Identify 20 charts of patients who should have received a vaccine last year and did not get one.  These should be patients who were seen in the clinic during the flu season but did not have a documented flu vaccine. This is your gap report.

Complete an audit of those 20 charts for patients who are listed on the gap report to determine whether there is some documentation in the chart that they did have the vaccines, but this fact was not documented in the vaccine section of the chart and therefore not picked up for billing or reporting purposes.

This audit effort highlights the opportunity for improvement in your charge capture and documentation process.

Complete one workflow map for seasonal flu vaccines. The second workflow map is for lifetime immunizations such as Shingrix. This is very important for codifying your system for immunizations and improving it. As part of workflow documentation try to confirm the time it takes to do each task as well as who does that task. Be sure to include any linkage to population health work or care management that is part of your outreach or engagement with patients.