Objective: We implemented a practice-level quality improvement (QI) education program designed to improve provider confidence in designing and executing office-specific QI projects with a goal of increasing HPV vaccine uptake among 11-12 year olds.
Design/Methods: During a 4 year period between 2016 and 2020, 44 pediatric and family medicine practices participated in this program. QI project education and training included lectures and discussions on QI methods, data tracking and analysis, and system changes known to reduce missed vaccination opportunities. Monthly for 6 months, designees at participating practices performed chart audits, captured data, printed run charts, and developed, implemented, and tracked practice-specific interventions. Outcome measures included rates of HPV vaccine initiation, vaccine series completion and missed opportunities to immunize during visits scheduled for other reasons.
Results: Aggregate data show that, over a 6 month QI study period, HPV vaccine series initiation increased 13% (206/393, 52% to 270/416, 65%, p < 0.05) and HPV vaccine series completion increased by 13% (134/204, 66% to 173/219, 79%, p<0.05). Overall, missed opportunities for vaccination decreased by 15% from 229/461 (50%) to 173/498 (35%) (p<0.05). When further stratified, a reduction in missed opportunities for vaccination was seen across all visit types (well child, acute, follow up, and nurse visits). Conclusion(s): Combining QI education with systematic practice-level interventions is associated with increases in HPV vaccine initiation and completion rates, and a decrease in missed opportunities to administer HPV vaccine to appropriate 11-12 year olds.
Authors/Institutions: Cynthia Bonville, SUNY Upstate Medical University, Syracuse, New York, United States; Joseph Domachowske, SUNY Upstate Medical University, Syracuse, New York, United States; Manika Suryadevara, SUNY Upstate Medical University, Syracuse, New York, United States