Communication Techniques
A question that asks for additional detail.
What is an open-ended question?
Asking open-ended questions is key because it creates a receptive, open tone, and invites them to talk more in detail about their perspective.
Asking closed-ended questions may lead to passive participation in the discussion or responses that do not provide a complete picture of their perspective.
The minimum number of IQIP Core Strategies that must be chosen for implementation or improvement.
What is two?
Awardees must ensure each provider receiving an IQIP visit selects at least two QI strategies for implementation or improvement.
IQIP stands for....
What is Immunization Quality Improvement for Providers?
*Requirement: Awardees are required to initiate IQIP activities with 25% of CDC-defined IQIP candidate providers within their jurisdiction and to conduct timely check-in and follow-up activities with those providers already engaged in the process.
Documentation of the site visit in the IQIP Database is required within _____ business days after the site visit.
What is four business days?
Name the three components each action item should include.
What is
- Brief description of the task
- Identification of the person(s) responsible for the task
- Target date for completing the task?
Statements of support made to emphasize the provider staff has done well.
What are affirmations?
By affirming provider staff, the consultant recognizes their strengths and reinforces to them their ability to effect change.
Example: "You've put a lot of effort into learning how to run these reports. Great job!"
On-time vaccination and catch-up depend on parents choosing to vaccinate their children, and providers play a critical role in creating vaccine confidence. Implementing this strategy will support providers in addressing gaps in coverage that may exist due to low vaccine confidence.
What is Giving a Strong Vaccine Recommendation?
Parents usually consider their child’s healthcare professionals one of the most trusted vaccine information sources.
Best Practices for Strategy Implementation:
Use effective communication approaches (presumptive language, bundling approach, sandwiching recommendations, etc.) when recommending vaccines.
Listen to parents and seek to understand the concerns behind parents' questions before responding.
Reduce disparities/ promote vaccine equity by training providers to recognize the diversity within their community and acknowledge the systemic, cultural, and historical reasons, some patients may have low confidence in vaccines.
True OR False
The purpose of IQIP is to promote and support the implementation of provider-level strategies designed to increase on-time vaccination among child and adolescent patients in adherence to the Advisory Committee on Immunization Practices (ACIP)-recommended immunization schedule.
What is True?
Please select the correct order that the site visit should proceed.
1. Initiate the site visit with introductions, the purpose of the visit, and an overview of the IQIP process.
2. Review assessment reports to identify opportunities for improvement.
3. Discuss and select at least two IQIP strategies.
4. Develop action items for each strategy.
5. Conduct the vaccination workflow assessment by working through the First Workflow Point, Practice Management, to the Sixth Workflow Point, Patient Check-Out.
6. Review the findings of the provider’s vaccination workflow assessment in relation to the IQIP strategies.
7. Provide technical assistance as needed.
8. Wrap up by discussing the following steps and establishing check-in and follow-up dates.
A) 1, 2, 3, 4, 5, 6, 7, 8
B) 1, 5, 6, 2, 3, 4, 7, 8
C) 1, 3, 4, 7, 5, 2, 6, 8
D) 8, 7, 6, 5, 4, 3, 2, 1
What is B) 1, 5, 6, 2, 3, 4, 7, 8?
The site visit should proceed in the following order:
1. Initiate the site visit with introductions, the purpose of the visit, and an overview of the IQIP process.
2. Conduct the vaccination workflow assessment by working through the First Workflow Point, Practice Management, to the Sixth Workflow Point, Patient Check-Out.
3. Review the findings of the provider’s vaccination workflow assessment in relation to the IQIP strategies.
4. Review assessment reports to identify opportunities for improvement.
5. Discuss and select at least two IQIP strategies.
6. Develop action items for each strategy.
7. Provide technical assistance as needed.
8. Wrap up by discussing the following steps and establishing check-in and follow-up dates.
Action items should be SMART. SMART stands for ......
What is
- Specific
- Measurable
- Attainable
- Relevant
- Time-bound?
A communication skill that involves going beyond simply hearing the words that another person speaks.
What is attentive listening?
Make sure you know who you are addressing.
Look at the speaker and give them your undivided attention.
Give non-verbal cues that you are listening (head-nod, open posture).
Maintain an open posture and encourage them to continue with their thoughts.
Let them finish their thoughts before responding.
This core strategy focuses on implementing clinical and clerical processes that support keeping follow-up appointments.
