CDC NIP/NIC Page
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Monday, March 17, 2008 - 11:25 AM
12

Missed Opportunity vs. Up-to-Date Status as an Effective Feedback Tool

John M. Fontanesi, Dept. of Pediatrics & Dept. of Family and Preventive Medicine, UC San Diego, 9500 Gilman Drive, #0821, La Jolla, CA, USA, Debra Bowers, Center for Management Science in Health, UC San Diego, 9500 Gilman Drive, #0821, La Jolla, CA, USA, and Howard Backer, Immunization Branch, CA Dept of Health Services, 2151 Berkeley Way, Berkeley, CA, USA.


Learning Objectives for this Presentation:
By the end of the presentation, participants will be able to understand:

  1. The standards for “classic” AFIX

  2. Expanded opportunities for applying the AFIX model



Background:
AFIX has been a cornerstone in the effort to improve provider vaccination practices. Standards for conducting “classic” AFIX have been issued, with these standards detailing methods for
managing up-to-date status of two-year-olds and other issues. However, AFIX field representatives must take part in dozens of local, state, and national audits each year. Further more, the present system of audit and feedback is labor-intensive and expensive, thus limiting the number and/or frequency of provider visits.

Setting:
VFC providers

Population:
VFC providers

Project Description:
This presentation will highlight methods for expanding AFIX, including shifting some of the auditing responsibilities to the provider and complimenting traditional feedback via up-to-date
status and monthly review of individual provider “missed opportunity” rates. We will also review the methodology, templates, and barriers to using missed opportunity as feedback mechanisms
to improve provider vaccination behavior.

Results/Lessons Learned:
Enhancing traditional audit and feedback using up-to-date status with monthly missed opportunity” rates can significantly extend the impact of public health by shifting assessment activities to provider offices, moving the assessment period closer to the point of service, and helping to track causes of the missed opportunities.