New York State Vaccine for Children Program Quality Assurance and Provider Practice Improvement

Background: The New York State Vaccines for Children (VFC) program performs quality assurance and educational activities to improve provider compliance with Centers for Disease Control (CDC) standards.  These efforts include site visits and desk audits. Vaccine storage and handling standards are necessary to ensure that children are immunized appropriately and to minimize vaccine wastage. Identifying providers at high risk for mishandling vaccine and developing ways to most effectively and quickly identify them will help ensure that children continue to be protected from detrimental diseases and that vaccine loss does not occur.

Objectives: To evaluate providers’ non-compliant behaviors and explore ways to improve their conduct according to existing CDC standards.

Methods:    The VFC site visit questionnaires entered into the Comprehensive Clinic Assessment Software Application (COCASA) for 2008, 2009, and 2010 were used for this analysis.  Questionnaires were evaluated to determine if compliance to one standard was related to compliance with other standards.    Other characteristics and behaviors of providers (e.g., provider specialty, public or private sector status and appropriate vaccine storage and handling) were also evaluated to determine if any associations with compliance existed.

Results: There was a relationship between compliance rates for different high-priority questions.  In addition, these compliance rates were associated with specific provider characteristics and behaviors.   

Conclusions: Certain questions may be asked more frequently through desk audits or through other means in order to identify providers at high risk for problems more quickly and, as a result, take corrective action before vaccine loss occurs.  Further, the results provide insight into how the New York State Department of Health can direct continuing educational and outreach activities.