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Family Medicine


Increasing Vaccination Rates of children up to 24 months old at PMG Milwaukie Family Medicine

Authors: Justin Ferley DO; Rachel Jackson MD; Aubrey Miller MD; Sebastian Reeve MD; Christelle Serra Van-Brunt DO; Jamie Skreen DO; Jeffrey Sun DO; John Yates MD; Daniel Ruegg MD

Introduction: Each year in the US, 42000 adults and 300 children die of vaccine preventable diseases. Yet across the country, clinics – including ours – fall short of the CDC Healthy People 2020 goals of pediatric vaccination rates. This resident-led quality improvement (QI) project aimed to improve our clinic vaccination rates in the under 24mo population.

Methods: We identified 3 opportunities for vaccinating children under our clinic current processes: well child visits, medical assistants’ vaccinations visits, and acute care visits. Using a multidisciplinary approach comprising residents, MAs, clinical care coordinators and our nursing quality supervisor, we analyzed our current vaccinations processes and our iterative plan-do-study- cycles (PDSA) included: PDSA #1: standardize our work flow for vaccine reconciliation. PDSA #2: sending personal reminder lebers to patients and overall improving our vaccine recall/ reminder system. PDSA #3: Minimizing provider variation for vaccines given at the 12-18mo WCC.

Results: We saw an improvement in our vaccinations rates after personalized reminder letters were sent out, outlining that we do not have a reliable vaccine schedule reminder system. We also noted that different providers created different vaccinations schedules in order to prevent giving 5 vaccines at the same $me – with no system in place to follow on missed vaccination, thus creating missed opportunities and suggesting that we need to implement a clinic-wide vaccine schedule.

Conclusion: Our last PDSA cycle was interrupted by current CIVD-19 pandemic. We have however found valuable data to help improve our clinic’s vaccination rates, and plan to continue this project over the next 2 years.


Family Medicine


Graduate Medical Education

Conference / Event Name

Academic Achievement Day, 2020


Providence Oregon Family Medicine Residency, Milwaukie, OR

Increasing Vaccination Rates of Children up to 24 months old at PMG Milwaukie Family Medicine