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Arch Pediatr Adolesc Med. 1999 Nov;153(11):1165-9.

Impact of resident feedback on immunization outcomes.

Author information

1
Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30303, USA. crust@emory.edu

Abstract

OBJECTIVE:

To investigate the effect on immunization levels of retrospective written feedback to residents regarding missed immunization opportunities.

DESIGN:

Randomized trial with control group.

SETTING:

Pediatric resident continuity clinic in an urban hospital-based primary care clinic.

PARTICIPANTS:

Thirty-two postgraduate level 2 and postgraduate level 3 pediatric residents.

INTERVENTION:

Monthly retrospective written feedback mailed to residents detailing their missed immunization opportunities and appointment failure rates over a 12-month period beginning in February 1997.

MAIN OUTCOME MEASURES:

The immunization level of 2-year-old children in the resident clinic was the main outcome of interest. Secondary outcomes included missed immunization opportunity rates and appointment failure rates.

RESULTS:

Postintervention immunization levels were 71.4% (95% confidence limits [CLs]: 63.2%, 78.7%) for patients from the intervention group and 68.5% (95% CLs: 60.8%, 75.4%) for patients from the control group. The immunization level for patients of both groups who had fewer than 2 visits during the second year of life was 47.2% (95% CLs: 38.2%, 56.3%). This compares with an immunization level of 78.1% (95% CLs: 66.0%, 87.5%) for patients from both groups who had 2 visits during the second year of life, and with an immunization level of 88.2% (95% CLs: 81.0%, 93.4%) for patients of both groups who had more than 2 visits during the second year of life (P<.001).

CONCLUSIONS:

In this setting, written retrospective feedback to residents was an ineffective strategy for improving immunization levels. Adequate follow-up during the second year of life is critical in achieving high immunization levels.

PMID:
10555719
[Indexed for MEDLINE]
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