What is Facilitate Return for vaccination?
Best Practices for Strategy Implementation:
Conduct routine training of current ACIP recommended immunization schedules.
Maintain accurate patient contact information to support scheduling and reminder and recall efforts.
Take action to prevent missed opportunities. Screen patients for vaccination eligibility at each visit.
Schedule next appointment prior to patient leaving.
Give parents a copy of current immunization record and list of future recommended vaccines with due dates.
Implement reminder and recall systems using more than one method (text, portal messages, emails, phone calls, etc.) to remind of upcoming appointments.
Track no-shows and cancelled appointments and contact those patients within the same week to reschedule.
Describe the IQIP Cycle.
What is Site Visit, 2-Month Check-in, 6-Month Check-In, and 12-Month Follow-Up?
Technical assistance and support are given via telephone 2 and 6 months after the site visit to aid providers in their strategy implementation. A final discussion of strategy implementation progress and sustainability of practice changes occurs after 12 months.
*Requirement: The 2- and 6-month check-ins and 12-month follow-up are not optional and must be conducted according to IQIP scheduling guidelines.
*Requirement: Documentation of the 2- and 6-month check-ins and 12-month follow-up in the IQIP Database is required within 4 business days after the check-in/follow-up.
*Requirement: If the 12-month follow-up will double as the site visit for a new IQIP cycle, then it must be conducted in person.
A staff member who takes the lead in promoting vaccination activities at the provider location and has different responsibilities than those of the VFC primary and VFC backup.
What is an Immunization Champion?
Practice management can increase support for vaccination by appointing someone to serve in the role of immunization champion if they have not done so already. During scheduling, the consultant should ask if the provider has someone on the staff currently in this role. If the provider does have an immunization champion, the consultant should ask that they participate in the site visit. If the provider does not have an immunization champion, proceed with scheduling the visit and be prepared to discuss the benefits of having a staff member serve in this role.
During the site visit, the consultant should ask about an immunization champion when discussing the practice management workflow point. If the immunization champion is present, the consultant asks what their role entails and then provides additional examples of other ways they can support vaccination in the practice. If the provider does not have an immunization champion, the consultant discusses the benefits of having someone in this role and encourages the provider to assign this responsibility to a staff member as an action item under any applicable IQIP core strategy.
For examples of how an immunization champion can promote vaccination in the clinic, see The Role of the Immunization Champion resource in the IQIP Library and the IQIP Database’s File Repository.
An awardee developed strategy that requires prior CDC approval.
What is a custom strategy?
An awardee may offer a custom strategy to providers along with the four core IQIP strategies. Only one custom strategy per awardee may be provided per project year. The custom strategy:
• May be new or based on an existing QI strategy.
• May focus on one or more vaccines.
• Must be based on available evidence or sound rationale.
• Must not be a component of one of the four core IQIP strategies.
• Must target a cohort of patients 18 years or younger.
• Must be presented as a strategy option to all providers with patients in the targeted age cohort.
*Requirement: Awardees must complete and send a custom strategy submission form to CDC for approval prior to offering it as an IQIP strategy. A custom strategy must not be entered into the IQIP Database prior to receiving CDC approval.
The practice of attentively listening during a discussion, then replying with a brief summary of what they said.
What is reflective listening?
A consultant who is practicing reflective listening appears open and receptive and delivers their response in a neutral tone of voice.
Example: "Are you saying that your front desk staff isn't really comfortable with the new scheduling procedures?"
The messengers and messages used to convey accurate information about vaccines are essential to combating mis/disinformation and improving vaccine confidence. Prioritizing clear, positive messaging about vaccination by all clinic staff creates an environment where patients and parents can have their concerns addressed and feel affirmed in their decision to vaccinate their child.
What is Strengthen Vaccination Communications?
Best Practices for Strategy Implementation:
Promote the provider's patient vaccination policy by sharing with all new and existing patients, including the policy in new patient packets, and displaying it in waiting areas and exam rooms.
Promote patient and parent education by including vaccine-related promotional materials in welcome packets for new patients and accessible locations throughout the clinic.
Promote vaccination on the practice's website and social media.
Promote vaccine equity by ensuring patient materials are in languages spoken within the provider's community are available.
Report required at the initial site visit and 12-month follow-up.
What is Vaccination Coverage Rate Report?
*Please review TennIIS QRG Coverage Rate Reports for IQIP Consultants.
