Competing healthcare systems in South Dakota worked together for several months to offer free H1N1 vaccine to the public.
Avera Health and Sanford Health are two large healthcare systems that serve rural eastern South Dakota, while Rapid City Regional Health serves the western part of the state. South Dakota only has one local health department in Sioux Falls, so less populated areas rely on the services of the state health department's community health nurses. In fall 2009, the South Dakota Department of Health (SD-DOH) asked the three healthcare systems to collaboratively plan community vaccination clinics with H1N1 vaccine supplied by the health department.The health systems, though competitors, had a history of collaboration and leadership on regional preparedness planning committees.
Although each company played a different role in the planning process, their partnership did much to standardize procedures that were used across the state. SD-DOH provided vaccine and used Public Health Emergency Response (PHER) funds to reimburse each health system up to $500,000 for the costs associated with logistical planning, staff training, and operation of the mass vaccination clinics. Avera and Sanford worked closely to hold clinics in Sioux Falls, Brookings, Watertown, and Aberdeen. The City of Sioux Falls Health Department was instrumental in coordinating vaccination clinics in the state's largest city. These larger clinics served as the basis for bringing best vaccination practices to smaller towns.
Small, rural towns were more likely to want to use healthcare workers and hospitals available in their communities. In these places, Avera and Sanford ordered vaccine, provided ancillary vaccination materials, and used their best practices to train local staff on how to run a mass vaccination clinic. Community health nurses with a history of providing care in rural communities worked at many of these small events.
While many vaccination clinics were held in hospitals or clinics, others were held in schools, senior centers, and malls. The events typically vaccinated approximately 2,000 people in the 2 to 3 hours that they were open to the public. More than 300 vaccination clinics provided H1N1 vaccine to approximately 255,000 people over the course of the flu season.
While the health systems worked collaboratively when holding vaccination clinics, each played a slightly different role in the planning process. Avera Health established a command center through which it coordinated decisions via phone or in-person meetings with Sanford representatives and SD-DOH staff. Four Avera staff members were devoted to planning vaccination clinics nearly full-time for approximately 45 to 60 days.
Vaccination clinics proved to be a significant addition to the health systems' ongoing role of usual healthcare provision, especially considering that Sanford clinics were seeing a 30 percent increase in patients during the H1N1 pandemic. South Dakota's mass vaccination clinics provided H1N1 vaccine to nearly one-third of the state's residents.
The joint effort shared by public and private organizations also benefited South Dakota by greatly expanding the number of vaccination personnel. Having larger numbers of skilled staff allowed the vaccination team to offer a greater number of clinics over a broader geographic area in a shorter period of time. Partnerships between the state health department, the three large healthcare systems that serve South Dakota, and local healthcare staff and residents played a significant role in forming a strategy that fit the needs of the state.