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  • Title: Re-engineering the primary care practice to eliminate adult immunization disparities.
    Author: Rust G, Strothers HS, Zimmerman RK.
    Journal: Ethn Dis; 2005; 15(2 Suppl 3):S3-21-S3-6. PubMed ID: 15945363.
    Abstract:
    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.
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