Learning Objectives for this Presentation:
Understand how the use of the Wisconsin Immunization Registry (WIR) has positively impacted Aurora's childhood immunization rates.
Understand the clinic process flow for administering vaccinations.
Apply interventions on communication, structure and follow-up to assist with increasing immunization rates.

Background:
The Childhood Immunization initiative began in 2003 with an ultimate goal of achieving a 90% primary series immunization rate in children. Our initial intervention was to implement the use of WIR, given documented evidence of improved rates using automated registries. Our continued success is due to structure and process changes, leadership support, and dedicated staff and resources.

Setting:
Aurora Health Care is a not-for-profit integrated healthcare system servicing 75 communities in 20 counties of Eastern Wisconsin via 14 hospitals, 120 clinics, and 136 community pharmacies. Currently, this initiative is focused within clinic settings.

Population:
Children up to 35 months old (focus on primary series and late up-to-date vaccinations)

Project Description:
Through ongoing quarterly team meetings, we have implemented a system-wide structure for communication, intervention and follow-up, including:
· Standardized patient education and clinic forms.
· Integration of WIR into the vaccine administration workflow.
· Assistance with system-wide policy and nursing competency.
· Assistance for clinics enrolling in the VFC program.
· Processes for follow-up on missing and invalid immunizations.
· Clinic self-assessment tool.

Results/Lessons Learned:
In 2003, our baseline childhood immunization rate was 58%, below the Wisconsin average of 77.6% and the National Healthy People 2010 goal of 90%. Our results have been at 90% or better since January 2006. Second-quarter 2007 rate was 93%.
· Use of an automated registry is beneficial.
· Constant diligence is required.
· The structure we have in place is extremely helpful in disseminating vast amounts of information quickly and effectively
· Resources from state public health department and CDC are invaluable
· Success should be celebrated