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Remediation & Data Clean-up as an ImmsBC Admin

  • Updated

Background

It is good practice to conduct daily clinic audits to identify cases of incomplete charting and blanks that were created in error.

When a user comes across a record with a pathway status of "vaccine_admin", this indicates that charting has not been completed yet. The situation around the client's appointment may not be clear, especially during busy seasons, and if several days have already passed. Clinic leads, program assistants, and remediators work together to resolve the pending situations and minimize data entry errors.

The Pathway Status Report provides the clearest summary of "stuck" records.

Click for information on how to generate it.

 

 

Overall goals:

For each record in vaccine_admin, determine:

1) Which (if any) products did the client receive at that location that day?

2) How best to close out the record (chart the vaccine, defer, or mark it as "entered in error").

 

 

Investigation flow:

>> What does the client's immunization history currently look like?

Carefully check the records (antigens + dates) that already exists under Immunization Records, then scroll to Relevant Immunization History. Data may have been entered through ImmsBC (ICE, CIR) or another method (PARIS, eForms).

For potential duplicates, look for similar entries within +/- 14 days. There may also be a comment indicating some kind of error.

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Tip: At mass clinics, the maximum number of products given on a single day is usually 2: one influenza, and one COVID-19. If both products are charted, and there is a 3rd record in vaccine_admin, it is usually a blank shell that was created in error.

 

Scenario: If data entry is already complete, then mark the incorrect or extra record as "entered in error" (EIE).

  1. Go to the Person Account > Related 
  2. Click the specific immunization record number
  3. In the right hand corner, click Update to Entered in Error
  4. Add the EIE reason and click Save

Update to EIE.png


NOTE: this action can only be performed by roles with the Admin role. There are designated users (e.g. clinic leads or remediation team members) that have this ability.

 

 

 

>> What does the vaccine_admin record look like?

  1. Open the "stuck" record from the Related tab of the client's profile. Often, it will be blank, except for some check-in information.
  2. Check if any partial information was saved by the user (e.g. consent, body site, lot #, and comments).
  3. Within the record, scroll to the Immunization History on the right side of the screen to see a log of all the changes. There may be clues depending on what information was saved and/or removed.

Record and its Immunization History.png

 

 

 

>> Is there a deferral recorded (or consent granted/refused)?

Scroll to the Deferral and Consent sections (on the Related page) and look for entries from that appointment date.

Scenario: If there is a deferral, go back into ICE and complete the charting.

  1. Set your User Defaults back to the original location & date of the appointment. 
  2. Locate the record that is in vaccine_admin. Click Go to In-Clinic Experience from Today's Appointments or from the client's profile.
  3. Select the agent
  4. Select View/Edit the existing deferral
  5. Adjust the end-date of the deferral to tomorrow's date, and save with a revision reason.
  6. Click Defer Vaccination & Save.

 

 

 

>> Is there vaccine information to be back-entered?

If the client was indeed vaccinated, then complete the charting through In-Clinic Experience. Information about the vaccine may be obtained from a downtime form (one-write), photo/scan of the immunization booklet, or phone call with the client. 

  1. Locate the record that is in vaccine_admin.
  2. Set your User Defaults back to the original location & date of the appointment.
    (the information can be found in Immunization Record > details)
  3. Re-enter the In-Clinic Experience from that day.
    > From the client's profile, click Related > Go to In-Clinic Experience
    OR
    > From the Client List > Today's Appointments, search by name/PHN > View
  4. Select the agent.
  5. Chart the consent.
  6. Chart the details from the immunization.

If the immunizer cannot be identified from their signature, initials, flow sheet, or reports, select the non-ImmsBC Provider (Contact) called “VCH Unknown VCH Unknown”.

Provider VCH Unknown VCH Unknown.png

6. Click Confirm & Save Administration, review the data, and click Confirm & Save Administration a second time.

 

 

 

 

Tips & Other Notes

  • There are other locations that hold "breadcrumbs" of information. These include Appointment details, Notes, and Comments (autogenerated due to deletions)
  • When back-entering, if the lot number does not appear in the dropdown menu...
    • Click "show depleted lot numbers"
    • Check the Daily Immunizations report to confirm the product(s) given that day. Some letters and numbers could be unclear from the documentation.
  • For deletions (records marked as Entered in Error), the entry will be removed from the Immunization Record section immediately, leaving an autogenerated deletion comment on the Related page. The data will remain in the Relevant Immunization History section until it can be deleted by the provincial team (can take up to a few days).