The COVID-19 pandemic has prompted rapid advancement of medical technologies to meet increased burdens on the health care system amid distancing guidelines. But not all problems are met with cutting-edge technology; when Joe Kurland had two weeks to develop a COVID vaccine rollout plan for the more than 5,000 employees and contractors at Children's Minnesota, he rolled up his sleeves and built a mammoth spreadsheet.
"It did require some programming in Excel," says Kurland, M.P.H., a vaccine specialist and infection preventionist at Children's Minnesota. "It required multiple tabs and it has crashed on me several times."
The key to the rollout plan Kurland and his team developed centered on a practical, data-based approach.
Weighted distribution system helps hospital maximize limited vaccine supply
With Children's Minnesota set to receive fewer than 1,000 doses at the outset of the vaccine's rollout in late December, the primary goal of Kurland's team was to maximize the benefit limited supply could provide to the hospital.
They determined it was most important to get those first doses to staffers who were at the greatest risk for contracting COVID and whose vaccination would do the greatest good for the organization. But how to determine who best represented those groups?
First, Kurland and team eliminated part-time workers from the initial vaccine distribution. Although they would be included in the wider rollout a couple weeks later, the very first doses were reserved for full-time employees. To gauge risk levels, Kurland polled managers in all hospital departments to ascertain the exposure their employees had to patients and the public. Armed with that information, an ethics panel comprised of 13 leaders from across the organization determined a vaccine priority scale for each unit and individual job function in the hospital.
From there, the employees—sorted by vaccine priority score and unit—were assigned random numbers to determine their groupings for vaccine distribution. Importantly, this process not only assured vaccine recipients wouldn't be hand-selected, but also staggered the doses across units so any potential adverse effects wouldn't cause bigger problems.
"It gives us a good reason to not have an entire department or service vaccinated at the same time," Kurland says. "You wouldn't want your entire trauma response team to be out—or not feeling well—with a response to the COVID vaccine."
Thousands successfully vaccinated; supply is the wild card
When each employee's turn comes up, they receive an email invitation to set up a vaccination appointment via the online scheduling system created for the rollout. Kurland says the Children's Minnesota team can vaccinate 72 people per hour, and as of Feb. 3 had distributed more than 6,000 doses. Because many practitioners serve several health care facilities, some of those doses were administered to independent contractors. Likewise, many Children's Minnesota employees qualified for and received vaccinations at other institutions—in all, Kurland says about 80% of Children's Minnesota's employees had received at least the first dose of the COVID vaccine, with more than half already having received both doses.
About six weeks into the vaccine administration, Kurland says the program is working smoothly. His greatest concern: a steady supply of vaccine doses to keep the distribution going. "We have a good supply right now, but that's based on last week's shipment," Kurland says. "We're on pins and needles to know what we're looking at going forward because that will directly affect our ability to provide vaccines—not only for our staff, but also to ensure health care professionals across our entire region are vaccinated in a timely manner."
Proper resources, communication key to successful rollout
As hospitals and health systems continue to work through the logistics of their vaccine rollouts—and perhaps are assisting state officials with distribution to the public—Kurland says there are a few key factors to consider:
- Space. Make sure the physical area used for vaccinations is not only large enough to accommodate the vaccination stations but also have safely distanced waiting areas—CDC guidelines call for each vaccine recipient to be monitored for 15 minutes on-site to ensure no adverse reactions to the dose.
- Staff knowledge. Leverage the expertise you may already have in-house around emergency management—current staff who have training in large-scale deployments should be included in your planning.
- Communication. Clear, actionable communication to staff via multiple methods is essential to a smooth rollout. Using an online scheduling platform ensures orderly distribution without the frustration—and social distancing concerns—caused by long lines.
Perhaps most important, according to Kurland, is strong leadership support for the effort required to effectively manage this process. "This is exhausting work—it's a sustained, prolonged effort," Kurland says. "This is a longer-term mobilization that requires staff to be at the top of their game for an extended period of time—the individuals engaged in this effort need support."