orders not all providers would give all immunizations per schedule Some providers would stop support staff from giving immunizations during walk-in visits because children were not up to date on well child check Lack of trust in safety of vaccines by community
Long Standing History of Low Immunization Rates
Long Standing History of Low Immunization Rates: Yamhill County
AFIX Program and Grand Ronde Health and Wellness Clinic AFIX (Assessment, Feedback, Incentives and eXchange) is a continuous quality improvement process informed by research and used for improving immunization rates and practices at the immunization provider level The AFIX components once understood and implemented by providers, can assist practices in meeting immunization coverage goals for a variety of standards, including but not limited to Healthy People 2020 and HEDIS (Healthcare Effectiveness Data and Information Set) measures Grand Ronde Health and Wellness Center started AFIX on March 8, 2018
Steps to increase immunization rates: RECALLS Letters were sent through Oregon Alert to active patients behind on immunizations Utilized NextGen to set up recall letters for patients due for a Well Child Check with their primary care provider
Steps to increase immunization rates: Pediatrician Team Welcomed Dr. Alison Empey to our team in August 2018 Dr. Empey provides care to our pediatric population on the 2ndand 4thMondays and Tuesdays every month Jennifer, CMA and Charlene, LPN are dedicated to our pediatric population Reaches out to patients the business day before their appointment to remind them of their appointment Reaches out to patients that no-shows to coordinate care with Dr. Empey or another provider or set up a visit for immunizations only Developed reporting tools to capture children not connected to care Dr. Empey has joined the health advisory committee for our Head Start Program Coordinated effort between medical clinic and Head Start Program to ensure children are immunized appropriately. Head Start will provide transportation to Medical Clinic if needed by parents to get immunizations Dr. Empey provides information to other providers and support staff on best practice surround childhood care and immunizations
Steps to increase immunization rates: Education Social Media Page Information is placed on the social media page about immunizations at key times such as school exclusion and the beginning of the school year to encourage families to bring in children for their immunizations Sport s Physical Event Incentives offered to students needing sport s physicals to come in for an event where all providers are seeing kids. Immunizations are given at Sport s Physicals Smoke Signal Educational Articles have been submitted to our tribal newspaper to increase education among the community. Community Events Immunization information is available at community events to provide education to community members.
Immunization Rates As of 10/1/19 Missed Opportunities[5]: 17% (decrease of 10% from 27%) Immunization Rates at 24 Months and Healthy People 2020 Goals 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 4:3:1:3:3:1: 4 29% 43% 76% 4 DTaP 3 Polio 1 MMR UTD Hib UTD HepB 1 Varicella UTD PCV 2/15/2018 10/15/2018 10/1/2019 33% 63% 83% 58% 80% 93% 67% 77% 93% 71% 83% 97% 71% 87% 97% 63% 60% 90% 54% 63% 90% [1] Active patients in ALERT IIS that were 24-35 months old as of the assessment date. [2] Vaccination status is as of this date. Immunizations administered after this date are not included in this assessment. [3] 4+ DTaP, 3+ Polio, 1+ MMR, 3+ Hib, 3+ HepB, 1+ Varicella, 1+ PCV [4] County rates are based on all residents according to their most recent address in ALERT IIS [5]Not all recommended vaccines were administered at a patient s most recent immunization visit
Immunization Rates As of 10/1/19 Immunization Rates at 13-17 Years and Healthy People 2020 Goals 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 1+ HPV 74% 77% 81% 65% UTD HPV 49% 53% 58% 44% 23% Tdap 95% 94% 92% 94% 5% Mening 87% 88% 90% 76% 8% 2/15/2019 10/15/2018 10/1/2019 County Missed Opps
