title: Vaccination management and vaccination errors: a representative online-survey among primary care physicians.
abstract: BACKGROUND
  Effective immunizations require a thorough, multi-step process, yet few studies comprehensively addressed issues around vaccination management.
  
  
  OBJECTIVE
  To assess variations in vaccination management and vaccination errors in primary care.
  
  
  METHODS
  A cross sectional, web-based questionnaire survey was performed among 1157 primary physicians from North Rhine-Westphalia, Germany: a representative 10% random sample of general practitioners (n = 946) and all teaching physicians from the University Duisburg-Essen (n = 211). Four quality aspects with three items each were included: patient-related quality (patient information, patient consent, strategies to increase immunization rates), vaccine-related quality (practice vaccine spectrum, vaccine pre-selection, vaccination documentation), personnel-related quality (recommendation of vaccinations, vaccine application, personnel qualification) and storage-related quality (storage device, temperature log, vaccine storage control). For each of the four quality aspects, "good quality" was reached if all three criteria per quality aspect were fulfilled. Good vaccination management was defined as fulfilling all twelve items. Additionally, physicians' experiences with errors and nearby-errors in vaccination management were obtained.
  
  
  RESULTS
  More than 20% of the physicians participated in the survey. Good vaccination management was reached by 19% of the practices. Patient-related quality was good in 69% of the practices, vaccine-related quality in 73%, personnel-related quality in 59% and storage-related quality in 41% of the practices. No predictors for error reporting and good vaccination management were identified.
  
  
  CONCLUSIONS
  We identified good results for vaccine- and patient-related quality but need to improve issues that revolve around vaccine storage.
authors.affiliation: Institute for General Medicine, Essen University Hospital, University of Duisburg-Essen, Essen, Germany.
authors.forename: Birgitta M
authors.initials: BM
authors.lastname: Weltermann
authors.affiliation: Institute for General Medicine, Essen University Hospital, University of Duisburg-Essen, Essen, Germany.
authors.forename: Marta
authors.initials: M
authors.lastname: Markic
authors.affiliation: Institute for General Medicine, Essen University Hospital, University of Duisburg-Essen, Essen, Germany.
authors.forename: Anika
authors.initials: A
authors.lastname: Thielmann
authors.affiliation: Institute for General Medicine, Essen University Hospital, University of Duisburg-Essen, Essen, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Gesenhues
authors.affiliation: Institute for General Medicine, Essen University Hospital, University of Duisburg-Essen, Essen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Hermann
mesh_terms: D003430:Cross-Sectional Studies; D005858:Germany; D006801:Humans; D058007:Physicians, Primary Care; D011216:Practice Management, Medical; D011786:Quality Control; D011795:Surveys and Questionnaires; D014611:Vaccination