BACKGROUND:
Under contract with the Texas Department of State Health Services, the Texas Medical Foundation (TMF) has used an electronic site survey tool while conducting quality assurance (VFC/AFIX) site visits for providers. This tool was used by TMF reviewers for 830 site visits in 2002; for 2,408 visits during 2003; and for a projected 2,427 visits during 2004.

OBJECTIVE:
1. To utilize data abstracted from VFC provider quality assurance site surveys over multiple years to assess the impact of VFC site visit feedback and education.
2. To utilize site survey data to identify significant indicators and trends that could affect provider-based immunization rates (CASA results) and determine the educational needs of providers.

METHOD:
In March, 2002, TMF staff implemented use of a newly-developed electronic site survey tool by TMF reviewers performing VFC provider quality assurance site visits. Data was drawn from these surveys for providers reviewed in 2002, 2003, and 2004. Statistical analyses were then performed on the abstracted data.

RESULT:
Results indicate notable improvements in provider performance over time on immunization rates and several indicators of compliance with VFC regulations or recommended immunization practices. However, there were some reversions and variances that posed interesting questions to be addressed by further investigation.

CONCLUSION:
Quantitative analyses, coupled with other inputs (e.g., provider feedback), has provided indications of the site visit effectiveness. However, because quality assurance site visits are once-a-year event and other variables could influence provider performance, a direct cause and effect relationship based on this data cannot be inferred.

LEARNING OBJECTIVES:
1. Describe the value of data collection via an electronic tool.
2. Identify significant indicators and trends that could affect provider-based immunization rates (CASA results).
3. Identify significant indicators and trends to determine the educational needs of providers.