Learning Objectives for this Presentation:
By the end of the presentation participants will be able to:
1.Identify the interface between VFC field service activities and the performance parameters of health care organizations
2.Identify methods for improving how VFC field service activities can facilitate improve health care organization's vaccination performance

Background:
The Vaccines For Children (VFC) program provides an essential and unique service to health care providers. In addition to distributing free vaccine, VFC also provides recommendations on improving vaccination services, or AFIX model. While AFIX nicely fits within a Quality Improvement paradigm, it has been constructed experientially without an overarching theoretical framework. This has made it difficult to delineate the relationships between what is audited, the advice provided and subsequent coverage rates.
The State of California VFC program, in partnership with the University of California, San Diego has embarked on a Quality Improvement program to enhance the AFIX model. This includes examining the relationship between audit activities, advice provided and coverage rates using Quality Improvement theory. This presentation will discuss the results

Objectives:
To evaluate VFC field service/AFIX activities within a quality Improvement framework

Methods:
Analysis of California's VFC program data using Quality Improvement theory

Results:
AFIX is presently strongest atidentify outcomes (like coverage rates) and less well developed to assess contributining factors (inputs) affecting outcomes. Process measures (e.g. staff turnover and documentation of training) appear better able to predict coverage rates than do structural measures (e.g. hours of operation).

Conclusions:
The VFC/AFIX model is a viable Quality Improvement paradigm that can be improved with the application of a theoretical framework that "maos" the relationship between oeprational factors and coverage rates to better match recommendations to provider issues.