Status of quality improvement activities to improve immunization practices and delivery: findings from the immunization quality improvement symposium, October 2003.
The Centers for Disease Control and Prevention convened a symposium on 22-23 October 2003 to bring together investigators and stakeholders working to apply the quality improvement (QI) approaches to immunization delivery in individual medical practices. The goal was to identify effective program components and further development of model programs. A call for projects was widely disseminated; of 61 submissions received, eight projects were selected. Three of the eight programs used the "train the trainer" approach, three used site-specific training, one used a "practice collaborative" approach, and one employed the use of tracking and outreach workers to effect change. At the symposium, invited experts reviewed each program. Common program features that appeared effective included involvement of a variety of staff within the office environment, collection and review of site-specific performance measurements to identify gaps in delivery, periodic monitoring of performance measurement to revise interventions and maintain the improvements, and provision of formal continuing education credits. While research is needed on ways to promote and integrate QI into practices, it is likely that a variety of QI strategies will be shown to be effective, depending on the clinical settings. The field will benefit from standardized outcome measures, cost analysis, and evaluation, so comparisons can be made among different programs.
Shefer
Abigail
A
Health Services Research & Evaluation Branch, National Immunization Program, Centers for Disease Control and Prevention, US Department of Health and Human Services, Atlanta, Georgia, USA. ams7@cdc.gov
Santoli
Jeanne
J
Wortley
Pascale
P
Evans
Vickie
V
Fasano
Nancy
N
Kohrt
Alan
A
Fontanesi
John
J
Szilagyi
Peter
P
D002487:Centers for Disease Control and Prevention, U.S.; D003226:Congresses as Topic; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration*; D011216:Practice Management, Medical; D015397:Program Evaluation; D017749:Total Quality Management; D014481:United States