Nancy Knickerbocker, BA Provider and Community Specialist County of San Diego Immunization Branch Epidemiological and Immunization Services

Transcription

1 Nancy Knickerbocker, BA Provider and Community Specialist County of San Diego Immunization Branch Epidemiological and Immunization Services 1

2 Who Are Some Of The Unique Providers Using The San Diego Immunization Registry (SDIR) Serving Populations With Health Inequities? WIC is a federally-funded health and nutrition program for women, infants, and children. San Diego has five WIC organizations in the county. Cal Works is designed to transition people from welfare to work. San Diego has twelve Cal Works facilities in the county. HHSA Foster Care (aka Child Welfare Services) provides culturally competent, family-centered and child-focused protective services. 2

3 The HHSA Polinsky Children's Center is a 24-hour facility for the temporary emergency shelter of children. The San Diego Black Nurses Association (SDBNA) is a provider of Health Education and Health Promotion for African Americans and other underserved population in the San Diego Community. The data is from their yearly mass vax flu clinics. The County of San Diego Probation Department operates two 24-hour, maximum-security, juvenile detention facilities. The Department also operates two 24-hour, minimumsecurity, juvenile rehabilitation facilities: Juvenile Ranch Facility and Camp Barrett. 3

4 The County of San Diego has four STD clinics. All clinics offer testing and treatment for most STDs, vaccines for hepatitis A and B, and HIV testing. The mission of St. Vincent de Paul Village is to help break the cycle of homelessness and poverty by promoting selfsufficiency. Vaccines are given to housing residents only. Southern Indian Health Council, Inc. (SIHC) provides a comprehensive range of professional health care and social services in a manner respectful of Indian values and traditions. They have two rural clinics in Alpine and Campo. Catholic Charities assists newly arrived refugees and asylees to achieve integration and self-sufficiency. They dispense both VFC and 317-funded vaccines. 4

5 What Data Are These Providers Entering Into SDIR? SDIR Vaccine Inventory Data January 1 through December 31, 2012* Provider Patients # of Vaccines Juvenile Hall Camp Barrett Juvenile Ranch Catholic Charities Polinsky Children s Center HHSA STD/HIV Clinics *SD Black Nurses Association (Mass Vaccination Clinics only) Southern Indian Health Council St. Vincent de Paul Villages Total

6 Vaccine Inventory Data Was Calculated by SDIR s Vaccine Usage Reports 6

7 2012 Vaccine Inventory Data by Age Grouping* Provider Age 0-2 Age 3-5 Age 6-9 Age Catholic Charities Polinsky Center's Center n/a Juvenile Justice Facilities *SD Black Nurses Assoc. (Two Mass Vax Flu Clinics) n/a St. Vincent de Paul n/a HHSA STD/HIV Clinics Southern Indian Health Electronically interfaced-no age range data available. Total

8 New Historical Data Added January 1 st Through December 31, 2012 (WIC, Cal Works, and Foster Care enter historical data only) Provider Historical Vaccines Cal Works WIC HHSA Foster Care 5074 Juvenile Justice Facilities 2071 Southern Indian Health Council 1220 Catholic Charities 2269 Polinsky Children s Center 1083 HHSA STD/HIV Clinics 54 Total

9 2012 New Historical Data Is Obtained by SDIR s Assessment Report-User Activity Report The User Activity Report displays how a User (or Users) is utilizing SDIR within a date range. This report is especially useful for Providers who only enter new historical data (WIC, Cal Works, and Foster Care). 9

10 At The End Of The User Activity Report, A Summary Of All Users Activities Appear At The Bottom Of The Report. 10

11 How Can SDIR Help A Provider Determine If Their Population Is Up-to-Date? What Other SDIR Reports Can Decrease Barriers And Improve Immunization Rates? One recommended report is SDIR s Missed Opportunities Report (MO). The MO report records instances where a patient made a clinic visit and did not receive a vaccine for which they were eligible. 11

12 Use down arrow to run report as summary, names only, or full detail. Select all facilities or an individual site. Enter visit date range. Enter age range by date of birth, months, or years. The report defaults to All Vaccine Groups. A User may select a specific vaccine or multiple vaccines. IZ Status, Patient Status, & Patient Visits all default to all. A User may select vaccines to remove from the report by using the down arrow & clicking add. The report can be run in PDF or Excel format. 12

