• Institute for Clinical Systems Improvement (ICSI). Immunizations. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2008 Oct. 64 p. [67 references]

Does not apply to this measure

This measure is used to assess the percentage of two-year-old patients who are on time with their primary series of immunizations (DTaP, IPV, MMR/MMRV, PCV7/PPV23, VZV, Hib, Hep B, Hep A, Rota, Influenza).

The priority aim addressed by this measure is to increase the percentage of patients who are on time with recommended immunizations.

Immunization; diphtheria, tetanus toxoids and acellular pertussis vaccine (DTaP); inactivated poliovirus (IPV); measles, mumps, rubella and varicella (MMR/MMRV); pneumococcal 7 valent conjugated polysaccharide vaccine/pneumococcal 23 valent polysaccharide vaccine (PCV7/PPV23); varicella vaccine (VZV); Haemophilus influenza type b conjugate vaccine (Hib); hepatitis B vaccine (Hep B); hepatitis A vaccine (Hep A); Rotavirus vaccine (Rota); Influenza vaccine

Number of children in the medical group's practice reaching the age of two years within the reporting month (see the related "Denominator Inclusions/Exclusions" field in the Complete Summary)

Number of children in the denominator who are on time with their primary series of immunizations (see the related "Numerator Inclusions/Exclusions" field in the Complete Summary)

• A clinical practice guideline or other peer-reviewed synthesis of the clinical evidence

Unspecified

Current routine use

Internal quality improvement

Physician Group Practices/Clinics

Physicians

Group Clinical Practices

Age 2 years

Either male or female

Unspecified

Unspecified

Unspecified

Unspecified

Unspecified

Unspecified

Staying Healthy

Effectiveness

Users of care only

Children who reach their second birthday during the specified time period

Select a random sample of the eligible population for data collection. The suggested sample size for each medical group is at least 10 each month. If the medical group identifies a total of fewer than 10 children, then all identified children are to be included.

The medical record of each child is reviewed to determine if each of the required immunizations is documented. A child should be considered on time with the immunization if and only a date and type of vaccination are documented in the medical record.

The suggested time period for data collection is a calendar month.

Patients associated with provider

Inclusions
Number of children in the medical group's practice* reaching the age of 2 years within the reporting month

*"In the medical group's practice" is defined as a child who has been seen two or more times by the medical group (including office visits and urgent care) by his/her second birthday. At least one visit should be after the child reaches 15 months of age.

Exclusions
Unspecified

All cases in the denominator are equally eligible to appear in the numerator

Encounter
Patient Characteristic

Time window is a single point in time

Inclusions
Number of children in the denominator who are on time with their primary series of immunizations:

• DtaP -- Diphtheria, tetanus toxoids and acellular pertussis vaccine
• IPV -- Inactivated poliovirus
• MMR/MMRV -- Measles, mumps, rubella and varicella
• PCV7/PPV23 -- Pneumococcal
• VZV -- Varicella vaccine
• Hib -- Haemophilus influenza type b conjugate vaccine
• Hep B -- Hepatitis B vaccine (schedule 1 and schedule 2)
• Hep A -- Hepatitis A vaccine
• Rota -- Rotavirus vaccine
• Influenza vaccine

Note: Dosing schedule is subject to change, depending on manufacturer's recommendations. Refer to the Immunization table and corresponding annotations in the original measure documentation for specific administration criteria.

Exclusions
Unspecified

The measure results are somewhat or substantially under the control of the health care professionals, organizations and/or policymakers to whom the measure applies.

Fixed time period

Medical record

Individual Case

Unspecified

Rate

Better quality is associated with a higher score

Unspecified

Internal time comparison

Unspecified

Percentage of two-year-old patients who are on time with their primary series of immunizations.

• DtaP -- Diphtheria, tetanus toxoids and acellular pertussis vaccine
• IPV -- Inactivated poliovirus
• MMR/MMRV -- Measles, mumps, rubella and varicella
• PCV7/PPV23 -- Pneumococcal
• VZV -- Varicella vaccine
• Hib -- Haemophilus influenza type b conjugate vaccine
• Hep B -- Hepatitis B vaccine (schedule 1 and schedule 2)
• Hep A -- Hepatitis A vaccine
• Rota -- Rotavirus vaccine
• Influenza vaccine

Institute for Clinical Systems Improvement

The following Minnesota health plans provide direct financial support: Blue Cross and Blue Shield of Minnesota, HealthPartners, Medica, Metropolitan Health Plan, PreferredOne and UCare Minnesota. In-kind support is provided by the Institute for Clinical Systems Improvement's (ICSI) members.

Work Group Members: James Nordin, MD (Work Group Leader) (HealthPartners Medical Group) (Pediatrics); Emma Carlin, MD (Park Nicollet Health Services) (Family Medicine); Barbara Yawn, MD (Olmsted Medical Center) (Family Medicine); Abinash Virk, MD (Mayo Clinic) (Infectious Disease); Barb Ottis, RN (Park Nicollet Health Services) (Nursing); Renner Anderson, MD (Park Nicollet Health Services) (Pediatrics); Robert Jacobson, MD (Mayo Clinic) (Pediatrics); Sarah Rall, PharmD (Marshfield Clinic) (Pharmacy); Penny Fredrickson (Institute for Clinical Systems Improvement) (Measurement/Implementation Advisor); Melissa Marshall, MBA (Institute for Clinical Systems Improvement) (Facilitator)

ICSI has adopted a policy of transparency, disclosing potential conflict and competing interests of all individuals who participate in the development, revision and approval of ICSI documents (guidelines, order sets and protocols). This applies to all work groups (guidelines, order sets and protocols) and committees (Committee on Evidence-Based Practice, Cardiovascular Steering Committee, Women's Health Steering Committee, Preventive & Health Maintenance Steering Committee and Respiratory Steering Committee).

Participants must disclose any potential conflict and competing interests they or their dependents (spouse, dependent children, or others claimed as dependents) may have with any organization with commercial, proprietary, or political interests relevant to the topics covered by ICSI documents. Such disclosures will be shared with all individuals who prepare, review and approve ICSI documents.

Dr. Robert Jacobson serves on the data safety monitoring board for Kaiser Permanente of Southern California overseeing a Gardasil trial. He receives less than $10,000 for this commitment.

Barbara Ottis, RN holds stock in Merck and Baxter. She also received speaker fees from GSK in an amount less than $10,000.

Dr. Barbara Yawn negotiated research funds on behalf of Olmsted Medical Center from Merck. Dr. Yawn receives less than $10,000 from Merck for serving on the advisory board for Zostravax.

No other work group members have potential conflicts of interest to disclose.

Measure was not adapted from another source.

2003 Jul

2008 Oct

This is the current release of the measure.

This measure updates a previous version: Institute for Clinical Systems Improvement (ICSI). Immunizations. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2007 Oct. 67 p.

• Institute for Clinical Systems Improvement (ICSI). Immunizations. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2008 Oct. 64 p. [67 references]

This NQMC summary was completed by ECRI on April 19, 2004. This NQMC summary was updated by ECRI Institute on October 11, 2004, August 11, 2005 July 17, 2006, December 26, 2007, and again on November 26, 2008.

This NQMC summary (abstracted Institute for Clinical Systems Improvement [ICSI] Measure) is based on the original measure, which is subject to the measure developer's copyright restrictions.

The abstracted ICSI Measures contained in this Web site may be downloaded by any individual or organization. If the abstracted ICSI Measures are downloaded by an individual, the individual may not distribute copies to third parties.

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