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Story of Measurable Improvement in Public Health

Name of Health Department/Agency: Deschutes County Health Services
State: OR
Contact Name: Cherstin Callon
Contact Information: cherstin@deschutes.org
Date Added: 6/27/2011
Program/Topic Area: Immunizations
QI techniques/tools:  Fishbone Diagram, Flowchart, Root Cause Analysis, Brainstorming, Hanlon Method, Process Map
Description of the process and intervention: The agency found that their immunization data entry did not meet the necessary benchmark of 80 percent of data being entered into the State Instant Response Information Service (IRIS) Alert database within 14 days of vaccine administration. The goal of this QI effort was to ensure that 95 percent of all immunization administration data from all the agency’s clinics will be entered into IRIS/ALERT within 14 days of administration. After process mapping and root cause analysis it was determined that the issue was lack of a regular courier schedule and data entry staff. The improvement theory was that if a regular courier schedule can be established, additional staff can assist with data entry, and immunization paperwork is checked for accuracy, then immunization data entry timeliness will be improved across clinics. To test the theory, the agency implemented a regular courier schedule, trained and allocated additional staff in data entry, trained front office staff to check immunization paperwork for completeness, and retrained clinicians to accurately complete paperwork. Immunization data entry rates were collected for each clinic on a monthly basis and compared to the baseline data collected.
Result/outcome: As a result of the new courier schedule and additional training and staff, timeliness of immunization data entry increased by 31%.
Next Steps: The agency will adapt the test by extending the study time. If additional improvements are achieved the improvement will be standardized. Subsequently, data entry rates will be monitored on a six month basis to ensure the maintenance of the improvements.

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