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Improving pediatric practice immunization rates through distance-based quality improvement: a feasibility trial from
Eric J Slora1, Jennifer M Steffes, Donna Harris
1Pediatric Research in Office Settings, American Academy of Pediatrics, Elk Grove Village, IL 60007, USA. eslora@aap.org
Clinical Pediatrics
|August 19, 2007
Summary
A distance-based quality improvement model is feasible for pediatric practices, potentially enhancing immunization rates. This approach may also improve practitioner systems for tracking childhood immunizations.
Area of Science:
- Pediatric Healthcare Quality Improvement
- Public Health Interventions
- Evidence-Based Practice in Pediatrics
Background:
- Pediatric Research in Office Settings (PROS) practices face challenges in maintaining optimal immunization rates.
- Existing quality improvement (QI) models may have limitations in reach and engagement for office-based practices.
Purpose of the Study:
- To assess the feasibility and effectiveness of a distance-based QI model in improving pediatric immunization rates.
- To evaluate changes in practitioner behaviors and attitudes towards immunization delivery.
- To compare a distance-based QI intervention with a traditional paper-based education approach.
Main Methods:
- A randomized controlled trial involving 29 Pediatric Research in Office Settings (PROS) practices with baseline immunization rates ≤88% for 8-15 month olds.
- Intervention groups included a year-long distance-based QI program (conference calls, Listserv, website) and a paper-based education group.
- Outcomes measured included the utility of QI modalities, changes in immunization rates, and shifts in practitioner behavior and attitudes.
Main Results:
- The distance-based QI group showed a 4.9% increase in immunization rates (P=.061), compared to a 0.8% increase in the education group.
- A statistically non-significant 4.1% difference in immunization rate increase was observed between the QI and education groups (P=.261).
- Practices in the QI group were more likely to adopt systems for identifying children with overdue immunizations.
Conclusions:
- A distance-based quality improvement model is a feasible approach for pediatric practices.
- This model shows potential for improving childhood immunization rates and enhancing practice systems for immunization management.
- Further research may be warranted to optimize engagement with distance-based QI tools like Listservs and websites.
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