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Using routinely collected data to improve immunisation histories.

¹Royal Cornwall Hospital.

BMJ Quality Improvement Reports

|January 7, 2016

Summary

Identifying under-immunised children is crucial for public health. A new system significantly improved the detection of children missing vaccinations, enhancing both individual and herd immunity against vaccine-preventable diseases.

Area of Science:

Pediatrics
Public Health
Immunology

Background:

Vaccine-preventable diseases continue to cause outbreaks in developed countries despite high community immunisation rates.
A significant number of paediatric inpatients are under-immunised, with their status often unidentified.
Under-immunisation in this vulnerable group poses a risk to individual health and community herd immunity.

Purpose of the Study:

To assess the effectiveness of a new system for identifying under-immunised paediatric inpatients.
To improve the routine identification of children missing vaccinations.
To enhance strategies for achieving adequate herd immunity.

Main Methods:

Two audits were conducted on consecutive paediatric admissions to a rural assessment unit.

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The first audit compared documented vaccination histories with the regional Child Health Information System (CHIS).

The second audit, after implementing a new system for accessing CHIS data, re-evaluated identification rates of under-immunised children.

Main Results:

Initially, 15% of paediatric admissions were not up-to-date with immunisations, with only 17% of these identified during routine clerking.
Following the new system's implementation, 14.5% of admissions were still under-immunised, but the identification rate increased to 52%.
This represents a 35% improvement in correctly identifying under-immunised children.

Conclusions:

Accessing routinely collected data, such as from the Child Health Information System (CHIS), significantly improves the identification of under-immunised children.
Improved identification can contribute to higher individual and herd immunity levels.
Targeted interventions can be more effectively implemented for under-immunised paediatric populations.