Immunizing Provider Resources

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Vaccine Workflow for Improving Immunization Rates.Different icons of a calendar, checklist, award and person. Arrows directing from each step.

Contact Information

Email ochdvfc@oakgov.com or fax 248-858-2388.

Pre-vaccination and preparation. Different icons of a calendar, checklist, award and person. Arrows directing from each step.
Vaccination Workflow Topics Discussion Prompts Resources
  • Patient Demographic Information
    • Maintaining accurate demographic and contact information supports reminder/recalls
  • How does staff ensure that they can contact parents for scheduling appointments?
    • Does staff update patient demographic information in their EMR and MCIR?
  • Patient Vaccination Status
    • The ACIP schedule is built into MCIR to ensure that staff can inform parents of vaccines needed at the visit
    • Complete data in MCIR improves vaccine recommendations and accuracy of assessing reports
    • By assessing vaccination status at every visit, missed opportunities to vaccinate can be avoided and the message that vaccinations are important can be reinforced.
  • How does staff identify which doses are due for patient's visit?
    • Does staff print MCIR for every visit (including sick visits)?
    • Does staff enter new and/or historical vaccinations in both EMR and MCIR to ensure accurate immunization assessments?
    • Does staff ensure that all immunizations are entered/transferred into MCIR within 72 hours of administration, consistent with Michigan's public health code?
    • Print MCIR prior to appointment
    • Ensure EMR record and MCIR are both up to date and accurate
    • Does practice merge duplicate MCIR records for patients?
  • Vaccination Promotion
    • Making information about vaccines readily available saves time by helping patients and parents get their questions answered before they meet with you
    • Proactively sharing your vaccination policy lays the foundation for effective vaccine recommendations
    • Welcoming and answering questions helps patients and parents feel supported
  • Is clinic staff aware of the available resources from reputable organizations?
  • Does that provider include their vaccination policy in new patient packets? In the waiting room?
  • Are all staff trained to provide positive vaccine messaging about vaccines?
  • Patient Status in Immunization Information System (IIS)
  • Are staff managing patient active/inactive status?
Provider discussion and vaccine hesitancy. Different icons of a calendar, checklist, award and person. Arrows directing from each step.
Vaccination Workflow Topics Discussion Prompts Resources
  • Presumptive Recommendation
    • Research has shown an effective recommendation from healthcare professionals is the most important reason parents decide to vaccinate.
  • Does provider and all recommending staff utilize a presumptive approach for vaccine recommendation?
    • Utilize presumptive approach
    • Give personal examples and stories
    • Motivational Interviewing
    • Open Ended Questions
  • Vaccine Hesitancy
    • Providers are the patents' most trusted source of information about vaccination.
    • Welcoming and answering questions helps patients and parents feel supported.
  • Are providers familiar with common reasons why parents request alternative vaccine schedules?
  • How does the provider response when parents express concern?
    • Be empathic
    • Ask, Acknowledge, Affirm and Answer
    • Vaccine acceptance takes time, continue to discuss vaccination and address concerns at every visit
  • Establishing a pro-vaccine culture with the office
    • Pro-vaccine messaging should be present and consistent among all staff with the practice
  • Does the office promote vaccination?
  • Are all staff promoting a positive immunization culture?
Vaccination and Documentation. Different icons of a calendar, checklist, award and person. Arrows directing from each step.
Vaccination Workflow Topics Discussion Prompts Resources
  • Administration
    • Knowledge of proper documentation is essential to safe and effective vaccination.
  • Is clinic staff aware of the available resources from reputable organizations?
  • Does that provider include their vaccination policy in new patient packets? In the waiting room?
  • Are all staff trained to provide positive vaccine messaging about vaccines?
  • Does staff provide VIS to patients prior to vaccinations?
    • VIS should be Michigan Specific and include passive consent for immunizations to be entered in MCIR.
  • Are staff aware of how to make vaccination less stressful for both the patient and family?
  • Does staff educate patients on what to expect after vaccination?
  • Documentation
    • Complete vaccination data in MCIR improved vaccine recommendations and accurate of assessment reports.
  • Does the clinic document vaccine refusals?
    • Have parent/guardian complete a Vaccine Declination Form at every visit?
  • How and where do staff record information about the vaccines administered to the patient during their visit?
    • All administrations should be entered in MCIR within 72 hours of administration.
    • EMR/handwritten records should contain all the following items:
      • Date of administration
      • Address of clinic vaccine was given
      • VIS publication date
      • VIS given date
      • Vaccine manufacturer
      • Vaccine lot number
      • Name and title of person administering vaccine
      • Patient eligibility

*Best practice is also to include site and route of administration.
  • Scheduling
    • AAP recommends scheduling the next vaccination appointment to help keep track for vaccination.
    • The ACIP schedule is built into MCIR to provide date ranges for scheduling so staff can ensure future vaccination visits are scheduled at the correct interval. 
  • When is the next dose appointment discussed?
    • On-time vaccination depends upon returning for subsequent doses as recommended in the ACIP recommended immunization schedule. Scheduling the next visit before the patient leaves the office promotes adherence to the schedule by:
      • Explicitly specifying when future doses are due and why.
      • Establishing continuity of care by supporting the patient's return to the office.
      • Creating a commitment to return and reducing barriers to act on favorable intentions to vaccinate.
    • Discuss future doses and emphasize the importance of receiving doses on schedule by using presumptive language.
    • Provide information about future doses and reinforce the importance of staying on schedule.
    • Schedule the next vaccination visits with the parent either immediately before or after vaccine administration and provide update immunization record.
    • Give and/or send confirmation of the next appointment to the parent via text, email, or phone call.
  • Does clinic have immunization only appointments available?
  • How does the provider inform scheduling staff about when next doses are due?
  • How is this information recorded and shared with patients?

Post-Vaccination and Follow-Up

Post-Vaccination and Follow-Up. Different icons of a calendar, checklist, award and person. Arrows directing from each step.

Vaccination Workflow Topics Discussion Prompts Resources
  • Documentation
    • Providing an after-visit summary to the patient and guardian as a reminder when to return for the next vaccination.
  • If the parent requests a copy of their child's updated record, how does staff provide it?
  • Does staff inform the parent of the MCIR public access portal for patients 18 years and older?
  • Scheduling
    • AAP recommends scheduling the next vaccination appointment to help keep patients on track for vaccination
    • When providers give a clear date range to parents/guardians at check-out to staff for selecting the next appointment date, it helps ensure patients aren't vaccinated too early, thus avoiding invalid doses.
    • Ongoing communication is essential in making sure patients stay on schedule with vaccination.
  • How does staff identify next vaccines and due dates for scheduling next appointments?
  • How is this information shared with the parent? Does staff provide the parent an updated vaccination record with next doses and due dates? From where?
  • Are clear "on or after" date ranges provided by prescribers to help the parent and check-out staff schedule the next vaccination appointment If yes, who determines it?
  • Does staff offer to issue appointment reminders?
  • Vaccine Promotions
    • Providers are parents'/guardians' most trusted source of information about vaccinations
    • Making information about vaccines readily available saves time by helping patients and guardians get their questions answered before they meet with the provider
  • Do communications reminding parents about upcoming visits promote on-time vaccination?
  • Does the clinic promote their vaccination services or general positive vaccination messages in their communication to parents/patients?
  • Does the clinic website include links to positive vaccination messaging and resources from reputable organizations?

Related Links

Additional Info