13 Notice the up-to-date and missed opportunities percentages. The number of missed vaccines are displayed by vaccine group. 13

14 By Reviewing the Missed Opportunities Report With Catholic Charities, Their 2013 Up-To-Date Numbers Increased And Their Missed Opportunities Decreased. This reinforces the Provider to make every vaccine count at every visit. 14

15 The Missed Opportunities Report run in full detail shows the patient name, vaccine groups, dose number, dates of provider visits, and displays MO under the vaccine group for missed opportunities. At the bottom of the report, the total number of patients with MOs and the total number of MOs are calculated. 15

16 Second Recommendation: Following Up The Missed Opportunities Report By Running SDIR s Recall Report. The Recall Report Can, Within A Date Range, List The Vaccines The Patient Needs, Make Labels For Recall Postcards, and Documents In SDIR That A Recall Was Sent. 16

17 Finally, The Provider Profile Report Is Another Tool To Make Providers Aware Of Their Immunization Delivery Patterns. The Provider Profile report tracks general indicators in the administration and documentation of vaccines, as well as quality assurance measures. 17

18 This report describes and counts the following General Indicators: -# of duplicate home records -# of reminder/recalls sent -# of expired vaccine lots -% of VFC patients not qualified -# of private vaccine lots -# of patients with no/bad addresses (this directly affects reminder/recall) -Data entry summary -Untimely data entry= the vaccine was entered into SDIR >14 days after the vaccine was given. -Timely data entry summary 18

19 The Quality Assurance Indicators lists vaccines: -given outside of the ACIP recommendations -displaying any vaccine series incomplete -by totaling the # of invalid doses given by antigen -by totaling the # of extra doses given by antigen. -and will provide the count in each vaccine category, identifying the patient who received the vaccine, the patient s date of birth, and date the vaccine was given. 19

20 What Outreach And Education Activities Have We Delivered To Providers Who Render Immunization Services To Populations With Health Inequities? For Providers who enter new historical data only (WIC, Cal Works, and Foster Care), we have given immunization updates, provided training to new staff, reviewed their SDIR historical entry data statistics, and reinforced how positively their data entry impacts the health of their communities. 20

21 For Providers Using SDIR s Vaccine Inventory, We Stress Always Double Checking The Patient s Yellow Card At Each Visit With SDIR s Vaccine Forecast Module. NO SHOT LEFT BEHIND! 21

22 We also emphasize to our immunizing Providers, to frequently run SDIR s reports. This can encourage maximizing their vaccination delivery by: minimizing their missed opportunities increasing their population s up-to-date percentages tracking, reviewing, and improving their quality assurance measures 22

23 We attend health/resource fairs dispensing fact-based information on vaccines, referring patients to immunization providers, and conducting informal intercept surveys on participant s self-reported up-to-date rates and attitudes toward vaccination. Every year SDIR staff provides registry support to the San Diego Black Nurses Assoc. and other public health centers for their mass influenza clinics. Our Goal: Making Every Immunization Count At Every Visit! 23

24 Acknowledgements San Diego Public Health Officer, Wilma Wooten, MD, MPH Karen Waters-Montijo, MPH, Chief, Immunization Program Dr. Mark Sawyer and Heidi Deguzman, Program Director San Diego Immunization Registry Special thanks to all the Providers included in this presentation: Catholic Charities HHSA Foster Care/Polinsky Children s Center WIC/Cal Works HHSA Juvenile Hall/Juvenile Ranch/Camp Barrett San Diego Black Nurses Association St. Vincent de Paul Villages Southern Indian Health Council HHSA STD/HIV Clinics 24

25 I have no relevant financial relationships with the manufacturer(s) of any commercial product(s) and/or provider of commercial products or services. Nancy Knickerbocker, Provider and Community Specialist San Diego Regional Immunization Registry a UCSD contract of the Epidemiology & Immunization Branch Public Health Services County of San Diego Health and Human Services Agency Office: , FAX: nancy.knickerbocker@sdcounty.ca.gov SDIR Website: sdir.org San Diego Immunization Program Website: sdiz.org Mail Address: Immunization Branch, Mail Stop Rosecrans Street, Suite 704 San Diego, CA