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10 Practical Tips to Increase Early Childhood
Immunization Coverage Rates Karen Dickenson-Smith MPH MBA PROSCI®
Anup Samra RN BScN
Dr. Shovita Padhi MD MPH FRCPC
Fraser Health Authority
Disclosure Statement
Dr. Shovita Padhi and Anup Samra were involved with a Novartis
study on Fluad intention to immunize
Introduction & Purpose
Fraser Health is the largest, most diverse, and fastest growing health authority in BC. We in the Population & Public Health program increased our regional 2-year old immunization coverage rate by 5% in less than one year, and we’re here to share our Top 10 Tips
2-Year Old Immunization Coverage Rates in Fraser Health
2011/12 2012/13 2013/14 2014/15 2015/16 2016/17*
Up-to-date for age 68.4% 70.9% 67.8% 69.0% 72.9% 76.1%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
% c
hild
ren
Percent of 2-Year Olds with Up-To-Date Immunizations in Fraser Health Authority, Fiscal Year 2011/12 to 2016/17*
*Data for 2016/17 include the period from April to Sept (Q1-Q2) of the fiscal year extracted on Oct 7,2016. Data sources are iPHIS (prior to 2015) and Panorama (2015 onwards).
Background & Context
2014 Measles outbreak in the Fraser Valley
Decision to focus on 2-year old coverage rate and aim for herd immunity
Provincial Target of
90% by 2023
2014 Review of 2-year old Immunizations in Fraser Health – Key Findings: (i) Drop off at 12-18 months (ii) Data issues
Change Fatigue
Multiple Reorganizations – Organization & Program level
Centralization of Public Health Administrative Functions -> Roll-out of Centralized Client Appointment Booking
Centralization of regional Communicable Disease Nursing
Implementation of new modules for Panorama Public Health Information System
Arrival of Syrian Refugees – Public Health leadership in coordination of immunization clinics with Primary Care
Top 10 Tips 10. Make Early Childhood
Immunization Rates an organization-wide key performance indicator
9. Communicate a compelling reason to staff
8. Incorporate evidence and feedback data from clients and practitioners
Top 10 Tips cont’d. 7. Utilize a structured change management approach
6. Provide regional structure and accountability AND the freedom to experiment locally / geographically
5. Examine clinic capacity and the potential need for resource re-allocation
4. Support creative use of clinical and non-clinical supports
3. Have the courage to look internally and make client-centred improvements
2. Standardize immunization appointments, access indicators and data entry timelines
Top 10 Tips cont’d.
Summary
Increasing your 2-year old immunization coverage rate IS possible if you make it an organizational priority and utilize focused change management and a client-centred,
data-driven approach
Acknowledgments Christina Fung, Epidemiologist, Fraser Health
Rachel Douglas, Evaluation Specialist, Fraser Health
Dr. Michelle Murti, Medical Health Officer, Fraser Health
Sherry Baidwan, Public Health Manager, Fraser Health
Steven Eng, Manager, Planning & Systems, Fraser Health
Population & Public Health Leadership, Fraser Health
Public Health Unit Teams, Fraser Health
Christine Halpert, former Fraser Health
Marilyn McIvor, Consultant