Context Matters: Practitioner Perspectives on Immunization Delivery Quality Improvement Efforts.

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Clinical Guidelines
Authored By
Gingold JA, Briccetti C, Zook K, Gillespie CW, Gubernick RS, Moon RY, Fu LY
Authored On
Interests
Immunology Allergy & Inflammation
Infectious Disease & Vaccines
Pediatric Medicine
Speciality
Pediatric Medicine
Immunology Allergy & Inflammation
Infectious Disease & Vaccines
Book Detail
volume
55
ISSN
1938-2707
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ISSN
1938-2707
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true
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Additional Info
["Gingold JA, Briccetti C, Zook K, Gillespie CW, Gubernick RS, Moon RY, Fu LY","Publisher: Sage Publications Country of Publication: United States NLM ID: 0372606 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1938-2707 (Electronic) Linking ISSN: 00099228 NLM ISO Abbreviation: Clin Pediatr (Phila) Subsets: MEDLINE","Journal Article; Research Support, Non-U.S. Gov't","2016-08-01","Clinical pediatrics [Clin Pediatr (Phila)] 2016 Aug; Vol. 55 (9), pp. 825-37. Date of Electronic Publication: 2016 Jan 06.","English","1938-2707","Attitude of Health Personnel*, Guideline Adherence\/*statistics & numerical data , Immunization\/*statistics & numerical data , Pediatrics\/*methods , Practice Patterns, Physicians'\/*statistics & numerical data , Quality Improvement\/*statistics & numerical data, Female ; Health Care Surveys\/statistics & numerical data ; Humans ; Infant ; Interviews as Topic ; Male ; Pediatrics\/statistics & numerical data ; Primary Health Care\/statistics & numerical data ; United States","Female, Health Care Surveys statistics & numerical data, Humans, Infant, Interviews as Topic, Male, Pediatrics statistics & numerical data, Primary Health Care statistics & numerical data, United States, Attitude of Health Personnel, Guideline Adherence statistics & numerical data, Immunization statistics & numerical data, Pediatrics methods, Practice Patterns, Physicians' statistics & numerical data, Quality Improvement statistics & numerical data","Clinical pediatrics","55"]
Description
Uneven adherence to immunization guidelines might leave some communities vulnerable to outbreaks of vaccine-preventable diseases. To examine factors related to implementation of immunization delivery best practices, we analyzed responses to monthly surveys and debriefing interviews from 16 diverse pediatric practices engaged in a year-long virtual learning collaborative. The collaborative provided a toolkit, online learning sessions, performance feedback, and conference calls with a quality improvement coach. Participants used iterative plan-do-study-act cycles to implement self-selected changes in immunization practices. Descriptive statistics were applied to quantitative data; qualitative data were analyzed using a framework approach. Impediments to implementing guidelines included difficulties with electronic record systems, rigid management structures, competing priorities, and parental resistance. Facilitators included linkage with regional immunization registries, positive social interactions, and performance feedback. Findings suggest that improving immunization delivery requires not only awareness of recommendations and training in improvement methods but also efforts to ameliorate contextual factors that impede immunization delivery.<br /> (© The Author(s) 2016.)
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