10 Practical Tips to Increase Early Childhood

Immunization Coverage Rates Karen Dickenson-Smith MPH MBA PROSCI®

Anup Samra RN BScN

Dr. Shovita Padhi MD MPH FRCPC

Fraser Health Authority

Disclosure Statement

Dr. Shovita Padhi and Anup Samra were involved with a Novartis

study on Fluad intention to immunize

Introduction & Purpose

Fraser Health is the largest, most diverse, and fastest growing health authority in BC. We in the Population & Public Health program increased our regional 2-year old immunization coverage rate by 5% in less than one year, and we’re here to share our Top 10 Tips

2-Year Old Immunization Coverage Rates in Fraser Health

2011/12 2012/13 2013/14 2014/15 2015/16 2016/17*

Up-to-date for age 68.4% 70.9% 67.8% 69.0% 72.9% 76.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

% c

hild

ren

Percent of 2-Year Olds with Up-To-Date Immunizations in Fraser Health Authority, Fiscal Year 2011/12 to 2016/17*

*Data for 2016/17 include the period from April to Sept (Q1-Q2) of the fiscal year extracted on Oct 7,2016. Data sources are iPHIS (prior to 2015) and Panorama (2015 onwards).

Background & Context

2014 Measles outbreak in the Fraser Valley

Decision to focus on 2-year old coverage rate and aim for herd immunity

Provincial Target of

90% by 2023

2014 Review of 2-year old Immunizations in Fraser Health – Key Findings: (i) Drop off at 12-18 months (ii) Data issues

Change Fatigue

Multiple Reorganizations – Organization & Program level

Centralization of Public Health Administrative Functions -> Roll-out of Centralized Client Appointment Booking

Centralization of regional Communicable Disease Nursing

Implementation of new modules for Panorama Public Health Information System

Arrival of Syrian Refugees – Public Health leadership in coordination of immunization clinics with Primary Care

Top 10 Tips 10. Make Early Childhood

Immunization Rates an organization-wide key performance indicator

9. Communicate a compelling reason to staff

8. Incorporate evidence and feedback data from clients and practitioners

Top 10 Tips cont’d. 7. Utilize a structured change management approach

6. Provide regional structure and accountability AND the freedom to experiment locally / geographically

5. Examine clinic capacity and the potential need for resource re-allocation

4. Support creative use of clinical and non-clinical supports

3. Have the courage to look internally and make client-centred improvements

2. Standardize immunization appointments, access indicators and data entry timelines

Top 10 Tips cont’d.

Top 10 Tips cont’d. 1. Regularly review and

communicate meaningful data

Summary

Increasing your 2-year old immunization coverage rate IS possible if you make it an organizational priority and utilize focused change management and a client-centred,

data-driven approach

Acknowledgments Christina Fung, Epidemiologist, Fraser Health

Rachel Douglas, Evaluation Specialist, Fraser Health

Dr. Michelle Murti, Medical Health Officer, Fraser Health

Sherry Baidwan, Public Health Manager, Fraser Health

Steven Eng, Manager, Planning & Systems, Fraser Health

Population & Public Health Leadership, Fraser Health

Public Health Unit Teams, Fraser Health

Christine Halpert, former Fraser Health

Marilyn McIvor, Consultant