We are giving COVID vaccines to community members, patients. And parents. We have tried to work into daily workflow, but prefer Saturday clinics (we do not usually have weekend office hours), drive up, stay in your car, and we come to you.
Eligibility does not open to general population here for another couple weeks. But then we plan to have larger events at our high schools. Looking good so far, we will see what uptake is. We are in a rural area with poor vaccine compliance in good times.
Our local Health department has handled supply and distribution of vaccines to individual clinics. This includes vaccine, syringes, needles, alcohol stores, and even masks and face shields. They are also reimbursing $75 for each injection given. If you bill Medicaid or insurance you cannot be reimbursed by county. If you give injections to persons living outside the county they do not qualify for $75 and you may bill, however, we have considered those our community service and not bothered with insurance. It is not usually more than the bonus doses we have gotten from being efficient with drawing up vaccines. They have not been large in number.
We do not enter orders into our EHR, but do scan the vaccine administration forms to their chart. Our state vaccine registry is super simple to enter data into, so upload the dose information this way (must be reported within 24 hours). I can do 120 per hour on this system.
Now for the shocker. We run at very low staffing since quarantine started. We are 2 NPs with 3.5 staff. We, the NPs have done all of the scheduling, managing doses, injections, and weekend clinics for the covid vaccine special projects. My son and his friends manage traffic control and paperwork ( they -4 are high school juniors, this really gives them joy to be doing something to get back to school. We are still distance learning). We have a previous MA who has helped some with injections, she needs volunteer time to get into nursing school.
For scheduling I got cell phones to use that are not our usual numbers and an email to send paperwork (VAR, EUA VIS, and appointment confirmations as well as directions). It could be another if our EHR wasn’t Allscripts, but I’m process of chaging over to PCC, so if we are still doing these clinics when that happens I imagine our flow will improve significantly.
These are not large events. Initially we volunteered at the mass events by county HD where e could give 2000 per day and had many volunteers. These stopped and they asked individual clinics to engage. Our first weekend was only 54 doses. Our weekdays, only 11 per day. Our average will be about 120 per week. Our thoughts, if we all do a little, together we do a lot.
There are clinics doing 500 to 1000 doses per week, but there has been a struggle finding enough patients. We are trying to be oh so careful to have zero wasted doses. So far with our tight quality control this has been the easy part. This was not true at the larger events.
This is not a business model for our clinic as it has been for some others in our community. We are keeping small. Focus on quality. Hoping to make our small corner of the world a little safer for the Littles who can’t be vaccinated yet.