# Presentation: 672688

## National Immunization Conference
Atlanta, GA
March 18, 2008

**Atlanta, GA**
**March 18, 2008**

**Vaccine Management Business Improvement Project****(VMBIP)**

## Agenda

- Status of resuming rollout and performance metrics - Brad Prescott
- Hib allocation process - Greg Wallace
- VACMAN/NIPVAC update - Karron Singleton
- VMBIP updates - Julie Orta
- McKesson updates - Tom Hart
- Questions and Answers - Panel

## Centralized Distribution Recap

- First grantee transitions 2/5/07
- 37 grantees transitioned by 12/17/07
- Pause for CQI implementation 12/17/07 – 2/25/08
- 3 additional CQI teams formed mid-February
- Sacramento Distribution Center opened 2/25/08
- Rollout resumed 2/25/08
- Rollout to be completed by 6/30/08

## Below are the metrics used to help CDC decide on resuming centralized distribution rollout

| Metric |
| --- |
| Ensure that 99.75% of vaccine order shipments arrive at the provider with a temperature monitor indicating product is viable |
| Ensure that 99% of vaccine order shipments arrive at correct provider with the correct vaccines and in the correct quantities |
| Perform Monthly Physical Inventories and Report Details to CDC |
| Complete Pilot Test with CA; provide system-wide implementation of Master Packing List (MPL) for all multi-box shipments |
| Receive vaccine within 24 hours for flu and 48 hours for other vaccines |
| Transmit Vaccine receipt status to CDC within 48 hours of bulk order receipt into McKesson IT System |
| Begin Scanning & Faxing all non-federally funded vaccine packing lists to grantees within 48 hours |

## McKesson Specialty has maintained at least a 99% for their scorecard performance metrics

| Criteria | Jan | Feb | Mar |
| --- | --- | --- | --- |
| Temp Monitors | 191 | 13 | 0 |
| Non Compliant Pack | 2 | 3 | 0 |
| Mis-Ship | 11 | 8 | 1 |
| Undeliverable/customer not avail. | 1 | 2 | 0 |
| Carrier Damaged | 13 | 9 | 3 |

**# Deliveries/Packages**

**Accuracy % Packages Shipped**

| Criteria | Jan | Feb | Mar |
| --- | --- | --- | --- |
| Temp Monitors | 99.284% | 99.944% | 100.00% |
| Non Compliant Pack | 99.993% | 99.987% | 100.00% |
| Mis-Ship | 99.959% | 99.965% | 99.984% |
| Undeliverable/customer not avail. | 99.996% | 99.991% | 100.00% |
| Carrier Damaged | 99.951% | 99.961% | 99.952% |

## CDC has expanded the CQI analysis and will cover three different areas

| CQI Area | Description |
| --- | --- |
| Information and Product Shipment Integrity | Discrepancies between the lot number and expiration date information received by the grantee and the physical product or McKesson-generated packing list received by the provider
Incorrect lot code information not only presents challenges in grantee administration but also would be a significant impediment in the event of a recalled vaccine
This CQI study will use McKesson-generated grantee data to analyze the different sources of product information:  the actual product and McKesson-generated packing list received by the provider, and the corresponding data file received daily by the grantee |
| Cold Chain Monitoring and Standardization | In January 2008, McKesson logged 117 instances of non-viable vaccine due to an issue with the cold chain process or temperature monitor
A non-viable instance occurred anytime the monitor recorded a variation in temperature outside the expected range throughout the duration of the shipment
These issues may be caused by improper packing or outside temperature conditions |
| Data, Systems and Reporting Issues | There are numerous CDC and McKesson systems used to facilitate centralized distribution.  To date, only a high-level understanding of how these systems interact has been documented and communicated to all parties.
This CQI analysis will focus on an end-to-end process review including mapping out all the touch points of existing and planned systems (both CDC and McKesson) and their roles and activities, understanding when data is generated, exchanged, and processed, and identifying all of the data outputs and their recipients |