Connecting the Silos: A Partnership to Improve Immunization Rates among Adolescents with High-Risk Conditions

The overall goal of this project is to improve the delivery and documentation of immunizations to adolescents with high-risk (chronic and immunocompromising) conditions. The primary target audience is adolescents with high-risk conditions cared for at Cincinnati Children’s Hospital Medical Center (CCHMC), along with their parents, Primary Care Physicians (PCPs), and specialists. They have assembled a Project Team at CCHMC that includes key members from six specialty clinics and Quality Improvement (QI) support. This team will address common barriers related to immunization in high-risk adolescents, including knowledge gaps and access to immunization records. Also, each clinic will address barriers that are unique to their patient population including differing vaccination requirements. They will survey practitioners, patients, and parents at baseline and several points throughout the project to assess acquisition of knowledge regarding vaccine recommendations, benefits, and risks. QI outcomes data (run charts) and process data (PDSA rapid cycles) will be employed to assess improvement in immunization rates among targeted teens who receive care in the six specialty clinics. Electronic health records (EHR) review will assess completeness of immunization records and adherence to guidelines. Surveys will be used to evaluate knowledge and practice patterns of specialists and PCPs, including the level of use of IMPACT-SIIS. In addition, a log of immunization data transfer between PCPs and specialists will be kept.

The primary outcome metric of this project will be the appropriate immunization of high-risk adolescent patients cared for in six specialty clinics at CCHMC. Our outcome goal is an overall 80% appropriate immunization rate.