As children's hospitals enter the fall and winter seasons continuing to battle COVID-19, hospital leaders and providers are also planning for an uncertain flu season and the role the COVID-19 virus will play.
Drive-thru clinics have been useful for COVID-19 testing—keeping potentially sick patients out of waiting rooms and reducing interactions with staff and providers, while still providing needed services.
For children's hospitals, special clinics can be an effective way to provide flu vaccines while adhering to ongoing COVID-19 prevention guidelines.
Keeping kids on track
Texas Children's Pediatrics—a network of more than 250 board-certified pediatricians affiliated with Texas Children's Hospital—is learning new methods for administering car-side immunizations through a drive-up, rather than a drive-thru, clinic pilot program.
Because drive-thru clinics can require the use of most or all of a parking lot, they can create logistical challenges. However, landlords agreed to dedicate two or three parking spots for immunization efforts.
"The first step was working with landlords of leased spaces to determine the configuration of the drive-up clinics," says Burke Wilson, PT, DPT, assistant director of Value-Based Care at Texas Children's.
He says the program works like online grocery pickup. Families pull into a reserved parking spot, check-in digitally with a mobile device, and a provider comes out to the vehicle to administer the vaccine. The program started as a pilot to administer vaccines to kids ages 9 and older during the pandemic to keep them on track with immunizations.
Parents loved it and so did providers—kids remained in a seated position, and there was no tent or outdoor refrigeration required for the vaccines in the Texas summer heat. "During the pilot, we gleaned incredibly useful insights about administering immunizations in this way, and we are eager to amplify this strategy during flu season," says Wilson.
The challenge was figuring out how to scale the program for flu season and how to effectively, and safely, vaccinate infants and toddlers in a car. Texas Children's recruited the help of its Child Life team to establish positioning techniques to better replicate a clinical environment for children in and out of car seats, including how parents can assist in keeping their child properly positioned.
The Child Life team is also developing a picture book for kids to help them better understand why they are being treated in the car instead of in an exam room. The book will be included as part of a digital packet parents receive through an online patient portal during the check-in process.
Waiting room clinics
Seattle Children's experienced similar challenges in obtaining landlord approval for drive-thru clinics, but Seattle's solution was to bring patients indoors. Since waiting rooms aren't being used right now due to COVID-19, some practice locations are using waiting areas as dedicated immunization space.
Partitions help prevent virus transmission, and the indoor space allows for vaccines to be stored properly and administered safely. Seattle Children's is also looking into partnerships with managed care organizations to share the cost and show support for their local communities.
These ideas were shared during a hot topics discussion among members of the Accountable Health Learning Collaborative (AHLC). The AHLC facilitates the exchange of best practices, accelerates the effectiveness of institutional strategy and progress in value-based care arrangements and enables exploration of new approaches among the 21 participating organizations.