8 Kansas Clinics Selected for Immunization Office Champions Program
Kansas lags behind other states in the rate of pneumococcal immunizations in seniors. The rate in 2016 was 59.2 percent, while the national average was 66.9 percent. There are 19 counties in Kansas where the rate is less than 40 percent.
Kansas Academy of Family Physicians (KAFP) was selected as one of three chapters of the American Academy of Family Physicians (AAFP) to receive a grant to participate in efforts to increase pneumococcal immunization rates in the Medicare population. Through a competitive application process, KAFP selected eight Kansas clinics to participate in its Kansas Family Medicine Pneumococcal Immunization Office Champions (KFMPIOC) program. They are:
- Community Health Center of Southeast Kansas, Pittsburg
- Health Ministries Clinic, Newton
- Heartland Healthcare Clinic, Abilene
- KUMC – Landon Center on Aging, Kansas City
- Montoya Family Practice, Wichita
- Post Rock Family Medicine, Plainville
- Rice Community Healthcare-Sterling (and Lyons) Medical Centers, Sterling
- Stonecreek Family Physicians, Manhattan.
The goal of the program is to increase adult pneumococcal immunization rates in participating family physicians’ practices through a targeted Quality Improvement (QI) project. The project uses an Office Champion (OC) model to increase adult immunization rates, utilizing a framework of Advisory Committee on Immunization Practices (ACIP) recommendations and National Vaccine Advisory Committee (NVAC) Standards for Adult Immunization Practices.
The Kansas Foundation for Medical Care (KFMC) serves as the Kansas Quality Innovation Network-Quality Improvement Organization (QIN-QIO), as part of the Great Plains Quality Innovation Network. KFMC will assist KAFP with many functions including developing quality measures, performing an environmental scan, physician recruitment, coaching calls, and development of the data collection tool. Additionally, they will assist in assuring that the program developed is replicable and sustainable beyond the conclusion of the project without ongoing assistance. It will also be translatable to any other practice with independent internal processes to evaluate rates and electronic health record solutions capable of internal queries. This will address and foster improvements in targeted areas to ensure timely and efficient achievement of measurable goals.
KAFP and KFMC will provide training/coaching sessions with each clinic. Topics for the sessions will include:
- Root cause analyses
- Baseline data on immunization rates
- Evidence-based standards for adult immunization
- Design and implementation of PDSA cycles choosing interventions from NVAC’s “Standards for Adult Immunization Practices”
- Benefits of team care
- Systems changes to support pneumococcal immunization screening and improvement
- Utilization of AAFP’s policies, tools and resources (i.e. Immunizations, EveryOne Project; Office Champions Quality Improvement Model)
- Use of the data collection tool.
The participating clinics will define and implement systems changes to ensure that pneumococcal immunization status is systematically assessed and treated at every clinical encounter, utilizing the Standards for Adult Immunization Practice.
KFMC developed an online data collection tool that will easily track and trend each clinic’s data. Each clinic’s baseline will be entered in the data collection tool after being validated with Medicare claims data. Clinics will update their data in the online data collection tool monthly, using clinic specific EHR data. KFMC will provide technical assistance with conducting Root Cause Analyses and completing PDSA cycles, adjusting goals as appropriate. Each clinic will have the opportunity to report best practices in many ways to share the knowledge gained and inspire others to also improve their rates. In addition to pneumococcal immunizations, the data collection tool offers the optional opportunity to measure three other immunization rates for seniors: Influenza, Herpes Zoster and Tdap. Clinics will be encouraged to apply appropriate interventions to increase rates of these three immunizations as well as pneumococcal immunizations.
Besides the coaching and technical assistance, each clinic will receive a $4,000 stipend at the successful conclusion of the program in January 2020 and up to $900 for participation in monthly coaching calls. Other resources that will be shared with participating clinics include:
- Geo-mapping tools such as the AAFP immunization map developed by Health Landscape to identify and map pneumococcal vaccination rates at the state and possibly the local level.
- KFMC data on the rate of pneumococcal immunization of disparate populations in the state of Kansas reveal that there is an approximately 10% gap between the rates for whites and non-whites in Kansas.
- AAFP’s EveryONE project provides resources for the project to assist each clinic with understanding their gap or disparity.
Many thanks to Aledade, another partner in the program, for their assistance in the recruitment phase, which was from October through December, 2018. The data collection portion of the project is from January 2019 through December 2019. The report phase will be January 2020 through March 2020. KAFP and AAFP plan to share results through many channels. AAFP plans to have a session at the 2019 Family Medicine Experience (FMX) in Philadelphia in September 2019 to share interim progress. KAFP will send clinic representatives to share their progress. KAFP will also invite clinics to share their best practices at the 2020 KAFP Annual Meeting. KFMC will make their data collection tool widely available and is working on a toolkit for adult immunizations in conjunction with the Immunize Kansas Coalition and Kansas Immunization Program, which are additional partners and collaborators in the program.