Here’s your assignment: Everyone in the state of Alabama needs a double dose of vaccine to avoid a highly contagious and deadly virus. You have six months to make it happen. Oh, and you may not have enough vaccine, especially at the start.
It sounds like the final exam in an emergency preparedness class, but as you know if you’ve been alive in the past year, it was an awful reality and an awesome challenge to health care providers.
While a few of your friends probably complained of long waits in closed rooms or hours in line before being told the doses were gone, several sites around Alabama earned stellar reviews from the people they served.
And they served plenty. UAB Health System alone has administered more than 210,000 doses of vaccine to date. USA Health System has topped 73,000 doses. Between them, they have provided almost 10% of all the doses given in Alabama as of early June.
Birmingham & environs
Jaye Locks knows plenty about health care, but the idea of the first UAB vaccine clinic came to her in a dream, she says. She dreamed of the Margaret Cameron Spain auditorium with its soaring ceilings, u-shaped lobby and multiple entrances to keeppeople from crossing each others’ paths. She dreamed of how many people would be needed to make it work smoothly.
“And when I woke up, I started writing furiously,” she says.
The auditorium site opened along with a parking deck site at UAB’s Highlands facility, trying to get caregivers protected. Before long, word came that they would open their program to everyone in the 1A category and new sites opened — the massive Hoover Met site among them. Then Parker High School and Cathedral of the Cross. As soon as practical, they began opening pop-up sites where needed, with particular attention to neighborhoods where health care access is limited.
“At the height, when all were open, we had six running at a time,” Locks says.
“UAB showed up in the most amazing way,” Locks says. In addition to staff members, volunteers came from all over campus and the community.
“Before we opened any site, we took time to train people so they understood what our mission was,” she says. “Our mission was to vaccinate central Alabama. People who volunteered wanted to be there, and patients — 99% of those — were happy to be there. That makes life easy.”
Key to keeping things smooth, she says, was drawing on the expertise of UAB staff — those with expertise in simulation, in facilities management, in efficiency.
Among the critical experts was JVann Martin, associate vice president for facilities and emergency management.
“It doesn’t matter whether you’re moving widgets or assets or people,” Martin says, “logistics is logistics.
“When you start your career, you never say I’m going to one day do a pandemic. You adapt to change as it occurs. You take what you know and what you’ve done,” he says, and build from there.
Even for a man who superintended moving patients — some critically ill — and their families from an older building to a new one, the vaccine clinics presented challenges.
“The element of surprise moving widgets is very low. The element of surprise with a human behind a 4,000 or 5,000 or 6,000-pound vehicle, it’s quite different.”
But they worked it out. Martin would visit a prospective site, map possible patient flow and figure a maximum number of potential doses per day. At the same time, the clinical team would figure how many people they needed, how quickly they could safely administer vaccines and their optimal number of doses per day. Then the two teams compared notes and set about making it happen.
Bottom line, says Locks, was the need to make the experience as pleasant as possible. “At the end of the day, we’re all patients.”
Near the Coast
In the South, the crisis hummed into action as worried patients called their primary care doctors, wondering how to get tested. That was back in March of 2020, recalls Natalie Fox, assistant administrator and chief nursing officer for USA Health Physician Group.
They set up small sites, testing steadily more people each day.
“About three weeks in, we got contacted by the city wondering whether we wanted to partner,” Fox says. Within a week, operations were relocated to Ladd Stadium, with a drive-through operation to protect both the testing team and the patients.
“Our core team was big on process improvement,” Fox says. “We learned early that we had to continually change the processes to make it better.”
One of the first reasons for change —weather. As Mobile’s summer thunderstorms arrived, operations moved indoors, to the Civic Center Expo Hall.
Having mastered the testing process, the good news came that a vaccine was available. Again, the process started small — trying to get employees vaccinated at system sites. But most of those had pandemic-caused limits on visitors.
Again, the team figured drive-through would be best, but they had never operated a drive-through vaccination clinic. A pediatric nurse practitioner, Fox is comfortable around vaccines, but had never worked at this scale. So, they created a flu shot drive through at three sites, where the team learned a new technique. Next came a drive-through, where parents could bring kids for routine vaccinations. Again, a success, once they learned to maneuver around car seats.
But none of the sites seemed suitable for a larger scale operation.
Again the team coordinated with the city and picked the Civic Center Arena — home to Mardi Gras balls, pro sports and such— with high dome and maneuvering space for trucks, and began to get it organized.
Fox can’t say enough good things about the city’s Doug Cooper, who developed the traffic flow strategy.
The first day was kind of a mess, she says, with vaccine traffic creating a traffic jam in downtown, but by the second day, cars flowed smoothly. They agreed from the first to set appointments so nobody would wait and wait, only to be turned away.
Some 25 to 30 people a day — a mix of staff members and volunteers — kept the patients moving. Fox is quick to note that in a project of this scale, people directing traffic are every bit as important as those administering vaccines. And despite the indoor traffic flow, never once did the CO2 monitors go off.
A computer glitch accidentally booked 500 more people than expected one day; the team simply called in more volunteers and moved those extras with hardly a delay.
And once they had mastered the Civic Center with its 750 people a day, the team branched out — taking vaccines to churches, shipyards, Brookley Field, even Art Walk downtown.
“This alternative delivery of health care is great,” she says, and she expects that some aspects of it are here to stay.
Now, say the clinic masterminds, if only the rest of Alabamians would get their shots in the arm, all could be well.
This story appears in the July 2021 issue of Business Alabama magazine.
