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Am J Med Qual. 2008 May-Jun;23(3):176-83. doi: 10.1177/1062860608314938.

Improving immunization rates: initial results from a team-based, systems change approach.

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  • 1American College of Physicians, Philadelphia, Pennsylvania 19106, USA.



The American College of Physicians (ACP) developed a quality improvement (QI) program to address deficiencies in immunization rates, primarily for influenza, and determine the program's impact on adult immunization.


An interventional study using a pre-post design. Three cohorts of physician practices were invited from a random sample of 2000 to attend 1-day training sessions in 2004, 2005, and 2006 in Philadelphia, Pennsylvania. Participants performed data abstractions and developed QI plans. Baseline data were compared with follow-up.


Fifty-five practices received training, 39 practices provided baseline data, and 11 practices provided follow-up data, reporting on 4208 patients. Baseline rates for influenza were 51% for cohort 1, 42% for cohort 2, and 59% for cohort 3. Follow-up data collection is ongoing.


Rates increased for patients with private insurance and patients aged 50 to 64 years, suggesting that many providers attending the training were unaware of the need to vaccinate these patients.

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