Overcoming Barriers to Immunization A Workshop Summary (1994) / Chapter Skim
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5 SUPPORT FOR IMPROVING PROVIDER PRACTICES
5 SUPPORT FOR IMPROVING PROVIDER PRACTICES
Pages 39-50
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From page 39... ...
, including ensuring that immunization services are available at places and times that facilitate access to them, observing only true contraindications to immunization, and operating tracking systems that can identify children who are due, or overdue, for immunizations. All providers who do, or could, deliver primary care or immunization services to children should be part of efforts to improve provider practices.
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From page 40... ...
Federally funded community and migrant health centers provide primary care to a highly mobile population in underserved rural and urban communities where children are at high risk for delayed immunization. INITIATING CHANGES The complex mix of public and private providers and the diversity of settings in which immunization services are delivered argue for emphasizing provider-based changes and for offering providers resources that facilitate change.
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From page 41... ...
14. Providers conduct semiannual audits to assess immunization coverage levels and to review immunization records in the patient populations they serve.
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From page 42... ...
HRSA's Bureau of Primary Health Care is collaborating with CDC to evaluate the effect on immunization rates of implementing the standards. In five community and migrant health centers, immunization levels and provider practices assessed at the beginning of the study will be compared with results after a 1-year period, during which CDC staff are providing technical assistance in making changes in immunization procedures.
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From page 43... ...
Identifying Children Assessment of immunization status needs to be a routine part of a provider's care for every young child. Providers should not assume that the preschool children they encounter have received recommended immunizations on time.
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From page 44... ...
The CDC standards support the use of every clinical encounter as an opportunity to immunize a child, but some clinics and providers in private practice will not immunize children during acute care visits. Peter Szilagyi noted that this included about two-thirds of the pediatricians and family physicians in the national survey that he conducted, but he pointed out that the survey was conducted before the CDC standards were published.
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From page 45... ...
ATPM also is beginning work on curriculum materials on immunization for nursing programs. Cost-Related Referrals Cost factors that lead private providers to refer children to public health clinics and other sources of free or low-cost immunizations contribute to missed immunization opportunities.
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From page 46... ...
Although the Vaccines for Children Program will reduce the financial burden on both families and providers, inadequate reimbursement for vaccine administration services and cumbersome paperwork may continue to discourage private providers from offering immunizations to Medicaid patients. Missed Visits Although providers cannot control whether families take their children to providers for immunizations, they can adopt practices that encourage families to make appointments and that include outreach and follow-up to encourage families to keep those appointments.
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From page 47... ...
The satellite communication technology available in the Department of Agriculture's Cooperative Extension Service offices in each county could make immunization education programs available to providers across the country.
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From page 48... ...
Academic health centers can ensure that the curricula of their training programs at all levels are consistent with the current Standards for Pediatric Immunization Practices. Special attention could be given to continuing education programs that inform providers about true contraindications to immunization.
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From page 49... ...
Providers from both the public and private sectors are needed to deliver immunization services. Health departments can promote better services for their communities by developing good working relationships with private providers.
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From page 50... ...
In their credentialing role, professional organizations such as medical specialty boards can devote more attention to appropriate provider training regarding immunization. Providers can be required to demonstrate an understanding of the care embodied in the Standards for Pediatric Immunization Practices or comparable practice guidelines.
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