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Developing immunization quality improvement in your practice

Marlene M. Lugg, DrPH, Panorama CIty Medical Center, Southern California Kaiser Permanente, 13652 Cantara Street, South 1 Bldg, Panorama City, CA 91402, (818) 375-3078, marlene.m.lugg@kp.org

Quality improvement in immunization programs is important regardless of the numbers of providers and numbers of patients seen. However, in large practices and multi-site practices, small problems may be compounded and more difficult to locate, assess, and solve.

The Kaiser Permanente Immunization Tracking System (KITS) management team began working on quality issues as the system was being implemented in the 11 Southern California Medical Center Areas, which serve over 3 million members. However, the methods tested here will apply equally to small practices.

Data quality measures now in place include routine automated data analysis and special analysis carried out by immunization coordinators at medical center and office practice levels.

Routine monthly or quarterly issues include: (1) immunizations given in the arm to infants under 1 year old, (2) expired lot numbers, (3) lot numbers whose “masks” do not match appropriate manufacturers, (4) duplicate immunizations recorded for the same date, (5) wrong agent abbreviations, (6) children with more than the recommended number of immunizations [i.e., 4 MMR’s, etc.], (7) persons not up-to-date for age, (8) possible duplication of members, (9) immunizations given but not entered into the tracking systems, and (10) correlation and "cross-checking with other systems, such as data being used for the Vaccine Safety Datalink Study.

Some of these data reports require further investigation locally, using patient or provider records. Working with providers and other personnel involved has improved data quality greatly.

Results: Immunization quality improved over 200% as a result of these interventions.

Learning Objectives:

Keywords: Immunizations, Quality Improvement

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Kaiser Permanente of Southern California
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Infant and Child Health Poster Session

The 132nd Annual Meeting (November 6-10, 2004) of APHA