BACKGROUND:
The District of Columbia 4:3:1:3:3 NIS rate has improved from 70.9% in 2000 to 76.2% in 2004. However, the District lags behind the national rate of 79.4%. In comparing the individual rates of District VFC providers to the national rate, over 80% of providers fell below the national average. To improve rates, the VFC program developed strategies to improve implementation of AFIX methodology.

OBJECTIVE:
To develop strategies that improve the implementation of AFIX methodology and determine if strategies were effective.

METHOD:
Developed four strategies to improve implementation of AFIX.
1. A data dump from the DC Immunization Registry into CASA which enabled staff:
a) to complete the VFC-AFIX process in one visit and provide immediate feedback.
b) assess all records within the 19 to 35 month age range
2. Missing immunization reports were printed out on site so providers know immediately which child in the practice was not up to date and which immunizations were needed.
3. Created reminder recall cards to distribute to providers who didn't have a current recall system.
4. A one page summary of findings and recommendations from the AFIX process was developed.
64 VFC-AFIX visits were conducted. Missing immunizations reports were distributed to all providers along with reminder recall cards to those without a recall system. The one page summary guided feedback, summarized findings and recommended strategies to improve or maintain their rates. Of the 64 visits conducted, 32 sites required follow-up. Follow-up visits were done at least three months after the initial visit to determine strategies were used and if were effective.

RESULT:
To date 5 of the 32 sites have received a follow-up. Results will be available upon completion of visits.

CONCLUSION:
The follow-up results will determine if the strategies implemented were effective.

LEARNING OBJECTIVES:
To illustrate how the AFIX process affects provider immunization rates.