Assessment, Feedback, Incentives, and eXchange
One of the most effective strategies for improving immunization coverage levels and adherence to standards of practice at the provider level is the use of the continuous quality improvement process known as Assessment, Feedback, Incentives, and eXchange (AFIX).
AFIX stands for:
- Assessment of immunization levels
- Feedback of immunization information to key staff
- Incentives to motivate and/or recognize outstanding performance
- eXchange of information on best practices to improve immunization coverage levels
During the "A" or assessment phase of AFIX, Immunization Program Field Staff assist providers in identifying opportunities for improving immunization coverage levels. An improvement goal is created. A plan is developed, implemented, and evaluated to determine if the goal was achieved. This process continues with revisions to the plan until the goal is met. The "F-I-X" components of the process are used to develop, implement, and evaluate the continuous quality improvement process.
The goal of AFIX is to ensure that viable vaccines reach all children served by the provider site in accordance with the Advisory Committee on Immunization Practices (ACIP) recommended immunization schedules and best practices. A successful AFIX process requires implementation of all four components and repeated contacts with a provider site. It requires the Immunization Program Field Staff and the provider site to become partners in improving immunization coverage levels.
The Comprehensive Clinic Assessment Software Application (CoCASA) software tool or the Florida SHOTS™ (Florida State Health Online Tracking System) is used to conduct the assessment component of AFIX. The assessment component is the foundation of the AFIX process. The other components build on the findings from the assessment. Field staff are mindful that all the components of AFIX interact and must be included when working with both public and private providers. Providers are encouraged to run their own assessments periodically. The Centers for Disease Control and Prevention (CDC) provides additional information on the CoCASA software tool.
Awards are given to Vaccines for Children Program providers who achieve high immunization rates. These providers receive certificates from the Immunization Program as recognition of thier acheivement.
- Gold Certificates of Superior Achievement are awarded to providers who achieve 95-100% coverage level.
- Silver Certificates of Outstanding Achievement are awarded to providers who achieve 90 - 94% coverage level.