KEYWORDS:
Preteen Immunization
Integrated Delivery System

BACKGROUND:
Preteens historically have low immunization rates. The reasons include immunization at many facilities with incomplete unified records, poor compliance and failure to take advantage of MD visits for intercurrent problems.

OBJECTIVE(S):
One of the Clinical Strategic Goals of the Kaiser Permanente Medical Center, Los Angeles is to have all preteens be fully immunized. This includes the HEDIS requirements of having received 2 MMRs, completed the Hepatitis B series and Varicella Vaccine or have evidence of past varicella infection documented in the electronic immunization record.

METHOD(S):
Medthods include: the identification of all preteens (11-13 year olds) in our practice; involving the entire department; identifying barriers and steps necessary to overcome barriers; utilize a computerized tracking and recording system for immunization data; having monthly chart audits by pediatricians; providing periodic educational updates on immunization practices; presenting monthly data updates;identify at every visit opportunities to address immunization status; outreach to preteens who have fallen behind the recommended immuniztion schedule.

RESULT(S):
Preteen immunization rates have dramatically improved from 9% in 1997 to 71% in 2001.

CONCLUSIONS(S):
Preteen immunization rates can be significantly improved using several different approaches.

LEARNING OBJECTIVES:
An accurate record, available to the physician at the time of all visits is important.
On going education and data feedback keeps physicians focused.
A review of records and outreach to those needing immunization are key to a successful preteen immunization program.