Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor
To the Editor.—A previous study documented success in improving immunization rates of 136000 children served by 200 public health clinics in Georgia through the application of a 7-year program of "measurement and feedback."1 This measurement and feedback program consisted of annual sampling of charts to determine the proportion of 2-year-olds up-to-date on their immunizations at each clinic, communication of clinic-specific rates, including their rank order, and awards for best performers.2 From 1988 to 1994, up-to-date rates increased from 53% to 89%.
Schlenker T, Sukhan S, Swenson C. Improving Vaccination Coverage Through Accelerated Measurement and Feedback. JAMA. 1998;280(17):1482-1483. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-17-jbk1104