March 3, 2021: UCHealth released a must-read COVID-19 mass drive-thru vaccination playbook. Here to take us through it is Sarah White, Senior Director, Innovation and Health Systems Engineering. What is the genesis of the playbook? How can other health systems replicate the success they had at Coors Field, Denver? What kinds of partnerships do you need to put on a mass vaccination event? How do you find a site? What about the logistics? What about efficient scheduling? How does technology stand up in a parking lot? How do you track the vaccines? And what are the biggest lessons learned from the process?
The UCHealth COVID-19 Mass Vaccination Playbook with Senior Director Sarah White
Episode 372: Transcript - March 3, 2021
This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.
[00:00:00] [00:00:00] Thanks for joining us on This Week in Health IT influence. My name is Bill Russell, former healthcare CIO for 16 hospital system and creator of This Week in Health IT, a channel dedicated to keeping health IT staff current and engaged.
[00:00:17]Bill Russell: [00:00:17] Today we have a treat for you. We are going to go in depth into the mass vaccination COVID playbook that UCHealth put together and we have Sarah White with UCHealth. She's the Senior Director of Innovation and Health [00:00:30] System Engineering. So fantastic conversation. I know you'll get a lot out of this one.
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[00:00:50] Just a quick note, before we get to our show, we launched a new podcast Today in Health IT. We look at one story every weekday morning and we break it down from a health IT [00:01:00] perspective. You can subscribe wherever you listen to podcasts. Apple, Google, Spotify, Stitcher, Overcast. You name it, we're out there. You can also go to todayinhealthit.com. And now onto today's show.
[00:01:13] All right. I'm excited today. We have a very timely conversation. We are going to talk with Sarah White, the Director of Innovation and Health System Engineering at UCHealth University of Colorado health. And we're going to talk about the COVID 19 mass [00:01:30] vaccination playbook that you guys put out there.
[00:01:33] And I'm really looking forward to this. Welcome to the show.
[00:01:37] Sarah White: [00:01:37] Thank you. Thank you so much for having me Bill. I'm excited to be here.
[00:01:41] Bill Russell: [00:01:41] You know, I'm excited to have a conversation. This is a phenomenal playbook. What was sort of the genesis for this? How did it, I mean, did everyone say, Hey, if we're doing it, I mean, was this thought of in the beginning or did you like document it all at the end?
[00:01:57] Sarah White: [00:01:57] Yeah. So the way so UCHealth, we're [00:02:00] a health system out in Colorado. We have 12 hospitals across the front range. And we have been participating in partnership with the state kind of in three different avenues to vaccinate our communities. So one is really mass pop-up clinics. So really targeting certain neighborhoods or certain areas to do vaccine events for and one is in this brick and mortar.
[00:02:26] So across our hospitals, we actually have vaccine locations. [00:02:30] And then third is this new concept that we'll talk about today, which is really around that mass vaccination. And so what happened is our the Colorado Rockies actually gave us a call and in partnership with the state said we need to ramp up our vaccinations and we have a target to do 10,000 vaccines in a weekend. So can you guys be our partner in that? So that's what happened. We got a phone call. [00:03:00] We had about two weeks to pull it together. Partnered with the state, the Rockies, the Denver police department. There was a whole team. But yeah that's the Genesis of this one.
[00:03:11] Bill Russell: [00:03:11] And that's fantastic. By the way I'm a Cardinals fan. So thank you for For now that's that is a phenomenal pickup for the Cardinals. And now everyone in Colorado is just tuned out of the entire show. No one in Colorado is going to listen to sorry about that.
[00:03:27] So from the documents there's so there's some great [00:03:30] statistics right out of the shoot. So two, six hour days, 10,000 vaccines administered 834 cars per hour, 22.4 minutes per car. Including the 15 minute observation period, which is interesting to me, that means your logistics and everything else only took about six and a half minutes. Zero unused dosage, 0.9% patient no-show rate.
[00:03:53] I know that's a significant accomplishment as well. I sorta want to cover [00:04:00] all of these things and try to figure out how you, how you got to this point of, you know fairly efficient model. So how important are the partnerships to get the word out?
[00:04:17] Sarah White: [00:04:17] Absolutely. I think the partnerships are one of the most important pieces to all of this.
