Questions for Dr. Lavania re: Curbside Flu Shots

Operations/Work Flows
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During our seminar last night, we had the honor of hearing from Dr. Lavania (@hlavania) about how she is adjusting her practice to see patients in her parking lot. Here’s a list of questions that popped into the chat while she was presenting:

what if the weather doesn’t cooperate?
if covid questionnaire is positive how will that change your management? no flu?
Hiral, did you survey your patients to see if they wanted this?
are you requiring parents to wait 15 minutes after getting flu shot - listed in cdc criteria
how many MAs/nurses are you planning to have giving vaccines?
Did you contact your liability ins?
What happens to the vehicular traffic of patients coming for Well Checks?

This wasn’t a question, but a good comment from @Jgruen

doing very similar clinic w first mini one this sat for college kids. we have a runner at these clinics to do fetching of whatever. a traffic director makes a huge difference to guide cars to spots. and we use walkie talkies to communicate

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what if the weather doesn’t cooperate?

If it rains, we will have ponchos and umbrellas. We have a small tent for the front office staff to check people in.

if covid questionnaire is positive how will that change your management? no flu?

No flu vaccine. They will have to reschedule.

Hiral, did you survey your patients to see if they wanted this?

We did not. They love Saturday Flu Clinic and it has been successful for the past 2 years. We’ve been telling families about our plans for the past month and mostly they are excited!

are you requiring parents to wait 15 minutes after getting flu shot - listed in cdc criteria

Yes, but only if the driver is getting. Otherwise we will highly recommend it.

how many MAs/nurses are you planning to have giving vaccines?

2 MAs, 1 LPN, 2 front office, 1 MD, 1NP (basically the entire staff)

Did you contact your liability ins?

Yes, no different than seeing sick kids in the car. Definitely check with your insurance.

What happens to the vehicular traffic of patients coming for Well Checks?
We aren’t open on Saturdays so it would just be Flu Clinic.

This is the list of vaccine coolers that I have found so far:

https://www.vericormed.com/product/cooler-cool-cube-08-vaccine-transport-cooler-at-refrigerated-temperatures-fresh-vaccine-vt-08/

https://www.temparmour.com/vaccine_carrier

https://www.fishersci.com/shop/products/sonoco-thermosafe-nylon-carriers/22046788

Do people think Flu mist is a good idea during Covid??
Should be fine as long as they have no Covid symptoms. It’s not aerosolized.

VIS sheets
This is attached to the questionnaire they fill out prior to scheduling

Why do you need wifi?
For the EHR. We want as little paper as possible. Trying to keep contamination down.

Hope this helps!

Hiral Lavania, MD, IBCLC, FAAP

hlavania@onefamilypeds.com

One Family Pediatrics

2575 Peachtree Parkway | Suite 301

Cumming | Ga 30041

www.onefamilypediatrics.com

678.962.PEDS (7337)

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thanks for the info. just an fyi our state vaccine regulatory group will not let us use soft sided coolers. we use a hard sided small cooler, that the medical currier transports samples with, and then they have a whole protocol, you use frozen waterbottles that have been partially melted so the ice turns freely in the bottom, then a piece of cardbord, then your vaccines and then another piece of cardboard. You use the same thermometer like we use for the vax fridge, in the cooler so you can monitor temp every 30mins. happy vacinating everyone!

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@hlavania’s tips are so well-thought-out. I love how she has detailed all her steps.

We did a drive through flu clinic a few years ago and parents loved it. We stationed our computers and supplies right inside the front door and staff ran in and out from there with one or two front desk runners checking people in and doing any necessary paperwork, two nurses drawing up and giving shots, and two other people on laptops inside the front door doing all the documentation. Keeping the station just inside the front door allowed us to stay on the wireless network and keep the vaccines inside. With this team, we were able to see 6-8 every 15 minutes. I’d do it like this again but now that I own a small under cabinet vaccine fridge, I’ll bring it to the front this time to store the vaccines while we run the clinic.

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I have really appreciated all of the postings and webinars as we have planned our drive thru flu clinic for the first time ever. We learned things would wouldn’t have otherwise thought about until it was too late!

We have been making a concerted effort to inform patients ahead of time. We put together a video so they can be prepared ahead of time. Our goal is to ease parent concerns ahead of time, and make safety a priority. Also, filming for the video was a great learning opportunity to refine set-up and flow. Here’s the link: https://tinyurl.com/ThruFlu

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Beth, LOVE the video! What an amazing job!!!

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Dr Lavania just want to say very impressive how detailed and thought out this whole process is. Do you bill this as a usual NV for flu ? Are the MAs giving shots or the MD ?

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Thank you, Manju! We bill this as vaccine only visit (flu cpt and admin codes). In Georgia, MA’s can give shots. I have 2 MA’s, 1 LPN, 1 NP and myself. We all help each other out during flu clinic. I have 2 front desk people who will register the patients as they come in.

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Hi Beth, loved your video. What program did you use to make the cartoon cars drive in?