WEBVTT
00:00:00.080 --> 00:00:02.240
Welcome to Cumberland Conversations.
00:00:02.399 --> 00:00:08.800
This is a place where we talk about the issues that matter most to you, your patients, and your community.
00:00:08.880 --> 00:00:14.800
We're diving into real conversations with real people, sharing insights you can actually use.
00:00:15.039 --> 00:00:17.359
Let's get this conversation started.
00:00:17.679 --> 00:00:22.879
Hi everyone, it's Jessica Ray, Executive Director of the Cumberland Pediatric Foundation.
00:00:23.039 --> 00:00:26.879
We're back today with our next episode of the Practice Management Minute.
00:00:27.039 --> 00:00:33.920
Today I'm excited to be talking about one of my favorite topics, and that's drive-thru flu clinics and pop-up clinics.
00:00:34.079 --> 00:00:40.640
But this is actually going to be a continuation of our vaccine town hall that we started approximately a year ago.
00:00:40.799 --> 00:00:46.000
And I'm joined today by Lucinda Vasquez, who is the site manager for Peeds East.
00:00:46.079 --> 00:00:52.079
And I'm going to let her tell a little bit more about her role and talk a little bit about the clinic that she works for.
00:00:52.320 --> 00:00:56.479
Yeah, so uh my name is Lucinda, and I'm so happy to be here.
00:00:56.640 --> 00:00:58.640
Thank you for inviting me, number one.
00:00:58.960 --> 00:01:02.719
I am the site manager for our Peeds East locations.
00:01:02.799 --> 00:01:03.840
We have three locations.
00:01:04.000 --> 00:01:06.799
We have Mount Juliet, which is our largest location.
00:01:06.959 --> 00:01:10.000
We also have Hermitage and Lebanon as well.
00:01:10.319 --> 00:01:15.439
I work with 16 providers and over 60 employees on a day-to-day.
00:01:15.840 --> 00:01:16.640
And yeah.
00:01:17.040 --> 00:01:17.840
That's wonderful.
00:01:18.000 --> 00:01:26.480
Well, I'm very familiar with Peads East and think it's just a wonderful um clinic, but I wanted to talk about what you all are doing with your drive-through flu clinic.
00:01:26.719 --> 00:01:30.879
So can you tell us just a just an overview of how that came to be?
00:01:31.040 --> 00:01:33.920
Why did you decide to start doing drive-through flu clinics?
00:01:34.159 --> 00:01:49.280
Yeah, so we we started this in 2020, and that was in efforts to try to keep patients out of the clinic as much as possible while maintaining getting vaccinated and protected against the flu for the year.
00:01:49.840 --> 00:01:52.799
So I think that was uh the intention behind that.
00:01:52.959 --> 00:01:56.079
And so we just saw a huge success with it over the years.
00:01:56.239 --> 00:02:06.159
And when I stepped into the role uh as a nurse, I had done it and, you know, performed in the flu drive-thru.
00:02:06.480 --> 00:02:13.280
And then I became the clinical supervisor uh probably less than a year after being in the role as a nurse.
00:02:13.439 --> 00:02:17.280
And then about a year after that, I became the site manager.
00:02:17.439 --> 00:02:24.719
And every year since we've been doing it, we just found so many great positive aspects to continue to do it.
00:02:25.039 --> 00:02:26.159
That's really exciting.
00:02:26.240 --> 00:02:33.360
And I know we do have several other member clinics who are doing similar events, but there are some of our members who have said, How do we do this?
00:02:33.520 --> 00:02:35.199
How do we start doing something like that?
00:02:35.360 --> 00:02:37.919
So I definitely want to dive into that a little deeper.
00:02:38.159 --> 00:02:40.960
So first I want to talk about just the planning and setup.
00:02:41.039 --> 00:02:42.879
What goes into making this happen?
00:02:43.039 --> 00:02:50.159
So, for a clinic who might be considering doing this, what are the most important decisions to make early on?
00:02:50.479 --> 00:02:55.599
I think the first thing you have to think about is looking at the goals and why you're doing it.
00:02:55.759 --> 00:03:00.960
And I tell this to my staff as well when they're performing things in the clinic, is look at the why.
00:03:01.120 --> 00:03:03.039
Why are you doing things in the clinic?
00:03:03.199 --> 00:03:06.159
What is the what leads you to your decision?
00:03:06.319 --> 00:03:09.199
And in our clinic, is there a need for it?
00:03:09.280 --> 00:03:10.800
I think that's the biggest thing.