[00:04:23] And honestly, the team chemistry that we had, we created a really transparent group. We met, you know, [00:04:30] daily. I think we've all kind of created this this bond that happens when you're all trying to, you have an end goal in mind and, you know, you have a pretty tight deadline on it. So we you know, the Rockies, the state, the city and County of Denver, Verizon wireless was a very strong partner for us in this.
[00:04:50] It really took kind of all of those partners, voices at the table to organize this to make sure we weren't missing [00:05:00] anything and really create those open lines of communication. So we stood this up, just you know, like I mentioned in, in two weeks and one of the really unique things about those partnerships and the whole UCHealth team that was behind this, which you know, involved many, many individuals.
[00:05:17] One of the things I think we still all talk about as a team was we went into it with a goal and a mission but we were all in this mindset of problem solving and making things better. [00:05:30] So we tweaked along the way. So the playbook that we published, we are actually in process of revising it because we just, this past weekend completed our second dose.
[00:05:41] So as you know, we have the Pfizer for our events. So we had a first dose weekend in January, and then we actually had to stand up the whole event again for a second dose, which we just completed this past weekend. And our staff actually were even better the second time. And it was really because we were just kind of tweaking things [00:06:00] along the way and making those adjustments that we needed to. But yeah, the team was. Probably what allowed us to pull this off.
[00:06:08] Bill Russell: [00:06:08] Was it the same people coming back to the same location for their second dose?
[00:06:12] Sarah White: [00:06:12] It was, yeah. So it was all the same individuals, the 10,000 who came that first weekend, they all came back three weeks later.
[00:06:20] Bill Russell: [00:06:20] I'm going to through this in a spare amount of detail because I think it's worth doing so let's start by elaborate a little bit on the team that you put together to do this.
[00:06:30] [00:06:30] Sarah White: [00:06:30] Absolutely. So from a UCHealth perspective we pulled in individuals across our entire health system. So we had supply chain, we had nursing, finance, IT operations and logistics, our emergency preparedness team, emergency services, medical director, is, event planning was actually one of the most critical roles.
[00:06:57] But the first day we actually didn't have event planning. [00:07:00] And it took us, you know, two days as we were planning the event to realize what a critical piece that was for, you know, an outdoor event that we were standing up, basically an entire infrastructure in the parking lot. Right? So the tents and the generators and the tables and chairs and all of those things that require that level of detail and expertise.
[00:07:20] You know, there were team members added throughout the journey. As we discovered, you know, potential holes that we had or ways that, [00:07:30] you know, we wanted to make sure that all of our bases were covered. Facilities was another one that was critical. Not only did we have a strong partnership with the city state, and Rocky is, you know, in Colorado, we deal with snow removal.
[00:07:42] And when it snows, everybody needs snow removal. So things like that. You know, if we weren't able to cover our bases with one of our potential partners, then you know, our team was able to step in. And so it just became a really seamless group and [00:08:00] a team that at the end of it, I think we all felt like each role was absolutely critical and each role knew what they were accountable for it and executed on it.
[00:08:10] Bill Russell: [00:08:10] Did you have to battle the elements at all or was it another sunny day in Colorado?
[00:08:15] Sarah White: [00:08:15] So it's so bizarre. We, so I think at the beginning, our incident commander, I remember him saying the first weekend was a beautiful weekend, like 50 degree weekend.
[00:08:25] And we set up our event to be a [00:08:30] 1000 person event as a pilot. And then the following weekend, we actually did our 10,000 person first dose event. So, you know, that's really three days of events. And then we had to do all of that again, three weeks later for the second dose. So I remember that first day we said there is no way in Colorado, we're going to get six perfect days.
[00:08:53] So we had built in a lot of contingency planning and we kind of had a joke because we all, we're all skiers and [00:09:00] snowboarders and we were excited to, you know, we're all praying for snow in Colorado, you know, especially in the winter so that we can hit the slopes. This was the first time I think in all of our careers, we were praying for no snow for you know for six weeks.
[00:09:17] And we ended up instead of getting snow, we actually got a day that was minus you know, about minus seven degrees and it was just not [00:09:30] possible, just not safe to have our staff and our patients coming through a drive-through model in sub-zero temperatures. So we did actually one day it ended up being our second dose pilot day.
