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Copy of Vaccination

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by Amanda Winebarger on 5 September 2013

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Transcript of Copy of Vaccination

24-35/36 month
vaccine inventory weekly
Our Success with Increasing Vaccination Rates
.
Amanda's Background
Medical Assistant
12 years at Blue Ridge Pediatric
Vaccine Coordinator 10 years
A mother to Bradley born 10/10/10

Example: on March 20, 2013:

Filter conditions used for this report:
Clients Associated with Provider:
BLUE RIDGE PEDIATRIC AND ADOL MEDICINE
Clients who did NOT meet the selected benchmark (s)
Consider refusals and immunizations as meeting the benchmark
Age between 24 months and 36 months
Evaluation date: 03/20/2013
Benchmark age @ 24 months
Selected benchmarks: DTaP (4), Hep B (3), Hib (3), MMR (1), Polio (3), Pneumo (4), Varicella (1)
Total Clients: 579; 474 clients
(70%)
met all benchmark criteria, 101 clients did not
Late up-to-date: 502 clients
(86%)
met all benchmark criteria as of report generated date, 73 clients did not

Blue Ridge Pediatric & Adolescent Medicine
(Watauga County)
Blue Ridge Pediatric & Adolescent Medicine, Inc

Who We Are:
Only Pediatric Office in Watauga and Avery County
serve Ashe, Avery, Caldwell, Watauga and Tennessee
5 Physicians, 4 Physician Assistants, 1 Pediatric Nurse Practitioner
Vaccine Rates
Children Who Are Behind On Vaccines
temperature logs
employee education
I am in My Vaccine zone
Number of Patients in Our Practice
Medicaid: 5900
Self Pay: 225
Private insurance: 6757
Total number of patients: 12,882
Number of Employees
:
WHY DID WE START WORKING ON OUR VACCINATION RATES?
SITE VISIT: Reports during the site visit showed that our Vaccination Coverage rates were low for ALL age groups especially 24-36 months of age.
Amanda's Vaccine Zone:
inventory (FOR MAIN OFFICE AND AVERY OFFICE)
ordering FOR MAIN OFFICE AND AVERY OFFICE
(STATE, PRIVATE-MERCK, SANOFI, GSK, MEDIMMUNE, PFIZER)
running benchmark reports
mailing out postcards
planning and coordinating Flu Clinics
entering demographic information into the NCIR.
anything vaccine related
The Zone just reminds my coworkers and physicians don't disturb me during this time. I get 1.5 day to work on vaccines the other times I am with a physician.
We started working on coverage rates
in 2011. We also looked at adolescents and upcoming sixth graders.
Rates are a continuous job! We have continued to check vaccine rates for all age groups
HOW DID WE BEGIN TO INCREASE OUR RATES:
Team- (Clinical Coworkers) explained how the rates looked, what we could do to increase those rates- each team member received a page of the benchmark report (in down time the team and myself would work on the reports
Comparison of EMR and NCIR-Transferred all Historical information from EMR to NCIR
Entered demographic information into the NCIR (BRP designed the information sheet to reflect the necessary information needed for the NCIR)
HOW DID WE BEGIN TO INCREASE OUR RATES
During the review of our charts if a patient had not received a checkup we would recommend a checkup or a Nurse Appointment to get vaccines caught up. We contacted patients through postcards that our office had designed.
If patients had moved from our practice, then we Inactive on NCIR & EMR.
Reviewed the NC Carolina Access Provider Enrollment Report- for those that had Medicaid who had not been seen I compared this list to see if we were still the patient's provider as well as an updated address to contact the parents.
WHAT DID THE PRACTICE DO TO HELP INCREASE THE RATES
Physicians & Extenders started recommending vaccines more, ordering more especially if patients were behind and had not had been in the office for checkups
Nursing Staff, logs into the NCIR on their laptops-while working up patients will review what vaccines are in the EMR/NCIR and then what the NCIR states patient needs or is recommended-the nursing staff will go ahead and order these vaccines in the EMR and during the checkup physicians will discuss these, physicians are responsible for taking out what is not ordered
Refusals- enter all refusals in the NCIR under the Client Comments
Disease of Varicella or Titers enter under the Client Comments

06/26/2013
Clients Associated with Provider: BLUE RIDGE PEDIATRIC AND ADOL MEDICINE
Clients who did NOT meet the selected benchmark (s)
Consider refusals and immunizations as meeting the benchmark
Age between 24 months and 36 months
Evaluation date: 03/20/2013
Benchmark age @ 24 months
Selected benchmarks: DTaP (4), Hep B (3), Hib (3), MMR (1), Polio (3), Pneumo (4), Varicella (1)
Total Clients: 568; 478 clients
(84%)
met all benchmark criteria, 90 clients did not
Late up-to-date: 520 clients
(92%)
met all benchmark criteria as of report generated date, 48 clients did not

