227932 Formative Evaluation Results for a Local Public Health QI initiative to Improve Immunization rates

Monday, November 8, 2010 : 3:10 PM - 3:30 PM

William Livingood, PhD , Center for Health Equity & Quality Research & JPHsu COPH, Duval County Health Department & Univ of Florida & Georgia Southern Univ, Jacksonville, FL
Radwan Sabbagh, MD, MPH , Duval County Health Department, Jacksonville, FL
Kimberly L. Pierce, MPH , Institute for Health, Policy, and Evaluation Research, Duval County Health Department, Jacksonville, FL
Steve Spitzfaden, MS , Duval County Health Department, Jacksonville, FL
Nancy L. Winterbauer, PhD, MS , Institute for Public Health Informatics and Research, Duval County Health Department, Jacksonville, FL
Anita Davis, BA , Institute for Health, Policy and Evaluation Research, Duval County Health Department, Jacksonville, FL
Eulisa Morgan-Murphy, BS , Duval County Health Department, Jacskonville, FL
Violatta DeLoatch , Duval County health department, Jacskonville, FL
David L. Wood, MD, MPH , Department of Pediatrics, University of Florida, College of Medicine-Jacksonville, Jacksonville, FL
Quality Improvement (QI) is a widely used tool to enhance organizational performance, but “there is little published evidence on the value and impact of QI in public health” (RWJF). The Duval County Health Department launched a RWJF supported effort to demonstrate the benefits and lessons learned from implementing QI processes to improve population health in June, 2009. The primary QI population outcome of concern for this project was the relatively low rate of childhood immunizations for clinics predominantly serving low income minority clients in Jacksonville, rates for the 4/3/1/3/3/1 series for children, 19 to 35 months old. The purpose of this QI evaluation project is to: 1) provide formative feedback for implementation, 2) document and disseminate the challenges and obstacles in applying QI processes and 3) document and disseminate the successes that are achieved by using QI processes for improved population health. Our evaluation employs a Mixed Method Design involving: 1) quantitative data on immunizations and factors influencing immunizations, and 2) qualitative data including observations of staff engaged in QI activities and interviews of staff. A public health primary care clinic with low immunization was identified for a pilot QI site, and a well structured PDSA process was implemented with the clinic staff and other key stakeholders serving as a QI team. Immunization rates improved from 74% to 81% in the first months of the project but then leveled off. Major insights for improving the QI efforts within public health settings emerged from this formative evaluation. These insights and resulting changes to the QI processes will be discussed.

Learning Areas:
Administration, management, leadership
Conduct evaluation related to programs, research, and other areas of practice
Public health administration or related administration
Public health or related organizational policy, standards, or other guidelines
Public health or related research

Learning Objectives:
1) Describe QI processes which can be used to improve immunization rates 2) Apply formative evaluation techniques to improve QI processes 3) Discuss the implications of insights gained from formative evaluation for future QI efforts

Keywords: Quality Improvement, Immunizations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Principal Investigator for evaluation
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
Duval County Health Department Research & Evaluation Employment (includes retainer)

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.