[00:09:44] So it was only a thousand individuals, but we ended up moving those thousand individuals to an indoor location. So we did have to trigger one of our contingency plans, but it all worked out. You know, we had the plans in place, a lot of support to make sure that we [00:10:00] were able to pull that off.
[00:10:02] Bill Russell: [00:10:02] Well, why outdoor in colorado? I mean, there's so many, so many things that could go wrong were they're not large indoor facilities or is the logistics harder for an indoor facility?
[00:10:15] Sarah White: [00:10:15] Yeah, it's what we found and we have like I mentioned 12 indoor locations actually already. And then we will go out to churches or to organizations and we'll do we'll do events in you [00:10:30] know, vaccine events in targeted areas.
[00:10:32] But what we found is there's still a population that we were missing. And there's still a population that prefers to actually, maybe they have mobility challenges or, you know, maybe they they're not comfortable being in an indoor setting exposure risk, or, you know they've really been hunkered down in their homes for the past year.
[00:10:55] And so we were getting some requests for that, you know, to help meet [00:11:00] that and accommodate that population. And so as we kind of worked through some. Some ideas of, you know, how we could do that. A drive-through model really became the most optimal way to address some of those needs of our population.
[00:11:17] So I, you know, this is one that potentially COVID well, and, you know, vaccines will be around and in need across the nation for several more months. And so our [00:11:30] thought was, you know, if we can pull this off in the winter then you know, the summer is going to be easy.
[00:11:35] Bill Russell: [00:11:35] Yeah. And the the car ends up being a natural social distancer or doesn't it? It's almost exactly six feet. And outdoors a lot more is lot safer I think just in the long run. Let me ask you about scheduling. So scheduling has been one of those things that gets talked about a fair amount, and it sounds like, you know, 0.9% no-show rate, you had a fairly efficient model for scheduling. How did you guys attack [00:12:00] that challenge?
[00:12:01] Sarah White: [00:12:01] Yeah, absolutely. So we actually have a, it's called my health connection and it's a mobile app that an, web app that our patients or community members, can actually create a user account for, and create a request for a vaccine appointment. So we've used that across all across UCHealth to help vaccinate hundreds of thousands or hundreds.
[00:12:28] Bill Russell: [00:12:28] Do they have to be a [00:12:30] patient to do that or?
[00:12:31] Sarah White: [00:12:31] They don't. Yeah. So it what it does is you create an account and then it actually we'll put you on the vaccine list and, you know, we have your your, age information. And so as the state deems, you know, we're ready for your age or your ages you know, part of the vaccine cohort. Then we actually have a random process where we can release an [00:13:00] invite to you through the electronic system.
[00:13:02] And then of course, we also have a call center and a way to invite our patients via phone call if that's just an easier model for them. So we use both of those kind of interchangeably, and we did that as we set out invites for the mass vaccination event.
[00:13:21] Bill Russell: [00:13:21] So when they show up, they, they went through this efficient scheduling. When they show up, do they have like a QR code or are our number that they just give and it [00:13:30] just connects to automatically it's an electronic system?
[00:13:34] Sarah White: [00:13:34] Exactly. Yep. You're spot on. So we have a QR code. Most of our patients actually went that route. So I think it was around 83%. Just over 80% of our patients or community members.
[00:13:47] I'm calling all of the, you know, everyone who showed up as patients, but so they arrive at the entrance. They go through kind of our registration process. [00:14:00] And show their QR code. If they don't have a QR code, it's very easy for our team to also just look them up and verify that they, you know, have an appointment and then get them vaccinated.
[00:14:11] So it was really made the whole process. I think our check-in process was around 30 seconds just because it was the majority of our population was able to either print their QR code or actually show it on their mobile phone.
[00:14:27] Bill Russell: [00:14:27] What did you track it in? Cause if they're not [00:14:30] patients, did you track it outside of the EHR or did you end up tracking it in the chair?
