Written by Dr. Nicole Shadbolt
When we first heard of a COVID-19 vaccine on the horizon in late summer 2020, the Rideau Family Health Team (FHT) in Ottawa realized that we would likely be called upon to vaccinate our patients when the time came. We also realized that our usual method of mass vaccination – walk-in shots on a Saturday in our clinic – simply wasn’t practical in the context of pandemic-related infection control.
Our patients were anxious to get an influenza vaccine that autumn, part of the massive uptake that was seen all over Canada. We realized pivoting to deliver those flu vaccines in a pandemic-friendly manner also allowed us to “test drive” our process for an eventual COVID-19 vaccine rollout.
We partnered with a local church, which generously loaned us their large parking lot, and we delivered almost 800 flu vaccines on a chilly November Saturday. It was a great day, uplifting for staff and patients alike. That day was the first time some of us saw each other in months. Most importantly, the process went off without a hitch.
Fast forward to the spring of 2021, when Ottawa Public Health offered our FHT the opportunity to deliver COVID-19 vaccines to our patients. We jumped at the chance.
Over two weeks, we quickly planned every element of the clinic, registering patients in advance, and training our staff. The provincial COvaxON vaccine registry added a new layer to the process, as well as more work. Nevertheless, on Saturday, April 24, we vaccinated over 500 patients in a drive-thru clinic in the same church parking lot. The sense of hope in the parking lot that day was almost palpable. The news media came and social media lit up with stories of our vaccination clinic. I can say without a doubt that the mobile approach worked extremely well for us, and we hope to do it again, both for COVID-19 vaccines and for future influenza vaccination clinics.
If you are considering a drive-through clinic, here are a few pearls we learned
- Book your patients in advance. If your EMR can do patient booking, that is ideal. Indivicare, our EMR, does not offer this capability, so we opened a dedicated phone line for patient bookings. Booking in advance allows you to download patient data from your EMR (we had incredibly valuable support from OMD with this part), and upload all of it to COVaxON in advance. This saves an enormous amount of time on the day of the clinic.
- In addition to fully booking your day, make sure you have a “waiting list” of additional patients who are willing to come at short notice if additional doses become available. Between no-shows, cancellations, and additional doses being drawn from vials, we exhausted our waiting list and were able to vaccinate more than 50 extra people. A waiting list of at least 10% of the number of booked doses should suffice.
- All clinical staff working at the clinic should be strongly encouraged to complete the free COVaxON training offered through OMD. COVaxON is not particularly tricky to learn, but can be intimidating at first. We also did a small pilot vaccine clinic the evening before the drive-thru, vaccinating 10 people. This gave everyone a chance to go through the COVaxON process in real-time before the “big day”.
- COVaxON works in a browser (except Internet Explorer), and no special software is needed. You do need an internet connection. We set up an internet hotspot on site for the day to allow us to access COVaxON, using tablets that were already owned by the FHT, as well as a number of personal tablets and laptop computers owned by the physicians.
- While some clinics email consent forms to patients in advance, we go through the consents verbally, on the day of the clinic. This saved a lot of paper shuffling on site, and only takes 1 to 2 minutes per patient.
- Our family members and friends directed traffic for the day. We provided lunch, snacks and refreshments, as well as traffic safety vests for all.
- Vaccines were drawn up on site. We considered doing this at our nearby clinic and ferrying the doses to the site, but one of our doctors was able to park her large RV on site for the team to work in. This also gave us an on-site washroom!
- A local community organization loaned us pop-up sun shelters to shelter staff and volunteers from the elements. Placed at each station along the way, the tents also gave patients a visual indication of where to stop. We rented pylons from a local construction company to mark lanes and traffic flow.
- Each vehicle stopped at three stations: registration, where the “check-in” process was completed in COVaxON; the vaccination area, where a team of two worked to complete the pre-vaccine health questionnaire in COVaxON and to vaccinate the patient while they sat in their car; and the check-out area, where patients were monitored for 15 minutes for adverse reactions and provided post-vaccine care advice while the “check out” part of COVaxON was completed.
- We found that each vehicle spent 3 to 5 minutes at check-in, 3 to 5 minutes at the vaccination area, and 15+ minutes at the check-out (the mandatory waiting time post-vaccine.) We had 6 lanes available and booked 11 people (across all lanes) every 10 minutes. However, the general consensus was that this was not enough – we felt we could have managed double this volume. Remember that 11 people being booked is not necessarily 11 cars – many couples came together – so you don’t need space for quite that many vehicles.
Although it took a lot of work up front, the day of the vaccine clinic was an extremely positive experience for staff, volunteers, and patients. The physical health benefits to our patients were expected, but the unexpected mental health benefits for all involved were enormous.
Planning your own drive-thru clinic? Dr. Shadbolt can be reached through her clinic at riversidecourt@rideaufht.ca and would be happy to answer your questions.
Need help with COVaxON? Find out when the next OMD COVaxON training session is and access useful tools and resources at OntarioMD.ca. If you have questions or need support, OMD is available to help. Simply contact COVaxON.Support@ontariomd.com.
