Programs & Tools:
VFC-AFIX Quarterly
Conference Call Minutes
April 7, 2006
Vaccines for Children Program Topics:
On this page:
Participants:
CDC/NCIRD: Nancy Fenlon
Grantees: South Dakota, Idaho, Hawaii, Wyoming, Kansas, Maine, Vermont, Alaska, Louisiana, New York State, Iowa
Overview/Purpose of Call
Nancy Fenlon provided a brief overview of why this conference call was established. The first call occurred on March 10, 2006. The originating call members felt that the call should allow participants to share challenges and successes related to AFIX and VFC that are unique to rural areas. The call would also allow grantees to network with other individuals working in similar settings.
AFIX Standards
Active Patient
Question: Alaska requested feedback on definitions of active patient. Frequently, children may see a medical provider in an urban setting for an acute episode and actually receives well care in a public health clinic many hundreds of miles away. How do other grantees define active patient?
Answer: There are many different ways to define active patient. Several grantees used a specific number of visits within a certain time frame to determine if patient was active or inactive. One grantee defined inactive rather than active patient and required that the child’s chart show documentation that office was not successful in making contact with the family. This is similar to the original CDC definition of when a child could be considered moved or gone elsewhere (MOGE). One grantee defined active patient as a child seen in the previous 12 months and additional grantees used at least one well child exam as part of their definition. The important concepts to consider are to make sure the definition is standardized across the entire program. It is equally important that the definition allows for a fair assessment of the immunization practices of a provider’s entire population.
Feedback Practices
Question: Alaska had some concerns over the AFIX Standards Level I regarding the Feedback component requiring the feedback session to be face to face and within 10 days of the assessment. Alaska faces many challenges related to distance and travel. A large number of providers can only be reached by air travel so it is too costly to make a return visit for a separate feedback session. In general, when Alaska conducts site visits, the visits are combined VFC/AFIX visits. The staff will briefly review with office the VFC findings and send a letter outlining the AFIX findings.
Answer: The “gold standard” for the feedback session is face to face within 10 days of the assessment. The standard does state “Feedback sessions should be a face to face meeting with provider staff members unless there is a documented justification for not conducting the session in person.” Implementing a well constructed feedback session is a critical factor in moving AFIX at the provider level from a periodic visit to a continuous quality improvement process (CQI) that improves coverage levels. If there are logistical reasons that feedback cannot occur in a face to face meeting, then other methods can be used. It is important to use feedback to highlight what the office is doing well and engaging the office in QI activities related to immunization practice areas that could be improved. Written reports in conjunction with phone conversations and periodic telephone and written follow up to discuss findings and engage the office in developing activities to improve coverage levels could be utilized in situations that make face to face feedback impossible due to the cost of travel.
AFIX Process
Question: Alaska wanted to know if other states were having difficulty in meeting the grant requirement of conducting AFIX in 25% of the VFC enrolled providers.
Answer: Most of the call participants that responded reported meeting this grant requirement. Some grantees on the call even reported visiting 100% of their VFC enrolled providers with limited staff and large distances. It is important to note that the volume of visits should be balanced with quality of provider interaction. Developing and documenting a relationship with provider and engaging the provider in QI activities that creates improved coverage levels is as important as meeting the grant requirement.
Question: Wyoming requested insight on how to create a universal state and any pitfalls to avoid.
Answer: No grantee had any insight at this time. A list of how the grantees supply vaccine to providers can be located on the NIP website at:
www.cdc.gov/vaccines/programs/vfc/projects/data/vacc-supply-public-2005.htm
Next Call Information
Friday, May, 5, 2006 2:30 – 3:30 pm (Eastern). Joanna Briggs from Wyoming will lead the call due to the absence of CDC staff. Please forward any agenda items to Nancy Fenlon by April 24, 2006.
Call in Information for May 5th:
Time of call(s): 2:30-3:30 p.m. Eastern (60 minutes)
USA toll free dial in number: 1-800-593-0825
Passcode: 14638
Due to the number of participants and to avoid continuous disturbances during the conference call, all participants will join the call silently.
Trouble or questions: (404) 639-8208
Return to VFC-AFIX Quarterly Conference Call Minutes main page
Content last reviewed on January 30, 2007
Content Source: National Center for Immunization and Respiratory Diseases