[00:14:35] Sarah White: [00:14:35] We actually tracked it in the EHR and we have a whole process to you know, one of the most important factors in inviting people to get a vaccine is making it as easy as possible. Right. And and removing any barriers. So really it's a phone. It's your name? Your birthday and a way to contact you, whether [00:15:00] it's an email or a phone number but that's really all we require. So there's no other information that our community members need to enter in order to be added to the distribution list or the vaccine distribution list.
[00:15:15] Bill Russell: [00:15:15] You know, there there's a wise guy in me that wants to ask the question. Did anyone crash the party? Did that anyone like. You know, I mean, vaccine right now, it's a hard thing to get.
[00:15:24] I have people who live in my neighborhood that are driving. I had one drove five hours to [00:15:30] get the first shot. And I'm like, you realize you have to go back. He goes, yeah, I'm going to go back and drive another round trip, 10 hours to get the vaccine. So literally did anyone get in line who didn't have an appointment?
[00:15:41] Sarah White: [00:15:41] You know, a lot fewer than we thought. So there were definitely some individuals. It was interesting. Right. We had a lot of pre community conversation with our some of our local government, as [00:16:00] well as our media partners. And they did just a phenomenal job of helping to spread the message, but this was by appointment only. So we had, we were trying to kind of get as much communication out as possible about that. And what happened is you know I think we, we were anticipating that a lot more people would show up without an appointment. There were a handful. And we had kind of like [00:16:30] a whole communication for those individuals that, you know, here's how we get you signed up.
[00:16:34] We can even help you if you need to, but almost what we called, like a bailout lane, where we could just have that conversation with them and make sure that they were able to get on a list and registered and everything. And it actually, you know, we had escalation plans in process. None of that was needed.
[00:16:53] It was really just some people came because they were curious, they saw other cars drive driving into the Rocky stadium.
[00:17:00] [00:17:00] Bill Russell: [00:17:00] Well, your, you know, your communication plan. I mean this is a 50, some odd page document. Your communication plan is really impressive. You had an AM band radio station when they got within range, which I assume it's the Rockies hormal. Oh, it's not the Rockies normal AM band that they would communicate, I guess not. So you had to do a partnership to get that AM band.
[00:17:24] Sarah White: [00:17:24] We actually did. Yeah. So what's actually interesting is what we found in [00:17:30] you know, I'm sure other States are doing this as well, but across Colorado we have partnered with our other health systems who are all kind of going through this as well.
[00:17:41] And it was one of our other health system partners who you know, suggested an AM radio might be helpful in communication. So we were able to secure an FCC license. We were able to [00:18:00] make sure that the amount of time that the message ran for us about two to three minutes was the appropriate amount of time. We had that message in both English and Spanish. We you know, worked closely with the city and state community communication team to actually develop that. And then launch it day of, we had a lot of really good feedback on it. We didn't end up doing it during our second dose.
[00:18:26] And a lot of our patients asked us if, but that was [00:18:30] so helpful. Like it. You know, just reiterated to me what the process was going to be and where I should go wait, and what happened next. So, you know, if we do one of these again, that's definitely something we would make sure we do both for the first dose. And second dose.
[00:18:42]Bill Russell: [00:18:42] Last week I keyed you in on something that's unfolding here at This Week in Health IT. We started off with our influencer podcast a little over three years ago, but since then we've been able to introduce Newsday and Solution Showcases and last year, We expanded even further with our daily COVID-19 series.
[00:18:59] And now we [00:19:00] have a daily show Today in Health IT and I'm happy to say that we're not done growing yet. We have something really exciting happening here at This Week in Health IT. Our goal, as you know is to help inform, educate and train health leaders. And we understand lots of people take information in in different ways.
[00:19:18] That's why we're introducing written content to our site for the first time. You'll be able to find news write-ups covering each of our shows in detail as well as feature stories. And I'm really excited about the feature stories. We've [00:19:30] hired two great feature story writers and they're going to take topics that are highly relevant to you and relevant to our industry.
[00:19:38] And they're going to turn them into feature stories on our website. I'm so thankful for all of our listeners and the conversations that we've had our sponsors and the dialogue that we've had in the back and forth has really convinced me that this is the best next step. I want to thank all of you for listening and joining with us on our journey of raising up the next generation of health leaders by amplifying [00:20:00] great thinking to propel healthcare forward.
