April 30, 1999
UCSD Community Pediatrics physicians and staff are already seeing positive results on the five-year $6.5 million grant awarded in 1996 by the Centers for Disease Control to improve immunization rates among young children in San Diego County.
After almost two years of intervention in pediatric clinics throughout the county, Mark Sawyer, M.D., a UCSD Healthcare pediatrician and principal researcher on the federal grant, along with his staff, have helped increase immunization rates among children two years old and younger. "Results from our intervention turned out better than we had expected, Dr. Sawyer said. "All nine clinics we worked with improved their immunization rates."
"We worked very closely with the clinics' physicians and staff to inform them about increasing immunization rates, educate them on current immunization information and gave them feedback on how they and their staff could increase their immunization rate," Dr. Sawyer said. We helped clinics identify missed opportunities to immunize and resolve the issues that are causing them to be missed, Dr. Sawyer said.
With the intervention over the past two years, some clinics reduced their missed opportunity rate by 25 percent or more, and increased their immunization rate by as much as 31 percent.
Sawyer's group identified correctable problems such as parents not bringing a child's immunization record to a medical appointment or not having a ride to a medical appointment as a cause of why children go without their immunization. A simple reminder phone call to parents to bring the immunization record can widely increase the chances a child will be immunized.
Although they should be taught the importance of keeping up to date on their child's immunizations, parents should not bear all the responsibility for keeping their children's immunizations current. "It is the job of the care providers to make sure their patients are up to date on their immunizations," Dr. Sawyer said.
To achieve this, aside from providing immunization education, Dr. Sawyer and his team went to clinics and helped them devise strategic plans and processes to increase immunization rates. These steps and processes included: improving clinic documentation of immunizations, developing a system to remind parents of appointments and to bring immunization record, and informing everyone of the importance of immunization.
Dr. Sawyer's group, UCSD Partnership of Immunization Providers (PIP), is working on this project in collaboration with San Diego County Infant Immunization Initiative and All Kids Count. The clinics involved in the first phase of the study were: North County Health Services, San Ysidro Health Center, UCSD Medical Center Pediatric Primary Care, UCSD Medical Center Family Medicine, Mid-City Community Clinic, East County Health Services, Comprehensive Health Center, Chil-dren's Healthcare Medical Associates and Sharp Gateway Medical Center.
The group is now designating clinics throughout the county to work with in the second phase of the study. Unlike the clinics from the first phase, Dr. Sawyer said the second group of clinics will be given the toolbox, however it will be up to the physicians and staff to put the tools to use.
At the end of the five-year study, Dr. Sawyer will report back to the CDC on his results, which are so far positive. But the end of the study does not mean the end of the program. His goal, Dr. Sawyer said, is to make his so-called "toolbox" available to all pediatric clinics in the county, enabling them to continually strive for high immunization rates.
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