Business strategy used to increase immunization rates in children

SAN FRANCISCO -- A strategy stemming from the business world can be used to increase rates of influenza immunizations in children in the hospital setting, according to a new study led by a physician at Cincinnati Children's Hospital Medical Center.

The study, which is particularly timely given the busy and sometimes deadly 2003 influenza season, will be presented May 1 at the annual Pediatric Academic Societies meeting in San Francisco.

A team led by Maria Britto, MD, a physician in the division of Adolescent Medicine at Cincinnati Children's, examined whether proven, successful immunization strategies could be implemented in a specialty outpatient hospital setting and spread, using a business-world model, to other hospital outpatient settings. The result was a substantial increase in immunization rates in a clinic where immunization is essential to child health, and immunization rates in other clinics that are higher than the national average.

"Overall, 60 percent of the target population was immunized twice that of most published pediatric influenza immunization rates," says Dr. Britto. "In the cystic fibrosis clinic, where immunizations are particularly important, rates were above 90 percent, which is the highest of any published report. By systematically planning for and addressing barriers in our systems, we were able to bridge the gap between what is known to be effective and what happens in the real world."

The project began in 2001 when, as part of a larger quality improvement initiative, the cystic fibrosis clinic implemented a series of immunization improvement strategies. These strategies included development of a paper-based tracking system, collaboration with the pharmacy to ensure vaccine was consistently available, mailed postcard reminders to all families, open access scheduling for shots, in-clinic reminders to patients and providers, prominently posted results, and phone calls to those not immunized by a certain

Contact: Jim Feuer
Cincinnati Children's Hospital Medical Center

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