Related Experiment Video
Updated: Jul 13, 2026
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
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
Insights
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.
Abstract:
The feasibility and effectiveness of a distance-based quality improvement model were examined in a cohort of Pediatric Research in Office Settings (PROS) practices, with the goal of improving immunization rates and practitioner behaviors and attitudes. Of an initially assessed 82 practices, 29 with baseline rates of < or =88% for children 8 to 15 months of age were randomized into year-long paper-based education or distance-based quality improvement intervention groups. Outcomes were utility/helpfulness of quality improvement modalities, immunization rate change, and behavior/attitude change. Quality improvement participants attended approximately 75% of monthly conference calls but used the quality improvement Listserv and Web site infrequently (mean 1.09 and 0.92 uses, respectively). Helpfulness ratings of quality improvement modalities mirrored usage. Analyses revealed a 4.9% increase in quality improvement group immunization rates (P = .061), a 0.8% education group increase (P = .752), and a 4.1% difference between groups (P = .261). More quality improvement practices adopted systems identifying children behind in immunizations. A distance-based quality improvement model is feasible and may improve immunization rates.
Related Concept Videos
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:51Vaccinations
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...