Aggressive Efforts Improve Protection

Sat., Sept. 30, 2000

Marie Rau Special To Handle Extra

Some people have asked why immunization rates for children immunized by Panhandle Health District have increased so dramatically in the past five years. Here’s a bit of history and an explanation:

In April of 1996, just 52 percent of the 2-year-old children who were immunized by Panhandle Health District in the five counties were up to date with their recommended immunizations. At that time, the staff at Panhandle Health District implemented an aggressive effort to improve the rate and increase the protection of the children who come to us for immunizations.

This aggressive effort consists of five major components. Our efforts began by routinely doing an assessment called CASA, Clinic Assessment Software Application. CASA is a tool developed by Centers for Disease Control (CDC) to be used to assess the immunization rates by individual clinics.

After assessing the rates, the software assists the staff to diagnose the reason for the rates and help staff to determine actions that would increase the rates. Consistently performing either quarterly or monthly CASAs and seriously responding to the suggested actions rates makes a difference.

A second component of Panhandle Health District efforts has been to recognize and avoid missed opportunities to immunize children. Missed opportunities are avoided by several means. Providing all of the immunizations for which a child is eligible at each visit is important.

The staff also is aware of, and avoids, invalid contraindications for receiving vaccine. A mild illness is an example of an invalid contraindication. Children who are in the office for a reason other than immunizations but are due for immunizations are encouraged to become up-to-date during that visit.

A third component of the effort has been to implement a reminder/recall system. This system provides for a reminder to parents shortly before their child is due for their next immunization(s) and a recall for children who are past the due date for their next immunization(s). Consistent and timely personal reminders help parents to remember in their otherwise busy lives.

A fourth effort is education. When children are at an appointment for immunization, the parents are complimented for their efforts and reminded that to keep their children safe they should start on time and stay on time. If at all possible, an appointment is made for the next immunization time. If an appointment is not possible, a card is included in their record, informing the parents of the next time an immunization is due.

The fifth effort offered to Panhandle Health Districts clients is to put the child who gets behind the recommended schedule on an accelerated schedule until they are current for their age. The accelerated schedule quickly and safely brings children up to date and reminds parents of the importance of timely vaccine.

Consistent use of the above five efforts has been effective in raising the immunization rates for Panhandle Health District. By April of 1997 the rates had increased from 52 percent to 66 percent, by April 1998 to 77 percent, by April 1999 to 84 percent, by April 2000 to 85 percent and by July 2000 to 87 percent.

A new opportunity, the Immunization Reminder Information System (IRIS) is being implemented in Idaho. This voluntary system will allow health care providers to access the immunization records of their enrolled clients.

No matter where immunizations are received in the state, one record will be established for each enrollee. The advantages of IRIS are that a complete, accurate record is available to the healthcare provider and to the patient.

This increases the accuracy of delivery of the next immunization as well as the accuracy of the assessment of completion of the immunization series.

This sidebar appeared with the story: THE EXPLAINER

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