*Requirement: CDC requires assessment of coverage for any provider receiving an IQIP site visit and 12-month follow-up if the provider has IIS data that are appropriate and available for assessment.
*Requirement: Awardees must assess both childhood and adolescent cohorts if the provider has any active patients in either cohort.
The review of assessment reports during the site visit is intended to help identify areas that might need attention for improvement in the processes and workflow.
Initial coverage data provide a baseline indicator of the provider’s on time vaccination performance
Reviewing assessment reports should be a conversation with staff, not a recitation of problems and flaws.
*Requirement: The 12-month follow-up coverage assessments must be run using the same parameters used for the initial coverage assessment.
Important provider staff that should participate in the IQIP visit.
What are physicians and other vaccine prescribers, immunization champion, QI Coordinator, nursing, and office management staff?
This is important because any workflow, policy, or procedure changes require their buy-in and approval. If conducting a combination VFC/IQIP visit, participation is needed from more than the VFC coordinator alone.
Materials, live demonstrations, role play, training, etc. are examples of ________.
What is technical assistance?
Tailored technical assistance is a critical component of an effective check-in. Consultants should come prepared with resources and training opportunities to advance the selected strategies. While discussing obstacles and new opportunities, the consultant should provide technical assistance that meets the specific needs of the provider staff. Consultants should not limit technical assistance to providing additional handouts; valuable activities may include live demonstrations, role play, training, etc. If there are time constraints during the check-in, technical assistance can be scheduled for a later date.
The CDC IQIP Resources Toolkit and IQIP Resources Index are great tools to support the IQIP process.
Questions designed to encourage deep thought about a specific topic, promote critical thinking, and help the respondent explore their thoughts and feelings on a particular issue.
What are probing questions?
Draws out a more detailed response.
Helps clarify a situation.
Can help pinpoint problems with the provider's workflow.
Can help understand why a strategy was chosen or not.
Example: "Why do you think this isn't working?"
On-time vaccination depends on tracking patient vaccination status and knowing which vaccines a patient is due for.
What is Leverage Immunization Information System (IIS) Functionality to Improve Immunization Practice?
Best Practices for Strategy Implementation:
Use reminder and recall functionality to communicate with patients about appointments.
Assess practice performance and generate practice-level coverage reports at regularly scheduled intervals.
Maintain accurate patient contact information.
Report all historical and administered vaccination data to the IIS routinely.
Assess immunization status for patient active/inactive status and doses due at every patient encounter.
Generate patient line lists routinely to identify patients who are not up-to-date and overdue and to determine future vaccine due dates.
Name 5 reasons where the provider can be designated as lost to follow-up.
What is...?
1. Provider location has permanently closed.
2. Provider has merged with another location.
3. Provider no longer participates in the VFC program.
4. Consultant has made four documented attempts to contact the provider by phone and e-mail over four weeks and received no response.
5. Provider location has opted out of further IQIP engagement.
Name the six workflow points when vaccination-related activities occur. These points are discussed during the IQIP vaccination workflow assessment.
What is
- Practice Management
- Patient Documentation Preparation
- Patient Check-In
- Prescriber Discussion and Exam
- Vaccination
- Patient Check-Out?
*Requirement: Awardees must assess the provider’s vaccination workflow prior to discussing coverage assessment data.
Vaccination workflow assessment is the process of evaluating a provider's vaccination workflow and identifying opportunities for improvement. The consultant discusses vaccination-related activities at six workflow points, comparing them with best practices associated with the four core IQIP strategies. The provider's current implementation status is determined by the core strategy best practices being followed while gaps or opportunities for improvement are identified.
The findings from the vaccination workflow assessment and the information from the provider’s assessment reports are used to assist with strategy selection and developing action items for the provider to work on.
The CDC IQIP program provides a vaccination workflow assessment tool in the IQIP Library and the IQIP Database’s File Repository for guidance and support during the assessment and ensure all relevant processes at each workflow point are discussed. This tool provides a page for each workflow point, workflow topics, open-ended discussion questions, and space for notes.
Non-IQIP QI Programs with goals that serve the purpose of IQIP.
What is Alternate QI Program Credit?
CDC allows 20% of required IQIP visits to be fulfilled by awardees documenting providers engaged in such alternate QI programs if approved by CDC.
*TN does not currently have an Alternate QA Program approved.