County Health Department Quality Improvement Site Visits
Yearly, County Health Department (CHD) site visits are chosen based on:
- Three-year visit cycle
- Two-year-old immunization coverage rates
- Changes in immunization staff at the CHD, a request for visit, and other identified concerns
Prior to each site visit, Immunization Program staff perform a comprehensive desk audit of county-specific and statewide data for the past three years, including:
- Vaccine-preventable disease cases reported
- Immunization coverage rates for one- and two-year-old children
- Kindergarten, seventh grade, and childcare immunization completion rates
- Perinatal hepatitis B case management activities
- Vaccine accountability
- Vaccine storage and handling issues
The QI site visit begins with an entrance meeting, in which the reviewer presents the desk audit data to key CHD staff, analyzing trends, special accomplishments, and areas in need of improvement.
Separate in-depth interviews are conducted with staff responsible for:
- Perinatal hepatitis B prevention and case management
- School immunizations
- WIC-Immunization Program linkage
Other Immunization Program areas included in the site review include:
- Vaccines for Children (VFC) Program requirements
- Standards for Child and Adolescent Immunization Practices
- Standards for Adult Immunization Practices
- CHD Guidebook Internal Operating Policies and Technical Assistance Guidelines
- Use of the Florida SHOTS™ (State Health Online Tracking System)
- Coalition/community partnerships and outreach activities
- VFC Program eligibility
- Ongoing staff education
- Vaccine management (e.g., storage and handling, inventory, accountability)
- Vaccine administration (e.g., risk/benefit information, administration procedures)
- Documentation
The site visit concludes with an exit meeting, in which key CHD staff return to receive an overview of the visit and develop agreements/strategies to address any findings.
Following the site visit, a written program summary report is prepared and sent to the CHD.
