BACKGROUND:
In October 2003, the American College of Physicians was awarded a cooperative agreement by the Centers for Disease Control and Prevention (U66/CCU323245-01) to train physicians and their staff in ACASA (Adult Clinical Assessment Software Application) to assess and improve immunization rates in internal medicine practices.
ACP developed Put ACASA Into Practice!, an interactive CME program, based on the concepts of team-training and systems learning that facilitate measurable change in practice.

OBJECTIVE:
To improve immunization rates of participating practices by 25%.

METHOD:
ACP members practicing in Pennsylvania, New Jersey, and Delaware were faxed an invitation to attend one of six Put ACASA Into Practice! training sessions scheduled between January and March 2004 at ACP headquarters in Philadelphia. Participants self-selected their desired training session; there was no randomization of participants or sessions.
Participants used the ACASA software to determine a baseline evaluation of their influenza immunization rates from a random sample of their patients age 50 and older. Participants then develop quality improvement plans to address areas of opportunity to improve immunization rates in the following influenza season.
Over the following two years, each practice will measure immunization rates to assess the effectiveness of the quality improvement plan.

RESULT:
To date, 18 physician teams have participated in Put ACASA Into Practice! Of those, 12 have completed their data entry and baseline evaluations, and have developed quality improvement plans to implement in the 2004-2005 influenza season. In April 2005, participants will take another random sample and enter data from that sample into ACASA for follow-up analysis. In March 2005, we will train an additional 20 practices from across the United States.

CONCLUSION:
Baseline immunization rates ranged from 30% to 89%. Results indicate that at baseline, most participants immunize their Medicare patients, patients 65 and older, and women at higher rates than the patient population overall.

LEARNING OBJECTIVES:
Participants attending this workshop will:
•Learn how to implement a practice-based quality improvement study focused on adult immunization
•Discuss findings based on aggregate data results and ongoing activities
•Address issues involving physician recognition and retention