Site Reviews as a Tool to Promote Provider Retention

Background:
VaxTrack implemented site reviews in 2006 as a tool to facilitate provider retention. The site review focuses on four aspects of IIS implementation: disclosure, record look-up, data entry, and return demonstration. Incentive items were attached to each section to promote successful implementation of the IIS.

Setting:
Riverside County, CA

Population:
Public health and private provider offices enrolled in the VaxTrack Immunization Registry.

Project Description:
In order to maintain on-going provider participation in an IIS, provider offices need to implement procedures they learn during new user training. Full deployment can wane with the reality of day-to-day clinic operations. To promote full implementation of the IIS, VaxTrack staff began conducting site reviews approximately one month after new user training was completed. Copies of the site review form are given to users at the close of new user training to serve as a reference for implementing parent disclosure, record look-up and data entry procedures in their offices. A small incentive item is pictured next to each procedure on the site review form. To encourage adoption of new office practices and reward provider participation, the incentives are given to users who successfully demonstrate the incorporation of the IIS into their office workflow.

Results/Lessons Learned:
During the first year of implementation, VaxTrack staff performed 144 site reviews and saw a 50% increase in providers who consistently entered data into the IIS. Because the site review also required users to be observed entering a shot record, data entry and other procedural errors were caught and corrected before becoming an ingrained habit. While some users were motivated by the incentive items, they did not make a significant difference in IIS implementation. The accountability of the site review visit and the feedback received had a greater impact on IIS participation.