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Rules and Tools That Improved Vaccines for Children Vaccine-Ordering Practices in Oregon: A 2010 Pilot Project

Hewett, Rafe BS; VanCuren, Anne BA; Trocio, Loralee MPH; Beaudrault, Sara BS; Gund, Anona MPH; Luther, Mimi BS; Groom, Holly MPH

Journal of Public Health Management and Practice: January/February 2013 - Volume 19 - Issue 1 - p 9–15
doi: 10.1097/PHH.0b013e3182464778
Original Articles

Objective: This project's objective was to enhance efforts to improve vaccine-ordering efficiencies among targeted clinics using publicly purchased vaccines.

Design: Using an assessment of ordering behavior developed by the Centers for Disease Control and Prevention, we selected and trained immunization providers and assessed improvements in ordering behavior by comparing ordering patterns before and after the intervention.

Setting: A total of 144 Vaccines for Children program providers in Oregon.

Participants: We assessed 144 providers trained in the Economic Order Quantity process between January and November 2010.

Intervention (if applicable): Providers were invited to participate in regional trainings. Trainings included assignment of ordering frequency and dissemination of tools to support adherence to the recommended ordering frequency.

Main Outcome Measure(s): The percent increase in targeted clinics ordering according to recommended order frequency and the resulting decrease in orders placed, as an outcome of training and ordering tools.

Results: Only 35% of targeted providers were ordering according to the recommended ordering frequency before the project began. After completing training, utilizing ordering tools and ordering over a 7-month period, 78% of the targeted clinics were ordering according to the recommended frequency, a 120% increase in the number of clinics ordering with the recommended frequency. At baseline, targeted clinics placed 915 total vaccine orders over a 7-month period. After completing training and participating in the Economic Order Quantity process, only 645 orders were placed, a reduction of 30% .

Conclusions: The initiative was successful in reducing the number of orders placed by Vaccines for Children providers in Oregon. A previous effort to reduce ordering, without the use of training or tools, did not achieve the same levels of provider compliance, suggesting that the addition of staff and development of tools were helpful in supporting behavior change and improving providers' ability to adhere to assigned order frequencies. Reducing order frequency results in more efficient vaccine ordering patterns and benefits vaccine distributors, Oregon Immunization Program staff, and provider staff.

This study aims to enhance efforts to improve vaccine-ordering efficiencies among targeted clinics using publicly purchased vaccines.

Oregon Immunization Program, Oregon Health Authority, Portland (Mr Hewett, Mss VanCuren, Trocio, Beaudrault, Gund, Luther, and Groom); and Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Groom).

Correspondence: Rafe Hewett, BS, Oregon Immunization Program, Oregon Health Authority, 800 NE Oregon St, Ste 370, Portland, OR 97232 (rafe.g.hewett@state.or.us).

The findings and conclusions in this article are those of the authors and do not necessarily reflect the views of the funding agency. No financial conflict of interest was reported by the authors of this paper. All authors have approved this paper for submission.

This project was supported by the Centers for Disease Control and Prevention through the Economic Order Quantity grant (28054009).

The authors thank Julie Orta, Ryan Bays, Barbara Laymon, and Mike Bell for their input and assistance throughout this project.

The authors declare no conflicts of interest.

© 2013 Lippincott Williams & Wilkins, Inc.