[00:20:02] You also have the signage you had. I mean, you had scripts and stuff in there. So I thought the communication plan was actually, let's talk to the logistics a little bit here. I would imagine, you know, getting the PPE out there, not all that hard, but what about getting the vaccine out there and you're talking to the Pfizer vaccine.
[00:20:21] So that's a heavy lift to keep that refrigerated. And you said zero unused doses. [00:20:30] So there were some logistics and planning around that. How did you take care of that?
[00:20:34] Sarah White: [00:20:34] Absolutely. So we had a you know, we had been, I'm going to say practicing quite a bit with our other locations. The trickiest part of this one was obviously it was outdoors.
[00:20:47] So creating a lot of redundancy just to make sure that nothing could go wrong was really what we needed to focus on for pharmacy. So we had [00:21:00] a whole tent outside a secure tent that was dedicated to our pharmacy team. So of course we had to, you know, get the vaccine out to the location.
[00:21:12] Make sure that we had freezers and backup freezers and generators a whole team, one of the most important pieces of our the operation for pharmacy was you know, our teams are working with their bare hands and so they need to [00:21:30] be in a space that's warm. They can't wear their gloves. It's very or, you know, they can wear surgical gloves, but no winter gloves.
[00:21:38] And so we had to make sure that the temperature was. Warm enough for them, for our staff, but not too warm for the vaccine. So there were quite a few just operational hurdles we need to work through. Also just the making sure that there was really constant communication, especially as the day wore on, [00:22:00] you know, our thawing process and making sure that we had enough vaccines up until the very last patient arrived.
[00:22:08] So It was just a very close communication. One of the lessons learned from our first weekend was we had the pharmacy tent kind of located off of site a little bit. And we ended up moving our vaccine tend to be in the middle of the madness. So we moved them to be inside of our [00:22:30] large tent that all of our cars were driving through. And that created a really close communication with them. And it just had them really at the center of the entire event, which helped us as the, you know, as we got closer to the end of the event, one of the most important pieces is just making sure we don't overthaw and making sure that we use every single dose.
[00:22:56] And so that, that became a really good lesson for [00:23:00] us to make sure that those vaccinators or the vaccinators and the pharmacists were arm-in-arm arm.
[00:23:05] Bill Russell: [00:23:05] Did you tap into anyone that has done this kind of crowd movement before? I mean, like, you know, I'm taking, you know, Disney knows how to do this. Well the Rockies would know how to do this, right. How to move a lot of people in a did you tap into their expertise in this?
[00:23:22] Sarah White: [00:23:22] Absolutely. So as we talk about kind of those critical partners, that was one of the roles the Rockies played for us. [00:23:30] Not only the Rockies, but also our Denver police department. So we we had a whole team from the Rockies as kind of our professional flaggers and they were
[00:23:43] Bill Russell: [00:23:43] The actual Rockies players.
[00:23:46] Sarah White: [00:23:46] Well, we had Dinger who's the Rockies mascot. And then we had many, many of the Rockies staff. Unfortunately, the players were already headed down for spring training.
[00:23:57] Bill Russell: [00:23:57] Oh, they were in Arizona [00:24:00] already. Okay.
[00:24:00] Sarah White: [00:24:00] Nice and warm in Arizona. So we had a lot of their team kind of the office team and they were really, really incredible to work with and definitely have an expertise in that.
[00:24:14] Bill Russell: [00:24:14] Yeah, I've talked about this before and the technology stuff. I'm not going to hit you up on too much but I assume the Verizon partnership is how you got the wireless communication infrastructure into the parking lot that you needed.
[00:24:27] Sarah White: [00:24:27] Yeah. And I would say kind of the [00:24:30] cliff notes of the IT piece was we actually did that that very first weekend, I was telling me about. The thousand individual pilot that we did.
[00:24:42] We actually did do a paper during that. And it was a little bit of just to just kind of test things out, like, is that the right thing to do and quickly our entire team you know, said, we gotta do this electronically. And you [00:25:00] know, one of the most important reasons we wanted to do it electronically was it allows for us to really back to like pharmacy, right?
