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Multi Pronged Approach to Vaccine Clinics

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Multi Pronged Approach to Vaccine Clinics

  1. 1. A Multi-Pronged Approach: On-Site, Drive-Through, and Mobile Outreach Vaccine Clinics March 24, 2021
  2. 2. Continuing Education Credits In support of improving patient care, Community Health Center, Inc./Weitzman Institute is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. This designation confers simultaneous continuing education accreditation across nine national accrediting bodies. This series is intended for physicians, nurse practitioners, nurses, physician assistants, psychologists, clinical social workers, dentists, pharmacists, and dietitians. Please complete the survey – linked in the chat, and emailed to all attendees – to request your continuing education credit for live viewing. A comprehensive certificate will be sent out at the end of the series.
  3. 3. This week’s COVID-19 ECHO session is a collaboration with This resource is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U30CS29049 entitled "Training and Technical Assistance National Cooperative Agreements (NCAs)" for grant amount $2,045,000 with 0% financed with non-governmental funds. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.
  4. 4. Disclosure • With respect to the following presentation, there has been no relevant (direct or indirect) financial relationship between the parties listed above (or spouse/partner) and any for-profit company in the past 12 months which would be considered a conflict of interest. • The views expressed in this presentation are those of the presenter and may not reflect official policy of Community Health Center, Inc. and its Weitzman Institute. • We are obligated to disclose any products which are off-label, unlabeled, experimental, and/or under investigation (not FDA approved) and any limitations on the information hat I present, such as data that are preliminary or that represent ongoing research, interim analyses, and/or unsupported opinion.
  5. 5. COVID-19 Update in the United States March 24, 2021 Stephen Scholand, MD Infectious Disease Specialist, Midstate Medical Center
  6. 6. 29,920,378 cases on 3/23/21 with 543,793 deaths COVID-19 in the United States
  7. 7. Resistance
  8. 8. How Many ‘Jet Liners’? A320 seats 182 passengers
  9. 9. Pressure on Hospital Systems
  10. 10. The Danger of Variants • 44 cases of B.1.526 (first found in NY) detected in CT. • Has the same mutation as the B 1.351 variant • Has not shown evidence of increased transmissibility or disease
  11. 11.
  12. 12. COVID-19 Vaccinations Across the Nation
  13. 13. Percent of People Fully Vaccinated by State/Territory
  14. 14. Trusted Resources • Nuvance Health, 2400+ articles reviewed: • CDC: • WHO: • Johns Hopkins: • Others
  15. 15. A Multi-Pronged Approach: On-Site, Drive-Through, and Mobile Outreach Vaccine Clinics Vickie Knapp, MBA Chief Operating Officer Mat-Su Health Services, Inc.
  16. 16. Mat-Su Health Services, Inc. Matanuska-Susitna Borough – Area the size of West Virginia – Most are on the road system – Some depend on boats, planes, or trains to access care
  17. 17. Mat-Su Health Services, Inc. • Patient Demographics – Low-income – Senior citizens – Current patients in our community-based behavioral health program – People who live close to our satellite location • 6500 Unduplicated Patients (last year) – Includes primary care, dental, behavioral health – Includes those who already received a COVID vaccine • COVID Vaccines Numbers – 1820 first doses – 1423 second doses
  18. 18. Setting Up Vaccine Appointments • State system online platform (was not working for those who do not have internet access) • Call-in appointments or emails requesting a call back • Coordination with community partners – Law Enforcement – Community providers for people with Developmental and Cognitive Disabilities, Dementia, Autism, and other difficult to serve specialty populations
  19. 19. Reaching Key Populations • Using local resources – Law enforcement – Community non-profit partnerships – Mental health services – Case managers
  20. 20. Reaching Key Populations (cont.) • Tackling a lack of transportation • Considerations for waiting rooms in small clinics • Requesting J&J vaccines for specific key populations • Utilizing paid staff at community outreach events
  21. 21. A Multi-Pronged Approach: On-Site, Drive-Through, and Mobile Outreach Vaccine Clinics Mette Smith, MS, LSSBB, CPHQ Vice President, Practice Administration Community Health Center, Inc. Amanda Schiessl, MPP Project Director, National Cooperative Agreement on Clinical Workforce Development, Community Health Center, Inc.