HEY LOOKING AT COVERAGE
RATES REALLY DOES WORK
WHAT WOULD 19 MONTHS-23 MONTHS LOOK LIKE?
Filter conditions used for this report:
04/22/2013
Clients Associated with Provider: BLUE RIDGE PEDIATRIC AND ADOL MEDICINE
Clients who did NOT meet the selected benchmark (s)
Consider refusals and immunizations as meeting the benchmark
Age between 19 MONTHS AND 23 MONTHS
Evaluation date: 04/22/2013
Benchmark age @ 21 months
Selected benchmarks: DTaP (4), Hep B (3), Hib (3), MMR (1), Polio (3), Pneumo (4), Varicella (1)
Total Clients: 216; 159 clients (
74%
) met all benchmark criteria, 57 clients did not
Late up-to-date: 159 clients (
74%
) met all benchmark criteria as of report generated date, 57 clients did not

DID WE IMPROVE?
Filter conditions used for this report:
06/26/2013
Clients Associated with Provider: BLUE RIDGE PEDIATRIC AND ADOL MEDICINE
Clients who did NOT meet the selected benchmark (s)
Consider refusals and immunizations as meeting the benchmark
Age between 19 MONTHS AND 23 MONTHS
Evaluation date: 04/22/2013
Benchmark age @ 21 months
Selected benchmarks: DTaP (4), Hep B (3), Hib (3), MMR (1), Polio (3), Pneumo (4), Varicella (1)
Total Clients: 185; 160 clients (
86%
) met all benchmark criteria, 25 clients did not
Late up-to-date: 176 clients (
95%
) met all benchmark criteria as of report generated date, 9 clients did not

WERE OUR POSTCARDS SUCCESSFUL?

VACCINES USAGE REPORTS:
2010 TOTAL VACCINE ADMINISTERED: 18030
TOTAL NUMBER OF CLIENTS: 5177

2011 TOTAL VACCINES ADMINISTERED: 18798
TOTAL NUMBER OF CLIENTS: 5437

2012 TOTAL VACCINES ADMINISTERED:
19952
TOTAL NUMBER OF CLIENTS; 5801




WHAT ABOUT OUR ADOLESCENT COVERAGE RATES?
11-12 YEAR OLD AS OF 01/01/2011 UP-TO-DATE 02/14/2011
HEP B3, MENG1, MMR2, TDAP 1=
26%
TDAP 1=
78%
MMR 2=
73%
MENG 1 =
36%
HEP B 3 =
78%
VAR 1 =
80%
VAR 2 =
50%
HPV 1 =
23%
HPV2 =
18%
HPV 3=
10%
What did we find out about
the Adolescent Rates

Historical information was not entered especially their MMR, Varicella, Hep B
Demographic information was not entered.
Adolescents had their 1st dose of HPV but we didn't track if they ever came back for their 2nd dose of HPV
WHAT OTHER AGES HAVE WE LOOKED AT?
2MONTHS-12 MONTHS OF AGE:
REPORT RAN ON 03/25/2013:
51 % MET ALL BENCHMARK CRITERIA
60% WAS LATE UP-TO-DATE

THEN REPORT RE-RAN ON 06/27/2013:
51% MEET ALL BENCHMARK CRITERIA
77% LATE UP-TO-DATE
HEP B3, MENG1, MMR2, TDAP 1=
46

%
TDAP 1=
91%
MMR 2=
82 %
MENG 1 =
57%
HEP B 3 =
85%
VAR 1 =
83%
VAR 2 =
58%

HPV 1

=

37%
HPV2

=

32%
HPV 3=

24%
REPORT RAN ON: 07/09/2012
Did we really increase 11-12 year old Rates?

HOW TO INCREASE VACCINATION RATES:
HAS TO BE A TEAM EFFORT
(THE OFFICE AS A WHOLE HAS TO BE INCLUDED)

Front Office Staff: 4 Full Time/3 Part-Time

Clinical Office Staff: 15 clinical staff members (12 full time/ 3 part time)- 4 LPNs, 6 RNs, 4 CNAs, and 1 Medical Office Assistant.

2 Billing Staff/ 1 Accounts Payable/ 1 Data Management Office Staff/ Office Manager/ Assistant Manager

The more demographic information entered into the NCIR the better
Don't get frustrated-rates are a never ending process, don't set unrealistic goals
High-Defying Acts
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