title: Improving immunization rates in private pediatric practices through physician leadership.
abstract: OBJECTIVE
  To determine whether a physician-led quality improvement initiative can improve immunization rates in participating private practices.
  
  
  METHODS
  Surveys of private pediatric practices at 6-month intervals over an 18-month period.
  
  
  METHODS
  Ten private pediatric practices in Norfolk and Virginia Beach, Va.
  
  
  METHODS
  Children aged 9 to 30 months attending the private practices.
  
  
  METHODS
  Practice immunization rates were assessed and presented to practices on 4 occasions at 6-month intervals. A physician leader convened an immunization task force meeting following the first 3 assessments to review practice guidelines, examine data, and discuss practice changes.
  
  
  METHODS
  Practice immunization rates for patients at age 24 months, with 3- and 12-month immunization rates as secondary outcomes.
  
  
  RESULTS
  The mean practice immunization rate at age 24 months increased significantly (P<.05) from 50.9% at baseline to 69.7%. Rates also increased at age 3 months, from 75.5% to 88.9%, and at age 12 months, from 72.9% to 84.6%. The median age at administration of the fourth dose of diphtheria toxoid, tetanus toxoid, and pertussis vaccine decreased (P<.05) from 17.6 to 16.8 months. Physicians also reported making additional changes, including improved record keeping and screening for immunizations at every visit.
  
  
  CONCLUSIONS
  A quality improvement initiative enabling physician leadership can improve preschool immunization practices and coverage levels in pediatric practices.
authors.affiliation: Department of Psychology, Winthrop University, Rock Hill, SC, USA.
authors.forename: J S
authors.initials: JS
authors.lastname: Sinn
authors.forename: A L
authors.initials: AL
authors.lastname: Morrow
authors.forename: A B
authors.initials: AB
authors.lastname: Finch
mesh_terms: D000704:Analysis of Variance; D002675:Child, Preschool; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data; D017589:Immunization Programs / Q000592:standards / Q000706:statistics & numerical data*; D007115:Immunization Schedule; D007223:Infant; D007857:Leadership; D010372:Pediatrics; D010819:Physician's Role; D017410:Practice Guidelines as Topic; D011331:Private Practice; D017749:Total Quality Management; D014768:Virginia