Determining Provider Compliance with Unannounced Study Visits

Background:
Quality Assurance Reviews (QARs) also known as Site Visits are conducted to Providers enrolled in the California Vaccines for Children (VFC) Program. The 17 standards for child and adolescent immunization practices are reviewed and VFC compliance issues are addressed at these visits. QARs are scheduled in advance allowing Providers to prepare and make any corrections before the visit, potentially changing the outcome and not painting the true data being analyzed. If unannounced visits were made and Providers were not given time to prepare or correct anything, would the data show differently? These study visits were conducted to examine that theory.

Objectives:
To determine if unannounced visits are effective and/or necessary.

Methods:
Conducted unannounced visits to 42 VFC Program Providers in Los Angeles County reviewing 8 key areas to determine if Providers were compliant with VFC Program guidelines. These Providers were randomly selected from 3 groups (based on the amount of vaccines ordered).

Results:
92% compliance rate for proper temperature range in refrigerator. 92% compliance rate for proper temperature range in freezer. 97% compliance rate for having proper working thermometers in both compartments. 85% compliance rate for not having vaccines in drawers or doors. 79% compliance rate for not having expired vaccines in units. 56% compliance rate for recording temperatures twice daily. 44% compliance rate for having current Vaccine Information Statements (VISs) on file. 74% compliance rate for having non-expired medications in emergency kit.

Conclusions:
Providers were not fully compliant in all areas reviewed. Unannounced visits were effective and illustrated that Providers are not always in compliance with VFC guidelines. New measures will need to be created in order for Providers to achieve a 100% compliance rate.