Adapting a common software tool during H1N1 helped streamline mass clinic operations, improve communication, and save money

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In Brief

Planning and staffing just-in-time vaccination clinics during an emergency presents considerable logistical challenges. In Michigan, the Oakland County Health Division adapted a common online document management tool to deploy well-informed staff to points of greatest need – and keep expenses down – during the 2009 H1N1 influenza pandemic.

Background

During an emergency health event, such as an influenza pandemic, health agencies must establish and staff public clinics as soon as vaccine is available. Oakland County Health Division (OCHD) scheduled H1N1 vaccination clinics as soon as vaccine became available in 2009.

Managing and staffing a vaccination clinic during a time of high and urgent demand often requires rapid decision-making and a large investment of time. Given high public turnout and a tight timeframe for efficiently dispensing medical countermeasures, the process of scheduling staff and effectively using their skills can pose a considerable challenge.

Specific issues

The agency experienced a number of difficulties when initially attempting to hold public health clinics for H1N1 influenza vaccination and mass dispensing site exercises. Issues included:

  • Inconsistent communications. Traditionally, the agency assigned staff to clinics either via e-mail or by speaking in person. Staff generally did not receive specific job assignments, guidelines for their roles, and maps to the clinic location until they arrived for their scheduled shifts at the dispensing site. In many instances, the delay in information-sharing meant that staff could not help set up the clinic or immediately assist patients.
  • Uneven capacity. Scheduling occurred before clinic administrators had an estimate of how many people would be needed to staff the clinics. This led to an uneven capacity to see patients on any given day. The agency incurred expenses for salaries and mileage reimbursement for staff that may not have been needed at a clinic.
  • Erratic vaccine supply. The flow of vaccine was unpredictable and often unavailable when administrators had been told to expect it.
The practice

The health agency developed an easier, streamlined way to communicate clinic logistics by using and adapting a Microsoft SharePoint system.

Adapting the SharePoint system was a four-part process, involving:

  • Online data storage and retrieval. The agency stored contact and availability data related to staff members along with possible dates of H1N1 vaccination clinics.
  • Staff selection of availability. Staff indicated their availability based on potential dates, after which clinic supervisors could determine how many support staff and nurses were needed for any given clinic.
  • Streamlining assignments. When dispensing clinic dates and times were finalized, staff could immediately be assigned to clinics based on their availability, skill sets, and the anticipated demand for vaccine.
  • Providing online access to critical documents. Once assigned to a clinic, staff received an e-mail directing them to the site where they could view their assignments, download job action sheets, and print maps to the clinic locations. Clinic supervisors and Incident Commanders then could view and edit a complete roster for each dispensing clinic.
What made this practice possible?
  • Strong partnerships across departments. The health agency relied significantly on the Oakland County Department of Information Technology to customize the software to meet their purpose.
  • Ability to adapt a Web-based tool. While SharePoint is generally used to manage multiple documents or various types of Web content, OCHD worked with the tool to design a system to simultaneously schedule staff to dispensing clinics, distribute information such as maps and job action sheets, and provide necessary training materials.
Results
  • Improved communication between staff and clinic administrators
  • The ability to distribute necessary information electronically
  • The means to modify staff levels before a dispensing clinic to better anticipate needs and demand
  • Less supervisory time spent verifying staff availability and delivering multiple training sessions
  • Efficient and fast set-up of vaccination clinics, including two clinics that took place within 48 hours of the decision being made to activate them and served approximately 24,000 people

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