00:03:11.039 --> 00:03:16.719
Do we have a large population of parents that are going to be getting their children vaccinated?
00:03:16.879 --> 00:03:18.879
So for us, there is a huge need.
00:03:18.960 --> 00:03:23.680
We have three clinics, um, and there is a huge need for children to become vaccinated.
00:03:23.840 --> 00:03:27.199
So the first thing that we look at is we choose the right dates.
00:03:27.360 --> 00:03:29.120
We have to choose the right time.
00:03:29.360 --> 00:03:32.719
Um, I think that is the first and foremost.
00:03:32.960 --> 00:03:35.599
The next thing we have to look at is the location.
00:03:35.680 --> 00:03:39.759
Uh, I think the location is a big deal because you want to make sure that it is safe.
00:03:39.919 --> 00:03:41.039
It's a safe location.
00:03:41.280 --> 00:03:45.280
You also want to make sure that it's easy in and easy out.
00:03:45.360 --> 00:03:48.719
Is the traffic flow easy for parents to get in and out?
00:03:48.800 --> 00:04:01.360
Um, as well as just making sure that it's a large enough location so that for uh the patients that come in just to make sure that they have a large parking lot for traffic.
00:04:01.759 --> 00:04:12.639
Um I also think one of the most important things prior to getting any of the dates on the schedule is making sure that you're working with your rep.
00:04:13.039 --> 00:04:24.480
Whoever your rep is, you have to make sure that you have enough of the vaccine delivered to your location prior to those dates because you're also going to be giving flu vaccines in the clinic as well.
00:04:24.720 --> 00:04:39.680
Um, and I think for me, over the years, I have learned some tips and tricks, and one of those is ordering pre-filled syringes in advance as opposed to the single dose vials, because when you're drawing up, it takes time.
00:04:39.839 --> 00:04:45.680
So if you have those pre-filled syringes, it's a lot less time to draw those up and get those prepared.
00:04:46.000 --> 00:04:58.160
Also, another thing that I learned coming into the manager role and being on the nursing side of it too, one of the most important things is making sure that your lot numbers are kind of the same.
00:04:58.240 --> 00:05:06.319
Um, and that helps the clinical staff because when they're drawing up and I have my nurses documenting, uh, they can memorize that lot number.
00:05:06.639 --> 00:05:11.920
Um, so I think that for efficiency is very important so that they're not taking too much time.
00:05:12.160 --> 00:05:13.120
Well, that's fantastic.
00:05:13.279 --> 00:05:15.600
And actually, I wanted to talk about efficiency.
00:05:15.759 --> 00:05:18.319
So let's go ahead and skip to that a little bit.
00:05:18.480 --> 00:05:18.720
Yeah.
00:05:18.879 --> 00:05:25.759
Um, so can you walk us through the ideal patient flow from arrival to departure whenever people are coming in?
00:05:25.920 --> 00:05:31.199
Because we did talk about under, you know, planning, making sure your locations have easy in and out.
00:05:31.439 --> 00:05:33.839
But can you just talk us through what that flow looks like?
00:05:34.000 --> 00:05:38.399
I've experienced it myself, and yeah, I know you all have it nailed down and very efficient.
00:05:38.560 --> 00:05:39.920
So tell us a little bit about that.
00:05:40.319 --> 00:05:54.480
So, well, prior to that, I have my clinical staff make neon signs to um pretty much show where the event is going to be so off the road they can see exactly where it is if they've never been to the location.
00:05:54.720 --> 00:06:19.120
Um so we have signs, we have um the cars will come in through one way, and we have two to three lines of vaccine traffic that we have, you know, it doesn't matter what lane they're in, but they come in and we have our medical receptionists check them in and verify insurance, making sure that we have the guarantor with them as well.
00:06:19.360 --> 00:06:25.199
Um and uh after everything has been verified there, they give us a yellow sheet.
00:06:25.279 --> 00:06:31.600
Um, well, the medical receptionists give us a yellow sheet, and that yellow sheet then goes to my clinical staff.
00:06:31.839 --> 00:06:35.120
That yellow sheet has demographic information.
00:06:35.279 --> 00:06:40.879
It also has what type of vaccine they're gonna be getting if they are 10 care versus private insurance.
00:06:41.040 --> 00:06:48.480
That's a really big important factor for when our nurses draw up uh the vaccine to make sure that it's the right um the right vaccine.
00:06:48.639 --> 00:06:54.720
Um, and then uh just making sure that uh afterwards they have an easy exit.
