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Action plan to increase your practice immunisation rate |
The actions listed have been developed to help increase practice immunisation percentages calculated by the ACIR. These are sent to practices registered for GPII quarterly. The division can access your quarterly reported percentage for your practice’s use.
For the action plan to be used effectively, indicate on the sheet what processes your practice is already using. Note which systems you could put in place immediately and then indicate the suggestions that the practice can work towards.
- Send your encounter forms in weekly. Before encounter forms are sent check the information is correct and that crosses are made inside the boxes.
- Check encounter copies against ACIR Statement of Payment to ensure all encounters have been paid.
- Correct unpaid encounters using the codes on the statements. Query all unpaid claims. Some will list the reason for non-payment as immunisation given by another provider. The original information may have been derived from the History Summary Form, which was processed through Centrelink before the encounter form was submitted by the practice. Resubmit your claim.
- Make sure your surgery is receiving the ACIR020A reports of overdue children. Ring the ACIR helpline for a hard copy or order an electronic report from the web.
- Allocate the task of data cleaning to a staff member/s. Because of patient privacy, it is essential that this work be carried out away from the main desk. Separate time needs to be allotted.
- Compare the ACIR020A report with the child’s known history. Correct the report where possible. Take the opportunity to fill in gaps that your practice may have in the child’s records with recorded history from the ACIR020A.
- Watch for children being ‘doubled up’ through one name being misspelt or wrong birth date on an encounter. Notify ACIR.
- Send in amended histories of patients to ACIR to data clean the records. Amendments can be made on a printed summary from your computerised patient notes. Changes to be written on this printed page. (See “Recalling Children Identified as Unimmunised using the ACIR020A report” for more information.) This can be sent in the same envelope as your encounters.
- Call or send letters to parents informing them of their child’s incomplete immunisation record. Patents should be advised to make an appointment with the doctor to discuss immunisation issues, ‘catch up’ their immunisation or ask the parents to provide proof of their child’s completed schedule (blue book).
- Be familiar with the ACIR website. It is an easy way to answer questions about individual’s immunisation status if you don’t have the information in the patient’s notes. Access is gained by applying through the website (www1.hic.gov.au)
- Have a complete immunisation history of children, less than 7 years old, who attend the practice. Make sure the immunisation summaries are entered in the patient’s file.
- Ask new families to bring their blue books in with them so that the immunisation history page at the back can be photocopied and entered into their files at a convenient time. Make sure the child’s name is on the page.
- A note needs to be made in the child’s immunisation summary or records, if their parents are conscientious objectors. If possible, include a reason eg. ‘Parents waiting until the child is two so there is less chance of SIDS’. These parents may be contacted at a later date or if the vaccine is refined/changed.
- Increase the chances of opportunistic immunisation by adding a reminder to all the children due/overdue. A note or encounter form can be put prominently in patient’s paper files or ‘flagged’ in the computer file.
- Encourage your doctors to ask about a child’s immunisation history if it is not known by the practice, as part of the consultation. Especially for new children to the practice.
- Keep in mind that the immunisation percentage rates are assessed quarterly: February, May, August and November. Make sure all relevant information is sent before the end of the quarter (ie. amendments, encounter forms etc). The next ACIR020A report should be delivered to the surgery the first month of the new quarter. Consider entering encounters though the website. If this is too time consuming, enter them for the last month of the quarter so you can be sure they are included in ‘that’ quarter.
- Obtain a report from your computer’s medical software under the “Files” –“Immunisation” or “Tools” – “Recall” (MD) section or request a ACIR 0210A, of all the children overdue/due. By using either of these reports you should be catching the children before the ACIR020A report (90 days overdue). By mail merging a letter can be sent to the parents of these children. Check for conscientious objector / medical contraindications before contacting parents.
- Older children requiring catch up vaccinations may not need to have HIB/Pedvax to complete a regular schedule. They will be counted as incomplete. Print a copy of the child’s immunisation summary and explain the situation on the bottom of the sheet. See page 47 & 48 of The Australian Immunisation Handbook 7th edition as references for catch up schedules for HIB. Send explanation to ACIR.
Things to remember about the ACIR reports and practice immunisation percentages:
- 7 year olds are not included in the percentages.
- A child is labelled by ACIR as overdue if the due date for an immunisation is exceeded by 90 days.
- Every practice that a child attends in the last 12 months, will receive notice via the ACIR 020A and ACIR021A, if that child becomes overdue.
- If a child only attends a practice once, they will be included in the reports but will not be included in the practice’s percentages.
- A child who attends the practice twice in twelve months, will be included in the practices percentages, whether their schedules are complete or incomplete.
- Conscientious objectors will always be counted as incomplete even if a conscientious objector form has been filled out and sent.
- ACIR does not keep record of immunisations administered before 1996.
- A child will be considered as complete if they have had all their age appropriate immunisations but missed the first Hep B given at birth.
- If a child hasn’t attended a practice for 12 months, it will no longer be included in the percentages for that practice.
- The percentages are calculated over the 12 month period. The results given are 6 month retrospective. The results released in May are for the 12 month period ending in the previous November. Results released in August are for the period ending in February etc.
- Practices that enter their encounters through the ACIR website have less problems with payments and confusion about data. Encounter forms don’t need to be sent if they are entered straight onto the website. This method of entering encounters allows the ACIR to be more accurate as the information is available instantly and practices aren’t waiting an extended period for conformation, recognition and payment.
- An asteric near the child’s name will indicate a known double, that is, the overdue child is noted on two Medicare cards and so may be reported twice, at different addresses. This child is only counted once in your percentages.
For any assistance regarding ACIR and the ACIR reports contact ACIR help line on 1800 653 809.
For assistance with the ACIR website, please call the helpdesk on 1300 650 039.
If I can be of assistance, I can be contacted at the Northern Rivers Division of General Practice on (02) 6622 4453 or gmcdonald@nrdgp.org.au.
Gae McDonald is the immunisation project officer for the Northern Rivers Division of General Practice.
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