MOBI TIES On-Demand Learning 6 Month Follow-Up Program * MOBI On-Demand Learning TIES On-Demand Learning Name * Date * Did you complete the entire self study? * Yes No BEST PRACTICES FOR OFFICE OPERATIONS 1. Are you willing to submit to an AFIX (Assessment-Feedback-Incentive-eXchange) measurement for your practice? Yes No 2. Is your practice a Vaccines for Children (VFC) provider? Yes No 3. How often does your practice provide a current Vaccine Information Statement (VIS) to parents prior to an immunization? * Never Rarely Sometimes Frequently Almost Always 4. Has the practice updated their vaccine policies/procedures since the On-Demand Learning session? * Yes No Don't have a policy 5. How often does your practice use the ImpactSIIS Registry to look up immunizations? * Never Rarely Sometimes Frequently Almost Always 6. How often does your practice check immunization status at every visit? * Never Rarely Sometimes Frequently Almost Always BEST PRACTICES FOR INCREASING VACCINE RATES 7. How often does your practice use an immunization REMINDER system? * Never Rarely Sometimes Frequently Almost Always 8. How often does your practice use an immunization RECALL system? * Never Rarely Sometimes Frequently Almost Always 9. Does your practice have a "go to" person for vaccine questions? Yes No 10. How often does your practice give all vaccines that are due, regardless of the number of injections? * Never Rarely Sometimes Frequently Almost Always 11. How often does your practice allow shots to be given to children with minor illnesses like colds, diarrhea or low-grade fever? * Never Rarely Sometimes Frequently Almost Always 12. How often does your practice allow patients to come in the same day for immunization-only nurses visits? * Never Rarely Sometimes Frequently Almost Always Is there anything else the MOBI/TIES office could do to improve this? 13. How often does the practice give age-appropriate vaccines even when no vaccine record is available? * Never Rarely Sometimes Frequently Almost Always 14. How often does your practice use combination vaccines? * Never Rarely Sometimes Frequently Almost Always VACCINE OBSTACLES 15. What would the practice say are the biggest obstacles to increasing your immunization coverage rates? (check all that apply) Time commitment Cost Staffing Parental Refusal No same-day immunization-only visits Nurses not authorized to immune if due Physician's decision I don't know N/A - we have incorporated the strategy(yes) into our practice Other Is there any way the Ohio AAP can assist with your vaccine program? If you are human, leave this field blank.
