Missed opportunities for improving practice performance in adult immunizations: a meta-narrative review of the literature

Abstract

Abstract Background We sought to characterize how the term “missed opportunities” is reported in the literature in the context of immunization rates and to assess how missed opportunities can be operationalized. Methods Peer-reviewed literature searches were conducted in April – May, 2015, to answer: “What methods research studies used to operationalize missed opportunities to vaccinate?” A meta-narrative review methodology was used. Results Seven studies met inclusion criteria. The methodologies for quantifying missed opportunities fell into two general categories based on: 1. the number of healthcare encounters per patient without appropriate vaccination services, defined as a number of visits per patient with no vaccination related services (Missed opportunities per patient); 2. vaccination status as “non-vaccinated” among a group of patients who had a healthcare encounter where the vaccination should/could have had happened (Missed opportunities per population). Conclusions Our study provided an initial overview of the methods reported in the literature, and concluded that the quantifiable missed opportunity holds promise as a measurable outcome (variable) for research and quality improvement projects aimed to increase adult immunization recommendation and uptake in primary care.

Keywords

• Missed opportunity
• Meta-narrative literature review
• Adult immunizations