KEYWORDS:
Reminder/Recall, Assessment, CASA, Attitude

BACKGROUND:
The 2010 national goal is 90% coverage, at 24 months of age, for each of the following: DTAP4, IPV3, MMR1, HIB3 and HepB3. Dropout rates reflect the failure of the system to track and retrieve those children who, although seen by the system during their first year of life, were in need of further vaccine doses but failed to return to receive them. Children who begin the series after 3 months of age are at increased risk of not completing the series on time.

OBJECTIVE:
Examine the use of recall/reminder systems and the effects on CASA rates in VFC private provider offices.

METHOD:
Twenty-two (22) pediatric practices had all charts of 12 – 35 months olds surveyed in 2001 and 2002. Current recall practices were reviewed and additional reminder/recall techniques instituted.
Those techniques included: computer tracking, tickler files, period chart review, phone call prior to appointment and scheduling appointments as the child leaves the office. Other factors identified included: physician attitudes regarding parent &/or provider responsibilities, transient children, office staff changes of 27% per year, competition among pediatric practices and consistent reviewer and criteria.
CASA rate increased an average of 1.8% in prior years with practices self reported as having rates over 90%.

RESULT:
The number and type of recall systems directly effect the vaccination coverage of children at age 24 months. Of the 22 pediatric practices surveyed with the CASA Diagnostic Report, the 4-3-1 mean rose from 80% to 90%. The private general practices mean rose from 69% - 82%.

CONCLUSION:
An increase in vaccination rate is directly related to the number and types of recall systems in place. Addition of one (1) reminder/recall technique during a 12 months period of time elevated the 4-3-1 CASA rate 10%.

LEARNING OBJECTIVES:
List five reminder/recall systems techniques that raise CASA Diagnostic rates.
Identify the application of at least two of the above systems techniques that can be incorporated into current practice.