  22. 22. Clinic Types Drive-Through – Vaccinate large patient populations Fixed Site – Convenient for patients who may not have the ability to travel to a drive-through clinic, or who are hesitant about the vaccine – Offers familiarity and access Mobile Events – Operate through community partners – Homeless shelters, congregate housing, church groups, community organizations, public housing authorities, schools
  23. 23. Scheduling Pathways Patients can schedule through:  Online Self-Scheduling – VAMS – challenge for much of our vulnerable populations  Call Health Center Directly – Available to existing patients, all eligible patients are offered – Use of IVR – prompts for vaccine information and dedicated vaccine line – Re-calls – prompts  Statewide Phone System – 211  In-Visit Scheduling – Planned care dashboard
  24. 24.  Website  Robo Calls  Text Message Campaigns  Postcards  Direct-to-Patients Outreach  Education  Community Partners Outreach
  25. 25.  1-4 vaccinators (40-160 patients per day)  Runs in parallel to seeing other patients  One vaccine given every 10 minutes  Allowed into building prior to 5 minutes before scheduled - Second dose scheduled for patient at time of check-in - ID not required  One type of vaccine offered per site - Challenge: patient schedules themselves at wrong clinic with a different type of vaccine - Dedicated staff person monitoring and alerting the patient Onsite Clinics
  26. 26. Temporary Employees  Screener at door  Registration – Enter/update demographics in VAMS/practice management system – Provide paper work – Ask HRSA questions  Observer – post-vaccine  Observation period and rooming  Vaccinators Onsite Clinics
  27. 27. Communication  Walkie Talkies  Morning and afternoon huddles  Bi-weekly all team huddles  Signage and visual indicators – Patients are very conscious of their order Onsite Clinics
  28. 28. End of Day ‘No Wastage’ Policy  Waitlist of patients who may be scheduled in the future  No Wastage Policy – if exhausted all other options, can go into next category  Most vulnerable populations identified by our providers. Very careful to document that we’ve contacted in-category first Onsite Clinics
  29. 29. Mobile Events Operate through community partners: Homeless shelters, congregate housing, church groups, community organizations, public housing authorities, schools  Patients are pre-registered  Pre-event huddles – Event overview – Assignments – Review of checklist  Post-Event Debriefs – Learnings – Reconciliation – Congratulations
  30. 30. Drive-Through
  31. 31. Drive-Through
  32. 32. Drive-Through  Vaccine Village – up to 1600 patients per day  Visual indicators are key  Over-flow area for early patients, or those who need help Patient Experience: 1. Arrive 2. Greet and verify appointment/eligibility 3. Receive paperwork 4. Answer question about epi-pen usage 5. Verify demographics & provide insurance 6. Car topper 7. Receive vaccine 8. Vaccine waiting area (15/30 minutes)
  33. 33. Drive-Through Staffing Onsite  Logistics – segmented roles: check-in, questionnaires, car toppers, observation, etc.  Traffic Control  Vaccinators  Site Leads – staffing, huddles, supplies, day-to-day operations
  34. 34. Drive-Through Staffing Remote  COVID Drive-Through Support Associates – Real-time problem solving to keep the line moving – End of day reconciliation – Download and upload of data
  35. 35. Drive-Through End of Day ‘No Wastage’ Policy  Afternoon huddles – process improvements & innovations  Working with operations – how many left, no-shows, slowing down & accounting extra doses  Reconciliation – Documentation
  36. 36. Thank You! To learn more about The Path Forward series To view previous COVID-19 sessions: