Improvement Insight: Immunization Completion
The Improvement Insight series highlights quality improvement projects within Southcentral Foundation’s Nuka System of Care. Each blog offers a detailed look at how SCF’s customer and community owned approach, data-driven strategies, and collaborative teams work together to initiate innovative solutions for current challenges.
Like many health care systems, Southcentral Foundation noted a decrease in health care visits and immunization rates especially with childhood immunizations during and after the pandemic. To address the decrease in childhood immunization rates, SCF’s improvement team, and medical and operational leaders convened and began reviewing data on childhood vaccinations. They found that while the initiation rates were high for all the immunizations that create Pediatric Immunization Combo3, completion of the series for vaccines requiring four doses like PCV and Dtap were low. This, along with additional customer-owner and community input, helped determine that vaccine hesitancy was not the primary issue.
Sharing this knowledge helped focus the workgroup’s attention on helping support primary care teams and customer-owners to complete vaccines that require multiple doses. The workgroup found that the best way to approach this was to look at the big picture of the entire vaccination landscape and focus on how to make improvements. Some of the actions SCF has taken in this area that have worked include:
- Creating immunization best practices, roles, and responsibilities by discipline.
- Investing time in training employees, and answering questions/addressing concerns that come up.
- Implementing quarterly reporting to SCF’s Primary Care Core Business Group and Medical Director meeting.
- Improving data visualizations that help teams better understand what is going on with a customer-owner and their panel; this is especially helpful for vaccines with multiple doses.
- Creating a letter for parents of newborns (this was initially focused on immunizations, but became a comprehensive message introducing and welcoming them to our system, and detailing resources available to them).
- Adding posters/signage on SCF’s campus about immunizations.
Immunizations are a team effort for SCF’s Integrated Care Teams. Primary care providers answer questions from families and offer strong recommendations. Registered Nurse Case Managers support immunization and well child tracking through Cerner reminders and placing reminders after the first dose. And CMAs scrub the schedules daily looking for immunization opportunities.
The work on this project is still ongoing, and SCF is tracking childhood vaccination data to see progress on this metric and make improvements in real time. If you would like more information on SCF’s work on childhood vaccinations, or any other aspect of SCF’s Nuka System of Care, feel free to contact the SCF Learning Institute.