[00:25:07] It allows for us to track those patients in real time. So the data all feeds back over to our pharmacy team and our it team to make sure that we are tracking those doses as closely as possible through the filing process. Then obviously just paper. I mean, we've, we work in innovation. We work in healthcare. I think all in our preferred [00:25:30] mode would be electronics. And one of the
[00:25:33] Bill Russell: [00:25:33] Yeah, no, go ahead. I was just going to cause you just create redundancy if you're going to do that. So anyway, go ahead.
[00:25:39] Sarah White: [00:25:39] Well, and so one of the lessons learned for us around IT was we we actually have what's called Rover devices and you can think of them like an iPhone that allows you to track all of this in real time. So you're in the EMR real time and you're able to document, you're able to consent patients. [00:26:00] It's handheld devices really easy, and we knew that our goal, if we could make that work we could save a lot of time rather than like a laptop. So we partnered with Verizon and this was one of probably the most critical pieces of the entire event was just around it and connectivity and power.
[00:26:19] And as we created those, we quickly realized we needed to create like a triple redundancy plan. So that triple redundancy was not only did we have a wifi [00:26:30] network up and running. But we also had signal via what's called jet packss from Verizon. And then we also had SIM cards within the the Rover devices.
[00:26:42] And so there was no way your network was going to go down, because if you had any trouble from wifi, you could, you had, you know, two other backup plans and that triple redundancy we actually did use. And that allowed us to keep the. The flow of cars [00:27:00] moving, keep the throughput times that we needed and that we had set out.
[00:27:04] Bill Russell: [00:27:04] Yeah. Well, I've not been to Coors Field but if it's anything like your airport, it's probably in the middle of nowhere.
[00:27:10] Sarah White: [00:27:10] So it's actually smack in the middle of downtown Denver.
[00:27:15] Bill Russell: [00:27:15] Oh, okay. So you should be able to get, should be able to get other signals and tap into things there. I would think.
[00:27:22] Sarah White: [00:27:22] Yeah.
[00:27:24] Bill Russell: [00:27:24] Well, I will have to get to Coors Field your, your airport has always cracked me up every time I fly in there. I'm like [00:27:30] these people have vision. They envision a time where this city is going to be so big that this airports will be relevant, but for now we're going to drive 25 minutes before we see a house.
[00:27:41] Sarah White: [00:27:41] Well you can appreciate the Colorado landscape when you arrive.
[00:27:46] Bill Russell: [00:27:46] It's a great document. I was kidding somebody. I'm like, there's more in this appendix. Than I've seen in most other playbooks. And it's just great. You have the, you know, the recruitment process, clinical clinical sport [00:28:00] volunteers police and medical. It really is comprehensive media and communications, vaccine storage and handling patient communication.
[00:28:08] Just you have maps of how you did the slow in and out of. I thought it was interesting. You talked about doing it outside as opposed to inside some, see Senate, some of these done inside. And, you know, the research would just tell us we're so much safer outside than we are inside. And I think people have heard that message over and over again that [00:28:30] the other question I think I would ask is you had 10,000 for the first event. How many of those people came back? Most of the percentage that actually came back?
[00:28:40] Sarah White: [00:28:40] All but I think it was a total of 17 that didn't make it back. So It was, it was really yeah. And we've actually found that to be pretty consistent across all of our locations. It's just like, like we kind of talked about it [00:29:00] is like gold and as soon as you know, you're committed and once you have that one, the first dose I think that's actually One of the things we've been talking about, you know, if we were to do another one, how amazing would it be to just have a one dose vaccine you know, not have to come back for that second dose?
[00:29:21] I think as we think of mass vaccination event, that would make a mass vaccination event even you know, more doable.
[00:29:30] [00:29:30] Bill Russell: [00:29:30] Right. You know, I think one of the things that's going to transpire, they say that 50% of the populations in line, they want to get the vaccine and then we're going to get to this other 50%.
[00:29:39] And actually, I think 20% of the next 50% is like, I'll wait and see, make sure there's no adverse effects and then they're going to get in line. But then there's this other 30%, these kinds of events I would think are well geared towards that 30% that are I dunno, that, that aren't prone. Even if [00:30:00] you know, they're not prone to, to go into the medical facility and they're not that somehow we catch them. Do you guys have you started thinking through that? What are we going to do for that 30%?
