Effectiveness of pediatric practice consultation on missed opportunities for immunization

Journal of Urban Health : Bulletin of the New York Academy of Medicine
N HughartB Guyer

Abstract

To evaluate the effectiveness of pediatric practice consultation in reducing missed-opportunity rates at eight pediatric sites in Baltimore, Maryland. The overarching goal was to decrease the occurrence of missed opportunities from 33% to 15% for the first, second, and third diphtheria and tetanus toxoids and pertussis vaccines during visits at which children were eligible for the vaccines. The effect of an in-office educational program alone at four sites is compared with the educational program and a consultation on office vaccination practices at four matched sites. All eight sites received a small grant ($2,000) to fund practice changes. The medical records of children making visits before and after the interventions were audited to determine missed-opportunity rates. The policies and operations and the knowledge, attitudes, and practices of physicians and nurse practitioners at each site were also assessed. The four education-consultation sites experienced a statistically significant 14% net reduction in the missed-opportunity rate relative to the education-only sites. This positive effect, however, was largely due to an increase in missed opportunities at one education-only site. There was a 10% increase in the missed-opp...Continue Reading

References

Sep 1, 1992·The Pediatric Infectious Disease Journal·P G Szilagyi, L E Rodewald
Sep 1, 1994·Archives of Pediatrics & Adolescent Medicine·N HughartL Horton
Oct 21, 1993·The New England Journal of Medicine·P J Greco, J M Eisenberg
Dec 3, 1996·Journal of Public Health Management and Practice : JPHMP·P G Szilagyi, L E Rodewald

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