00:06:54.959 --> 00:06:57.279
So yeah, that's pretty quick.
00:06:57.519 --> 00:06:58.000
That's great.
00:06:58.639 --> 00:06:59.839
It's been very efficient.
00:07:00.000 --> 00:07:06.240
Um I know that I feel like I pulled in and within 10 minutes we were pulling back out of the parking lot.
00:07:06.319 --> 00:07:11.920
Um and so that makes it a lot easier to handle hundreds of patients in one day.
00:07:12.079 --> 00:07:21.360
This is kind of, you know, not in the line of questions I planned on asking, but what is the typical amount of patients that you do um see in one of these um drive-through fluid clinics?
00:07:21.519 --> 00:07:30.639
Yeah, so it's funny that you asked that because I was actually forecasting for the amount of vaccines that we had to order this year based on last year's numbers.
00:07:30.800 --> 00:07:35.680
And last year in our Lebanon location, for one date from 8 a.m.
00:07:35.920 --> 00:07:40.480
to 1 p.m., we had 291 vaccines that we gave.
00:07:40.720 --> 00:07:41.040
Wow.
00:07:41.199 --> 00:07:47.439
Yes, and in Mount Juliet, in one day, we had 430 vaccines that we gave that day.
00:07:47.759 --> 00:07:48.480
That's amazing.
00:07:48.720 --> 00:07:52.959
Yeah, so within two days, we gave a total of 721 vaccines.
00:07:53.120 --> 00:08:01.360
Um, and I broke it down because I just, you know, I like to kind of do the math, and that we did 72 vaccines per hour.
00:08:01.519 --> 00:08:13.120
Um, because if we added up both hours, uh, we did 10 hours of of work time, and that's about 72 vaccines per hour, and about six vaccines per five minutes.
00:08:13.360 --> 00:08:16.319
So our staff were very efficient, very busy.
00:08:16.639 --> 00:08:18.399
That's amazing, very safe.
00:08:18.639 --> 00:08:26.720
I think that's a very big important that's one of our most important factors is maintaining patient safety during all of this because it's a quick process.
00:08:27.040 --> 00:08:28.480
It is a very quick process.
00:08:28.639 --> 00:08:32.559
What are some of the protections that you put put in place to maintain safety?
00:08:32.799 --> 00:08:42.399
Yeah, one of the biggest things is making sure that your staff are comfortable doing a model like this because some staff will clearly communicate to me that they do not feel comfortable.
00:08:42.480 --> 00:08:51.840
Um, and in in my setting as a manager, I communicate sometimes a little bit too much to my staff because I do need to know do you feel comfortable?
00:08:52.000 --> 00:08:56.559
We also have Saturday Vaccine Clinic uh that runs during those hours too.
00:08:56.639 --> 00:09:05.840
So if somebody doesn't feel comfortable but they're on the schedule, I can swap um, you know, a nurse for who's working the floor versus who wants to work in the vaccine clinic.
00:09:06.000 --> 00:09:10.720
Um so um that is that is one of the most important things.
00:09:10.879 --> 00:09:26.480
Um making sure I think that the parents have a conversation with the kiddos that can understand that they're gonna get a vaccine because them just showing up to our clinic and seeing a needle uh reaching into the car could be a little bit scary.
00:09:26.639 --> 00:09:28.879
Um so the parents do such a great job with that.
00:09:28.960 --> 00:09:32.639
I've noticed that you know they do communicate with the patients prior to.
00:09:32.960 --> 00:09:38.960
Um, and obviously, PPE, our nurses wear PPE with every single patient.
00:09:39.200 --> 00:10:04.080
Um, and I am on site for all of these dates throughout the whole time just to make sure that if there is a patient that is screaming or crying or really just not prepared to get it that day, I will call it off and just make sure that, you know, both the patient is safe as well as my clinical staff because the last thing we need is, you know, for something to happen to the patient or this the staff.
00:10:04.320 --> 00:10:13.039
We don't we allow the parents to jump in and kind of you know help hold, but we don't rely on the parents because it's not their job.
00:10:13.200 --> 00:10:18.879
And they're also, you know, trying to maintain maybe a far car full of other children.
00:10:19.039 --> 00:10:25.679
So I've I've experienced it myself, and I love your point about, you know, kind of coaching the parents to prepare their children for this.
00:10:25.840 --> 00:10:33.120
Um my son, I believe, was three or four when we went through the drive-thru flu clinic the last time, and it was extremely efficient.
