Re-Engineering the Primary Care Practice to Eliminate Adult Immunization Disparities
George Rust, MD, MPH;
Harry S. Strothers, III, MD, MMM;
Richard K. Zimmerman, MD, MPH
Traditional ``one-patient-at-a-time,'' doctor-centered primary care practice models do not achieve optimal immunization rates for pneumonia and influenza, in part because of time pressures and competing demands from a burgeoning list of clinical guidelines. Some widely used quality improvement methods (physician education, provider feedback, academic detailing, etc.) have only a modest and short-lived impact on improving immunization rates. Evidence is mounting that practices can substantially improve immunization rates by changing practice systems and processes with standing orders and algorithms, expanded nurse decision-making, patient education and incentives, and partnerships with community-based pharmacies. Quality-focused, constantly-learning practices that cultivate a culture of excellence will be most effective in adopting such changes.
(Ethn Dis. 2005;15[suppl 3]:S3-21-S3-26)
Key Words: Health Disparities, Immunizations, Influenza, Primary Care, Quality Improvement
From the National Center for Primary Care and the Department of Family Medicine,
Morehouse School of Medicine Atlanta, Georgia (GR, HSS); and the Department of Family Medicine,
University of Pittsburgh School of Medicine; Pittsburgh, Pennsylvania (RKZ).
Address correspondence and reprint requests to:
George Rust, MD, MPH
National Center for Primary Care
Morehouse School of Medicine
720 Westview Drive SW
Atlanta, GA 30310
404-756-8908
grust@msm.edu
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