Feedback Incentives eXchange (AFIX)
is the cornerstone of the AFIX process. Assessment
refers to the evaluation of medical records to ascertain
the immunization level for a defined group of people. This step, along with feedback of the
results, is essential because most providers overestimate
their practice’s immunization rates. Accurate
assessments done in provider settings can identify
overall coverage levels and pinpoint problem areas
that the provider may not have known existed.
It enables providers and their staff to make
data-based decisions on how to improve performance.
results from an assessment can be used to guide strategies for improving
immunization service delivery and office policies. Continuous, ongoing assessments of performance are also essential
in order to effectively monitor change in provider behaviors and practices. Assessment
purpose of an assessment is to:
service delivery problems
useful changes in policy and practice
and refine interventions.
has developed an assessment software known as
(Comprehensive Clinic Assessment Software Application).
CoCASA is widely used and is instrumental for efficient and effective
assessments in provider offices. CoCASA
can be downloaded from the NIP website or obtained on CD-Rom or diskette
from NIP. The time necessary
for the assessment depends upon which assessment
method is selected and the quality of the recordkeeping practices
at the provider office.
CoCASA provides detailed reports on the
specific diagnosis of the problem, for example, whether children start
their series on time, whether and when patients drop out of the system,
and whether vaccines are given simultaneously.
CoCASA also can help to raise awareness regarding issues such as record
keeping and documentation and the need for reminder and recall systems.
order to conduct an accurate, reliable assessment,
issues such as how immunizations are documented,
what type of
will be used, how to determine sample size and selection,
and the development of assessment working definitions
need to be addressed prior to the actual assessment
definitions for “active clients” and children in
the Moved or Going Elsewhere (MOGE) category, for
example, should be established and agreed upon if
comparisons are to be made to other provider sites.
In general, standardized data collection allows
for more accurate comparability among provider types
within and between states. CDC has outlined several
assessment methods to assist public and private providers
in assessing their immunization coverage levels.
For technical details on planning and conducting
provider assessments, please refer to Assessment
page last modified on January 3, 2006.