00:10:33.200 --> 00:10:38.000
But I had prepared him and told him what was going to happen, and there were no tears.
00:10:38.240 --> 00:10:39.200
He sat still.
00:10:39.360 --> 00:10:40.799
I wasn't having to hold him.
00:10:40.960 --> 00:10:46.080
I will say nurses have some very strategic holding uh processes in the car.
00:10:46.480 --> 00:10:49.600
I was very, very impressed with that when we were there.
00:10:49.759 --> 00:10:58.799
But I think it's so important to speak to the safety, but um I did want to go back to the efficiency because again, I think that is so important.
00:10:58.960 --> 00:11:08.159
And we were talking about with the efficiency, um, you know, having come from clinic operations previously, I know how important those time slots are in clinics.
00:11:08.320 --> 00:11:11.039
So I did want to talk about how do you all pair this?
00:11:11.120 --> 00:11:19.200
Because obviously you didn't vaccinate every single patient at your drive-thru flu clinic, although you knocked out a very large amount of those.
00:11:19.679 --> 00:11:26.080
But how do you handle that along with just your regular in in-house vaccinations for for appointments?
00:11:26.159 --> 00:11:29.200
And you mentioned your Saturday clinics, but in addition to that.
00:11:29.600 --> 00:11:45.840
Well, we, you know, the goal for this whole flu drive-thru was to improve accessibility for patients, for clinical staff, for providers, and especially keeping in mind that during six season, you could see many different other things besides the flu.
00:11:46.000 --> 00:11:54.320
Um, those those spots are gonna get taken up pretty quickly, as well as having just a well visit on the schedule for a patient to be seen by a provider.
00:11:54.799 --> 00:12:07.279
So we really wanted to knock out as many vaccines as we could, as well as just making it easy for the parent that they didn't have to take their kiddo out of a car seat, come up the stairs, and have to wait for a an injection.
00:12:07.679 --> 00:12:16.720
Um we do have nurse visit-only appointments that allow for for this to um take place if they didn't make it to the flu drive-thru.
00:12:17.120 --> 00:12:26.720
Um, but it really knocks out the need for the nurses to step away from their regular day to um, you know, administer the flu vaccine.
00:12:26.879 --> 00:12:31.600
But in addition, yes, we have the flu vaccine um nurse visit only option.
00:12:31.919 --> 00:12:41.279
We also pair it with the well visits, and we also had a flu clinic that we offer on but we did it last year.
00:12:41.360 --> 00:12:47.759
Uh, we don't know if we're gonna do it this year just because there wasn't a need for it on Wednesdays and Fridays.
00:12:47.919 --> 00:12:53.200
So we allow a certain amount of time for patients to come in and we call it the flu clinic.
00:12:53.279 --> 00:12:58.240
Um, they come into our Mount Juliet location and we have a nurse available for four hours throughout the day.
00:12:58.559 --> 00:12:59.200
That's amazing.
00:12:59.679 --> 00:13:12.159
Oh, we we alluded to staffing, and you were talking about staff who may be comfortable in this model, and yeah, there's always those who are, you know, able to work more efficiently or quickly, and again, just don't mind giving vaccinations.
00:13:12.399 --> 00:13:16.960
I've worked with some nurses that you know are always a little hesitant, especially with some of the littles.
00:13:17.120 --> 00:13:21.679
But yeah, and will you tell me a little bit about how you prepare your staffing model for an event like this?
00:13:21.919 --> 00:13:35.039
Yeah, so uh the staffing model is probably one of the most important because you want to make sure that you have enough staff, but not that you're overstaffed, because again, you're you know, it's it has to be a very uh strategic operational model.
00:13:35.519 --> 00:13:42.799
So for us, uh we have two to three medical receptionists just to be ready, prepared for the cars coming in.
00:13:42.960 --> 00:13:52.799
Um, and we have two lanes normally, and one receptionist per lane uh where they identify the insurance and the guarantor.
00:13:52.960 --> 00:13:56.080
And then we have a runner if needed for those yellow sheets.
00:13:56.159 --> 00:14:06.000
If there's a yellow sheet backed up, we have the medical receptionist runner to, you know, transfer those yellow sheets between the medical receptionist and then the clinical staff for the next step.
00:14:06.159 --> 00:14:11.519
Um, so then I have about two to three nurses who are documenting the vaccines.
00:14:11.679 --> 00:14:18.399
Um, we work very closely with IT to make sure that we have our hotspots available because again, this is outside of the clinic.
00:14:18.480 --> 00:14:23.440
Um so we have to make sure that we have connection to our database.
