Peer-reviewed article
Application of quality improvement approaches in health-care settings to reduce missed opportunities for childhood vaccination: a scoping review
Abdu A. Adamu, Olalekan Abdulrahman Uthman, Elvis Omondi Achach Wambiya, Muktar A Gadanya, Charles Shey Wiysonge ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This scoping review examined how quality improvement approaches have been used in healthcare settings to reduce missed vaccination opportunities for children. The authors searched published studies and gray literature, finding 12 quality improvement projects, all conducted in the United States between 2014 and 2018. These projects tested 45 different change ideas targeting healthcare providers, clients, and health systems. The review highlights a growing interest in using quality improvement methods to address vaccination gaps, but found no published evidence from low- and middle-income countries, particularly sub-Saharan Africa.
Key points
- 12 quality improvement projects addressing missed vaccination opportunities were identified, with 11 published manuscripts and 1 conference presentation
- All identified projects were conducted in the United States, with the majority implemented between 2014 and 2018
- 45 different change ideas were tested across the projects, targeting providers, clients, and health system factors
- No literature on this topic was found in low- and middle-income countries or sub-Saharan Africa
- Quality improvement approaches show growing interest as a method to address missed vaccination opportunities and improve immunization coverage
Limitations
This is a scoping review that maps the landscape of quality improvement research on missed vaccination opportunities rather than evaluating the effectiveness of specific interventions. The review cannot provide evidence on which quality improvement approaches are most effective, as it focuses on describing what has been studied and identifying geographic and temporal gaps in the literature.
Abstract
Missed opportunities for vaccination (MOV) is a poor reflection of the quality of care for children attending health facilities. It also contributes to a reduction in overall immunization coverage. Although there is a growing interest in the use of quality improvement (QI) in complex health systems to improve health outcomes, the degree to which this approach has been used to address MOV is poorly understood. We conducted a scoping review using Arksey and O'Malley's framework to investigate the extent to which QI has been used in health facilities to reduce MOV. The review followed five stages as follows: (1) identifying the research question; (2) identifying the relevant studies; (3) selecting the studies; (4) charting data; and (5) collating, summarizing, and reporting results. The search strategy included electronic databases and gray literature. A total of 12 literatures on QI projects focused on addressing MOV were identified. Eleven were published manuscripts, and one was a conference presentation. All the QI projects published were conducted in the United States and majority were between 2014 and 2018. In these projects, 45 change ideas targeting providers, clients, and health system were used. This study generated important evidence on the use of QI in health facilities to reduce MOV. In addition, the result suggests that there is a growing interest in the use of this approach to address MOV in recent years. However, no literature was found in low- and middle-income countries especially sub-Saharan Africa.