by Dr. Sue Kressly, MD, FAAP
Anything you can do to minimize or eliminate in-person interaction is smart and helpful. For example, make the Vaccine Information Statements and Emergency Use Authorization Fact Sheets available on your website and ask parents to upload pictures of their insurance card to the patient portal, if you need to validate insurance information.
Automate wherever you can. Allow patients to self-schedule appointments and have standing orders and templates ready to go.
Eliminate waiting inside the office whenever possible. Encourage patients to check-in online. You could also have a check-in concierge who escorts families to open exam rooms, then completes the check-in process there. Think LEAN. Eliminate unnecessary handoffs which often cause bottlenecks.
Send messages to families early, often, and consistently, letting them know that your office is a safe place to receive care and the vaccine is safe and effective. Use multiple formats for your messaging, knowing that your families access information in different ways. Email blasts, texts, patient portal announcements, phone greetings, website updates, and social media channels are all great options.
In addition, consider creating a walkthrough video showing how your immunization clinic will work. From the moment they arrive in the parking lot, show families the path they’ll take and the touchpoints they’ll see outside and inside the office. This will be incredibly encouraging to parents. Patients and families can read words, but seeing how safe they will be and what the workflow will look like will help them feel confident.
Many of us are continuing to promote social distancing. Consider creating as much spacing as possible, whether patients are outdoors or indoors. Think about how many other industries have marked their floors with signs that read, “Please wait here.”
Start figuring out what spacing will look like to instill confidence, and how you can create interesting visual spacing marks on your sidewalks and in your office. Get creative by making waiting in line educational and interesting.
If you go with a traffic cone strategy, put them six feet apart and place signs on the cones that begin to stage the vaccine clinic process.
Here are some examples of sign messages:
In addition, consider displaying a prominent sign that reads, “If your child is not feeling well today, or has been exposed to COVID in the past 14 days, please go back to your car and call the office.” You want to make sure those folks do not stay in line.
Considering the recent declaration from the AAP, AACAP and CHA of a national emergency in children’s mental health, consider some positive messaging in those signs:
Consider Drive-Through Strategies
While in previous years, drive-through clinics were the exception, it is clear that more and more practices have adopted them and are thrilled. A lot of practices are understandably trying to minimize their staff exposure, and drive-through clinics can be done safely if you have the physical parking lot space available OR you find a community partner who might allow you to use theirs.
There are two strategies for this method:
Both strategies require a team effort — one group for registration and another for vaccination. The first group makes sure kids are ready to go with sleeves rolled up, and the second team administers the shots.
While research has shown that fainting is not a significant concern with flu vaccines, waiting is currently recommended for COVID vaccines. You may want to leave a couple of spots available for cars who received COVID vaccines. Especially when vaccinating drivers, allow those folks to wait 15 minutes before driving off, just to make sure they’re OK. Let’s not let fear keep us from doing what’s right for our patients.
And remember, it is perfectly acceptable to administer COVID and flu vaccines at the same time (different arms or legs are recommended.) It should be a discussion with your team who is doing this work if it is easier to do both at the same time or separate. Maybe have a 5-11 year old clinic that intends to do just that since it is the first opportunity for that age group to receive COVID vaccines.
To protect your team members, assume every patient who enters your parking lot or building and touches your staff might have asymptomatic COVID. You don’t want a vaccine clinic to sideline your entire team for 14 days.
Keep each staff member focused on one task. This is especially true for your vaccinators, like medical assistants and nurses who should be dedicated to only vaccines during certain hours. Have those team members stay in an exam room, with supplies being brought to them. This will minimize the traffic in your hallways and increase efficiency.
For all patients who need a second vaccine, schedule that while the family is still in the exam room. This means that the vaccinator or another team member in the room needs to be prepared to schedule the appointment.
Finally, when it comes to scheduling your vaccination clinics, make sure some occur on weekends. Another option is to hold flu clinics on light office days, like Tuesdays and Thursdays, from 7-8:30 in the morning and/or 7-8:30 at night. In addition, make a decision whether you will also be protecting your community by administering vaccines to parents/family members.
No matter how you tackle this issue, your patients, families, and communities will be healthier and safer because of your efforts.