Improving pediatric immunization rates: description of a resident-led clinical continuous quality improvement project

Fam Med. 2014 Sep;46(8):631-5.

Abstract

Background and objectives: Increased emphasis is being placed on the continuous quality improvement (CQI) education of residents of all specialties. This article describes a resident-led continuous quality improvement (CQI) project, based on a novel curriculum, to improve the immunization rates of children under 2 years old at the Madsen Family Health Center (MHC).

Methods: All third-year residents were trained in the FOCUS-PDSA CQI methodology through concurrent didactic lectures and experience leading the CQI team. The CQI team included clinical staff led by a third-year family medicine resident and mentored by a member of the family medicine faculty. Immunization records were distributed to provider-medical assistant teamlets daily for each pediatric patient scheduled in clinic as the intervention. Compliance with the intervention (process measure), as well as immunization rates at 2 and 5 months post-intervention (outcome measure), were monitored.

Results: Immunization records were printed on 84% of clinic days from October 24, 2011 to March 31, 2012. The percentage of patients immunized at baseline was 66%. The percentage immunized as of December 31, 2011 was 96% and was 91% as of March 31, 2012.

Conclusions: An important educational experience was organized for third-year family medicine residents through learning CQI skills, leading a CQI team, and directing a CQI project to completion. Significant improvement in the percentage of patients under 2 years old immunized at the MHC was achieved by presenting provider-medical assistant teamlets with immunization records of all pediatric patients on the daily clinic schedule.

MeSH terms

  • Chickenpox Vaccine / therapeutic use
  • Diphtheria-Tetanus-acellular Pertussis Vaccines / therapeutic use
  • Family Practice / education*
  • Family Practice / methods
  • Female
  • Haemophilus Vaccines / therapeutic use
  • Hepatitis B Vaccines / therapeutic use
  • Humans
  • Immunization Programs / methods*
  • Infant
  • Infant, Newborn
  • Internship and Residency*
  • Male
  • Measles-Mumps-Rubella Vaccine / therapeutic use
  • Poliovirus Vaccines / therapeutic use
  • Quality Improvement

Substances

  • Chickenpox Vaccine
  • Diphtheria-Tetanus-acellular Pertussis Vaccines
  • Haemophilus Vaccines
  • Hepatitis B Vaccines
  • Measles-Mumps-Rubella Vaccine
  • Poliovirus Vaccines