[00:30:10] Sarah White: [00:30:10] Yeah. And you know, one of the things that's attractive, like I think where you're going is the drive-through model. So think of, think of the the individual, you know, in your life who has, you know, three children and is the primary care provider for their family from a childcare [00:30:30] perspective and honestly just doesn't have the time to find a sitter to, you know, go drive to an event or go drive to a clinic walk in get their vaccine and then, you know, potentially even do that twice within, you know, a month. Like there is definitely a population where a drive-through model will be possible because of just life [00:31:00] circumstances.
[00:31:00] And so as we, you know, developed this model, it was really around there. You know, we talked about drive through versus walk up and, you know, talk through the pros and cons of it. But we hadn't seen across Colorado. We hadn't, there was no drive-through model and yeah. The more, you know, we talked with our patients and we talked with the community, there was a need for this type of event to help meet those needs of those communities.
[00:31:27] And this is a model that we could take [00:31:30] and scale down you know, to other parts of Colorado, we could actualy. We, think we could probably even scale it up quite a bit. We you know, as, as there's more daylight in the summer, we could extend hours to be probably 10 hours, you know, in a day and do double the amount of individuals in one day.
[00:31:50] So I think because of all of those things, there's just a lot of variability with this one.
[00:31:54] Bill Russell: [00:31:54] So I'm pushing you a little bit here with stuff. That's not what we in the [00:32:00] document. Which is so if you were, let's assume you didn't work for UCHealth, you worked for a rural facility out in out in Colorado, and there's a lot of rural in Colorado.
[00:32:13] You could, you could still do a mass vaccination event. It's just not mass as you would consider in Denver, it's mass, like as a percentage of the total population, you could still do something like this in a town of, I don't know, 25, 30,000 people couldn't you?.
[00:32:29] Sarah White: [00:32:29] Absolutely. [00:32:30] Yeah. And I think the way you would do it you know, the, what I would tweak is obviously you'd have a smaller staff, right?
[00:32:39] You'd have you wouldn't need the massive tents that we had. You could extend your throughput, right? We were hitting 834 cars per hour. You would not need to hit that throughput of course, right. In 20,000, 30,000 person town you could also have a dry, a walk-up [00:33:00] option, right? So you could actually have both models in, you know, one area share some of those, you know, pharmacy services share some of maybe the oversight and even some of the staffing, but create a model that would meet the community needs pretty easily.
[00:33:19] Bill Russell: [00:33:19] And you have ,somewhere in here, you have financials. I'm missing it right now.
[00:33:27] Sarah White: [00:33:27] Towards in the bottom of course.
[00:33:29] Bill Russell: [00:33:29] Yeah. [00:33:30] I remember seeing it, but I guess the question is you know, is this expensive to do and are there you know what ends up being the greatest expense?
[00:33:41] Sarah White: [00:33:41] So it's about $27 per vaccine. So that was what our kind of our math came out too. So we one of the takeaways, and like I mentioned, this playbook that you have today is [00:34:00] our first edition playbook. And we tweaked our model. So we went from having what we call like the standard model, which you'll see in the appendix was, you know, one large tent, which was where our registration happened.
[00:34:15] There were six rows of cars that would go through registration and then they would actually get funneled into 18. Cabanas, we call them. And those cabanas is actually where you received your vaccination. And then after your vaccination, you went [00:34:30] around to the observation area. So we decided, you know, to save money and resources.
[00:34:35] And actually we think to keep the group at the same pace we can actually have. And because we had 80% of individuals checking in online before the appointment. We expanded our mega tent and went from six lanes to eight lanes. And we actually did our registration and vaccination [00:35:00] altogether within that that mega tent. So we did away with our cabanas for our second model. And we called that our pit crew model, which you know, NASCAR, right? So it was our pit crew model where we were registering you and vaccinating you all at the same time. And that proved to be even more efficient. It proved to be cheaper.
[00:35:22] So we you know, if we were to do more of these we got our group put at one point in one hour, it was, it [00:35:30] was over a thousand cars per hour. And the average time was actually 14 minutes and 36 seconds. And that was that was partly because observation for your second dose is actually. It can be 10 minutes instead of 15 minutes.
