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Vaccine Preventable Disease in NJ: Improving Outcomes. Peter Tabbot, NJCEPH Project Director Mitchel Rosen, UMDNJ-School of Public Health MLC-3 Open Forum - State Sharing Session September 2009. NJ Public Health System. NJ Department of Health and Senior Services
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Vaccine Preventable Disease in NJ: Improving Outcomes Peter Tabbot, NJCEPH Project Director Mitchel Rosen, UMDNJ-School of Public Health MLC-3 Open Forum - State Sharing Session September 2009
NJ Public Health System • NJ Department of Health and Senior Services • County, regional and municipal departments • Local Boards of Health • Practice Standards of Performance for Local Boards of Health • Performance evaluation instrument
Selecting Target Areas • Process Outcome: Steering Committee • Health Outcome: Applicants (ranked) • VPD selected by both mini-collaboratives • The composition of our mini-collaboratives…
Selecting Participants • Online application process; bidder’s conference call • Seven applicants • Scoring • Final selection: • Quality of application • Capacity & sustainability • Geography & demographics
Two Groups, Two Approaches Monmouth • Intent was to educate non-vaccinating parents about safety/importance of childhood vaccinations • Sought out local data as first step (PLAN) • Lack of reliable/complete/ current data became a concern • Result: Shift in aim statement / focus area
Monmouth GPHP What the Data Showed • Immunization rates* • ‘Adequate’ compliance until 12 mos. • Not HP2010, but close…. • At 24 months, rate dropped to 69% • But still incomplete data • Shifted from education to data collection • Needed to gather reliable local rates • Needed to implement process to do so
Monmouth GPHP • Developed retrospective audit process for use during routine pre-school immunization audits PLAN: • Assessed and selected existing immunization audit form • Develop sampling protocol of 10% of pre-school population, aged 36 - 60 mos. DO: • Each dept. performed audits, Feb - May ‘09 • Assessed local Immunization Exemption reports
Monmouth GPHP STUDY: • 818 records collected • CoCASA employed by epidemiologist to assess immunization rates • Reports shared and reviewed by MC members in July ACT: • MC is evaluating frequency of repeat audits • Upcoming NJSIIS implementation will influence decisions
Monmouth GPHP Next Steps • Careful analysis of data to define education effort • Development of targeted education • Dissemination of materials as appropriate
Southern GPHP • Focused on development of HCP ‘tools’ for patient education (re: childhood immunization) • Focus on prenatal, including: OB/GYN, childbirth educators and others • Surveyed HCP to assess preferred mode of education materials
Southern GPHP PLAN • Assessed HCP preferred mode of education materials • “Tip cards” selected as mode of education • Developed list of 36 objections to immunizations for ‘counter’ statements DO • Divided ‘objections’ among GPHP participants for response development • Researched science-based responses; credible sources for additional information
Southern GPHP STUDY • Evaluate each objection response for validity, clarity of message, etc.. ACT • Pilot tip cards with locally-identified HCPs • Partner with local vaccine producer to assist with material review/development • Distribute ‘toolkit’ in fall to identified providers
Improvements Overall • Improved planning capacity for those involved • Increased regional collaboration • Established foundational QI knowledge and application • Developed unified PH response to anti-vaccination voice
Improvements Specifics • Development of replicable audit process to gather local immunization data • Gathering of reliable baseline immunization data • Development of educational ‘toolkit’ that can be distributed regionally and replicated by other departments
Next Steps Monmouth • Develop education effort to address findings (possibly apply Southern GPHP’s) • Continue to review exemption reports Southern • Implement campaign to provide HCP with easy-to-use resources for parental education
Sustainability • Mini-collaboratives to participate in ‘round two’ learning sessions • All story boards/resources to be posted on NJCEPH website • Retreat and implicit/designed mentoring • Showcase at future local and regional conferences