Learning Objectives for this Presentation:
By the end of the presentation participants will be able to:
1. Using performance improvement process of Plan, Do, and Check in a office setting.
2. Define steps of surveillance of immunizations using CASA assessments in combination with the office organizational process of scheduling patients and of following up the No Show patient appointments.



Background:

Quarterly CASA assessments are done at St. Joseph's MCHC Pediatric Office since March 2003. The focus study of 27 immunization delayed children /316 children age 2 year was to determine the assumptions that children who do not show for appointments, were improperly rescheduled for a return visit; that vaccines were not given at recheck appointments after sick visits; and that children had missed opportunities due to improper assessment at the visit. Validity of social factors: is there a common age for delayed vaccines, do self pay patients have a higher no show appointment rate and do families with multiple children under age 5 have a higher no show appointment rate.



Setting:

St. Joseph's MCHC Pediatric Office is a hospital based off site office in Syracuse, NY.



Population:

Our population are urban children with some children coming to us from the surrounding Central NY.



Project Description:

Interactive assessment in CNYRIIS Healthy Shot, our computer scheduling system PHS, our computer billing system Eclipysis and the delayed children's medical record to identify scheduling process, social factors and nursing follow-up of the delayed child were done by nurses



Results/Lessons Learned:

None of the assumptions contributed to the immunization delays. However, the performance improvement process identified lacking communication at the Well Child visit for rescheduling the next Well child visit and vaccines.