[00:35:46] And so our throughput with just about a minute and 54 seconds to register and back to meet you, and then our patients moved very quickly through the process. So that actually [00:36:00] reduced our costs from that $27 to even even cheaper.
[00:36:05] Bill Russell: [00:36:05] Any other learnings that, that, that we should know about from the the post game of the process.
[00:36:15] Sarah White: [00:36:15] Oh, that's a really good question. Yeah, so we did lessons learned kind of after each one of our events. We actually interviewed patients as well as volunteers [00:36:30] and. You know, I think moving from that standard model to pit crew with one of the biggest lessons for us,
[00:36:37] Bill Russell: [00:36:37] Do you guys normally do like a lean and agile model in your health system?
[00:36:42] Sarah White: [00:36:42] Yeah, we do like a little bit of a mix right. Of six Sigma lean Toyota way depending on kind of what the effort is, this one was you know, very lean kind of always reassessing ourselves. So we, we, I [00:37:00] followed kind of like Toyota way principles as much as possible. We some of the wayfinding I would say is always something and over communication to the our community and our patients.
[00:37:14] We I would just say like if you have, you know a strong team you know, that was one of our biggest lessons learned. We walked out of this just, you know, knowing that if we were thrown [00:37:30] another challenge that this team would be able to rally and pull it off.
[00:37:35] Bill Russell: [00:37:35] Yeah, it is phenomenal. I actually, I want to thank you. I mean, this is such a great document. I already shared it specifically with two of my clients who were asking questions around that, and I'm like, That here. I mean, yeah. You know, they, they did it and here it is. So this has been phenomenal. And then the other thing is just that it takes work to put the document together and I just want to thank you for that contribution.
[00:37:59] How can [00:38:00] people get a hold of the document and you know, how, how can they hear more about what you guys have done this if they want to?
[00:38:09] Sarah White: [00:38:09] Absolutely. And Bill, thank you so much for just the opportunity to share this. You know, the reason we even put this together was really when we went out to create this, we couldn't find anything you know, out there and we thought we're all in this together.
[00:38:25] We are all trying to end this pandemic together and you know, if we can [00:38:30] develop something that's successful course, you're going to have to tweak it. You're going to have to figure out what works best for your population, your area and your location. But our thought was really we are looking ending this pandemic in the most collaborative way possible.
[00:38:45] So we're open to suggestions. All is open to conversation. Would love to connect with you. If you go on the UCHealth website uchealth.org, there is link actually to the playbook under [00:39:00] our vaccine tab. So you can, I think you put your name in there and your maybe email address and the document is available to you.
[00:39:11] So it's of course, you know, free, there's no strings attached. If you have questions I'm always here and happy to help answer them or help connect you to the right individuals across UC health. But yeah, we're just looking forward to ending this pandemic and looking forward to whatever comes next.
[00:39:30] [00:39:30] Bill Russell: [00:39:30] Yeah. It's and you haven't marketed to me yet. And I signed, I put all my information in to download the PDF and you should probably what you think the numbers are, because I think I've forwarded the PDF to at least three or four people. So and I think that's happening probably a significant amount.
[00:39:49] This is a great resource again. Thanks. Thanks for putting it together and thanks for your time. Thanks for coming on the show to, to share even more with the community. Really appreciate it.
[00:39:58] Sarah White: [00:39:58] Absolutely. Thank you [00:40:00] Bill.
[00:40:00] Bill Russell: [00:40:00] What a great discussion. If you know someone that might benefit from our channel, from these kinds of discussions, please forward them a note, perhaps your team, your staff. I know if I were a CIO today, I would have every one of my team members listening to this show. It's conference level value every week. They can subscribe on our website thisweekhealth.com or they can go wherever you listen to podcasts, Apple, Google, Overcast, which is what I use, Spotify, Stitcher. You name it. We're out there. They can find us. Go ahead. [00:40:30] Subscribe today. Send a note to someone and have them subscribe as well. We want to thank our channel sponsors who are investing in our mission to develop the next generation of health IT leaders. Those are VMware, Hill-Rom, StarBridge Advisers, Aruba and McAfee. Thanks for listening. That's all for now.