Improving pediatric immunization rates in a safety-net delivery system.

BACKGROUND: Denver Community Health Services (DCHS)' goal was to increase childhood immunization rates in the high-risk pediatric patient population served through its safety-net delivery system. The specific goal of the initiative was to ensure that children younger than 3 years of age with at least one primary care visit received all recommended vaccines by 24 months of age. METHODS: An immunization registry was developed to accurately track patients- regular assessment of immunization levels were conducted with provision of clinic-specific feedback- and team-based quality improvement meetings were held. The computerized immunization registry assisted in implementing all the remaining improvement activities. For example- improvement of on-time delivery of vaccines in primary care clinics was accomplished through a rules engine in the vaccine registry- standing orders for vaccine delivery- and implementation of vaccine delivery protocols that eliminated missed opportunities. RESULTS: From 1995 to 2006- Denve