What hospitals are learning as they distribute the COVID-19 vaccine

The COVID-19 vaccine rollout has been a massive undertaking for hospitals and health systems as they work to inoculate healthcare workers and others based on state and federal guidelines. Among other things, they have had to ensure appointment scheduling is efficient and that shots are kept at the required refrigeration storage temperatures.

Many organizations already have vaccinated all or most of their front-line employees, but efforts will continue for months as more groups reach their turn in line. 

Becker's asked hospital and health system leaders how they are preparing for the continued rollout, given what they already learned during the first weeks of distribution. Below are their answers:

Editor's Note: Responses were lightly edited for length and clarity. 

George Ralls, MD. Chief Medical Officer of Orlando (Fla.) Health: Orlando Health has prepared by staying flexible with our plans and our operations. Since launching our vaccination program in mid-December, we have administered nearly 40,000 vaccines to team members, physicians, family members of team members and physicians 65 or older, first responders across the community, patients 65 or older, and nursing home residents that hadn't received vaccines. This week we further expanded our program out of the hospital setting and into seven community-based locations. At Orlando Health, we remain actively engaged in ensuring the COVID-19 vaccine is available and accessible to the communities we serve.

Roberta Schwartz, PhD. Executive Vice President, Chief Innovation Officer and CEO of Houston Methodist Hospital: We have been vaccinating our employees, physicians, our patients and first responders for weeks now, with more than 32,000 vaccinated as of Jan. 8. Our appointment system draws from the medical records, and automated invitations are sent. Our first batch of text/email invitations had a link that could be forwarded — which we did not think about until it was too late. Thousands of excited 75- year-olds forwarded their customized link to others. So, we had appointments made for people not even in tier 1a or tier 1b. We quickly had to cancel all the appointments — 1,000 of them — that did not meet the criteria and then quickly fix the security issue, which we did. Everything worked out, but it added a lot of stress and chaos to our system.

Another lesson learned is to expect long lines at the vaccine sites that are not socially distanced. We had not factored that in, and the sight of all these people lined up close together was frightening. So we put measures in place to be sure the line was short or that people were distanced. The same goes for us not anticipating so many people without appointments showing up and demanding a vaccine, and the need to communicate that folks should not show up early or late, as it makes the line worse.

We just didn't think about the small things like that while we were focused on the larger logistics of getting large numbers of people vaccinated. But we have figured it out.

Adam Smith. Senior Vice President of Ambulatory Services at Tampa (Fla.) General Hospital: On Dec. 14, Tampa General Hospital was one of five hospitals in the state to receive 19,500 doses of the Pfizer COVID-19 vaccine. Per Gov. Ron DeSantis, Tampa General immediately started vaccinating their front-line healthcare workers and shared doses of the initial vaccine with five local health systems: Advent Health, Bayfront, BayCare, HCA and Moffitt Cancer Center. As Tampa General Hospital receives more vaccine, we continue to share doses with other hospitals.  

On Dec. 23, Gov. DeSantis issued an executive order requiring Florida health systems with the vaccine to begin offering it to community members 65 and older or people most vulnerable to COVID-19 as ordered by the CDC (i.e. those with heart conditions, cancer, diabetes, etc.). Tampa General Hospital immediately began vaccinating these community members at TGH vaccine clinics, including Tampa General Hospital Family Care Center Healthpark, our clinic for underserved, under and uninsured community members. 

In addition to opening our own vaccine clinics, Tampa General has supported the local department of health for Hillsborough County's vaccine rollout through delivery of 3,000 doses of vaccine to support vaccination centers serving county community members 65 and older and those with severe comorbidities that make them more vulnerable to COVID-19. 

Tampa General provided 2,340 doses to our partners at USF Health to support their vaccine efforts. TGH also provided vaccine doses to Cancer Center of South Florida, which TGH owns and operates on Florida's east coast, for administration to their medically vulnerable patients.

This week, Tampa General Hospital will begin vaccinating other healthcare providers in the community and will lend support to a Hillsborough County "strike team" that will begin providing mobile vaccinations countywide to various communities the week of Jan. 18. 

Chris Van Gorder. President and CEO of Scripps Health (San Diego): Scripps rolled out our vaccination program within a few days of receiving the vaccines. Led by our acute care chief medical officer, information services and operations worked together to develop a priority-based appointment scheduling process for physicians and staff in three internal tiers — front-line staff and physicians in tier 1 with a focus of equitable distribution to all front-line employees. Tier 2 was for ambulatory staff and physicians, and tier 3 included other employees who were or might be needed to support front-line care. Our Epic patient portal was used for appointment scheduling at multiple locations, tracking of the vaccine given and an automatic link for making an appointment for the second dose. As of Jan. 8, roughly 70 percent of Scripps employees have been vaccinated, and we are starting the administration of the second dose. At this point, based on county guidelines we are also reaching out into the community to assist in vaccinations of other healthcare workers.




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