Weitzman ECHO on COVID-19 Recorded on March 24 2021

1. A Multi-Pronged Approach:
On-Site, Drive-Through, and Mobile
Outreach Vaccine Clinics
March 24, 2021

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. 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. 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. COVID-19 Update in the United States
March 24, 2021
Stephen Scholand, MD
Infectious Disease Specialist, Midstate Medical Center

6. 29,920,378 cases on 3/23/21 with 543,793 deaths
https://coronavirus.jhu.edu/us-map
COVID-19 in the United States

7. https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html
Resistance

8. How Many ‘Jet Liners’? A320 seats 182 passengers

9. Pressure on Hospital Systems
https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html

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

12. www.cdc.gov/coronavirus/2019-ncov/transmission/variant-cases.html

13. COVID-19 Vaccinations Across the Nation
https://covid.cdc.gov/covid-data-tracker/#vaccinations

14. https://covid.cdc.gov/covid-data-tracker/#vaccinations
Percent of People Fully Vaccinated by State/Territory

15. Trusted Resources
• Nuvance Health, 2400+ articles reviewed:
https://spark.adobe.com/page/dkBGIBUH6QEZJ/
• CDC:
https://www.cdc.gov/coronavirus/2019-ncov/index.html
https://emergency.cdc.gov/coca/calls/2021/
• WHO:
https://www.who.int/emergencies/diseases/novel-coronavirus-2019
• Johns Hopkins:
https://coronavirus.jhu.edu/map.html
• Others
https://www.thelancet.com/coronavirus
https://covidactnow.org/

16. A Multi-Pronged Approach:
On-Site, Drive-Through, and
Mobile Outreach Vaccine Clinics
Vickie Knapp, MBA
Chief Operating Officer
Mat-Su Health Services, Inc.

17. 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
http://explorenorth.com/library/communities/alaska/bl-MatSu.htm

18. 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

19. 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

20. Reaching Key Populations
• Using local resources
– Law enforcement
– Community non-profit partnerships
– Mental health services
– Case managers

21. 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

22. 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.

23. 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

24. 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

25.  Website
 Robo Calls
 Text Message Campaigns
 Postcards
 Direct-to-Patients Outreach
 Education
 Community Partners
Outreach

26.  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

27. 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

28. 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

29. 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

30. 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

31. Drive-Through

32. Drive-Through

33. 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)

34. 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

35. 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

36. 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

37. Thank You!
To learn more about The Path Forward series
WeitzmanLearning.org/the-path-forward
To view previous COVID-19 sessions:
WeitzmanLearning.org/coronavirus