Taking a Closer Look at the Immunization System in New Mexico

Learning Objectives for this Presentation:
By the end of the presentation participants will be able to:
1. understand purpose of systems analysis
2. identify steps involved in systems analysis
3. describe information gained

Background:
The New Mexico Immunization Coalition (NMIC) is currently in its fifth year. While immunization rates have increased in the past five years, they are still lower than desired. After dropping to 61% in 2001, NM steadily increased to 83.5% in 2005, but dropped to 76.3% in 2006 for the 4:3:1:3:3 series. Because we are concerned with improving our rates, we want to ensure we are targeting our efforts to see the most improvement. As a precursor to revising our 5-year strategic plan, NMIC is undergoing a structured systems analysis process to better target activities to address system problems.

Setting:
New Mexico is a large, rural state, with a high rate of uninsured children and significant barriers to healthcare.

Population:
The NMIC serves the entire state of New Mexico and is primarily focused on childhood immunizations.

Project Description:
NMIC contracted with a consultant skilled in Systems Analysis. Using a structured methodology, the consultant led the NMIC through a process that looked at the steps involved in the immunization process, generated hypotheses as to the possible barriers at each step, and then looked for data to determine whether each of those hypotheses might be true. The NMIC Steering Committee and a small working group did the bulk of the preparatory work, but the entire NMIC was brought into the process for input and buy-in. Based on what the data showed to be problem areas, interventions were chosen to make the greatest impact.

Results/Lessons Learned:
By closely examining the data, NMIC was able to focus its activities to have the greatest impact on immunization rates. Investing in a facilitated process provided guidance as to how to best use limited resources.