Unifying Statewide Efforts to Improve Immunization Rates in North Dakota

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Description: In the largely rural state of North Dakota, Medicare claims data does not provide a complete picture of true adult immunization rates, as it excludes those for whom the roster billing method is used – such as all rural health clinics. The Great Plains Quality Innovation Network (QIN) – the QIN-QIO for Kansas, Nebraska, North Dakota and South Dakota – sought to ensure complete tracking, documentation and reporting of data, and the use of best practices in improving adult immunization rates. Ultimately, the QIN aims to have all immunization providers – including those located in rural areas – included in its interventions to improve immunization rates, which will implemented by Fall 2016.

To accomplish its goals, the Great Plains QIN – through North Dakota-based Quality Health Associates – established partnerships with the North Dakota Department of Health, the State Association of City and County Health Officials (SACCHO), and local public health units. First, the Great Plains QIN conducted an environmental scan in conjunction with the State Health Department Adult Immunization Coordinator to determine where they could pool efforts, thus streamlining immunization work with participating providers. The QIN also introduced its immunization initiative to executives from local public health units and directors of nursing at a SACCHO meeting, then followed up with a letter inviting public health units to join the North Dakota Population Health Collaborative with a focus on immunizations.

Results: To date, 13 local public health units, including 26 counties – some with the lowest immunization rates in the state – have joined the North Dakota Population Health Collaborative. The Great Plains QIN’s collaboration with the North Dakota Department of Health also has led to joint immunization efforts with nursing homes and will soon expand to local public health units and clinics.