00:14:23.840 --> 00:14:24.399
Right, false.
00:14:24.799 --> 00:14:26.960
So, yeah, that is a very important thing.
00:14:27.360 --> 00:14:29.759
Um, because we do everything in real time.
00:14:30.080 --> 00:14:39.600
Um, so making sure that the hotspots set up, two to three nurses documenting, they just sit down the entire time and document these um flu vaccines given.
00:14:39.759 --> 00:14:50.480
And then we have about three to five nurses who are doing the injecting, um, including myself, when if we were to ever get backed up, and normally that doesn't happen, um, but I'm available too to inject.
00:14:50.559 --> 00:15:02.480
But three to five nurses, um, because we have again two lanes, and sometimes you may need two nurses per car to help out because sometimes you may get one patient, sometimes you'll get seven, you know.
00:15:02.720 --> 00:15:06.080
Uh, and we I think seven was our most that we've gotten in a car.
00:15:06.240 --> 00:15:08.799
Sometimes we've had families bring two cars for families.
00:15:09.039 --> 00:15:09.360
Oh wow.
00:15:09.440 --> 00:15:11.679
I was gonna say they must have had a 15-passenger van.
00:15:12.000 --> 00:15:12.720
It's so convenient.
00:15:12.799 --> 00:15:13.600
Why would you not?
00:15:13.759 --> 00:15:16.000
So it is convenient, it is convenient.
00:15:16.159 --> 00:15:16.720
It is really great.
00:15:16.879 --> 00:15:28.080
And then again, I'm always on as a site manager because um, God forbid, any adverse effect, any type of um um, you know, issue that's a very important thing.
00:15:28.480 --> 00:15:31.519
Yes, and thankfully we have not had to, you know, deal with that.
00:15:31.600 --> 00:15:44.879
But um, and I make it fun because, you know, when they're doing the hard stuff, I try to keep the parent busy um and ask the parent questions as well as asking, you know, maybe the second one who's about to get their flu vaccine a question about their sports.
00:15:44.960 --> 00:15:49.200
Sometimes they're in uniforms going somewhere else afterwards, so I'll try to keep them distracted.
00:15:49.360 --> 00:15:51.120
Um, so I just try to do that as well.
00:15:51.279 --> 00:15:52.080
And then yeah.
00:15:52.320 --> 00:15:53.039
That's very smart.
00:15:53.120 --> 00:15:57.200
And you alluded to the fact when you have to jump in because you got might get a little behind.
00:15:57.360 --> 00:15:57.519
Yeah.
00:15:57.679 --> 00:16:03.200
So tell me what are some things that sometimes can cause delays or make things slow down?
00:16:03.279 --> 00:16:12.240
And along those lines, let's also talk about how do you prepare for unexpected, you know, challenges like the weather and things along those lines.
00:16:12.320 --> 00:16:14.480
So if you kind of want to touch on both of those together.
00:16:14.799 --> 00:16:26.240
So, for one of the challenges that we may face is when um if somebody's not on the schedule and if they're not on the schedule, we know that we can add them fairly quickly.
00:16:26.399 --> 00:16:32.240
We just have a blank yellow sheet that we have them fill out and we get them on the schedule right away.
00:16:32.480 --> 00:16:49.519
And maybe another challenge that we face, and um this happens every year as well, is you have an unconsolable child that is just not ready for the vaccine and knowing when to say it's not a safe environment.
00:16:49.679 --> 00:17:00.639
So sometimes we spend a lot of time with someone who's visibly upset in the car, and we give it a lot of time until we make that executive decision, and that's when I jump in.
00:17:00.879 --> 00:17:03.440
But just maintaining patient safety is the most important.
00:17:03.600 --> 00:17:10.240
So if I need to call it off for that for that moment, we may just have them come into the clinic at a later date.
00:17:10.480 --> 00:17:19.680
Um, and then you face the weather, you face heat challenges, you also face the rain challenges, and we come up with a plan.
00:17:19.759 --> 00:17:25.119
We do have tents that we have our staff under, especially for the computer system.
00:17:25.200 --> 00:17:28.640
We have them uh covered, as well as our medical receptionists.
00:17:28.720 --> 00:17:30.880
You have to also prepare for things like wind.
00:17:31.200 --> 00:17:35.200
Um that was was learned through trial and error.
00:17:35.359 --> 00:17:47.519
Um, just making sure you have paper weights, as simple as you know, paper clips to keep everything together, um, baskets underneath your chairs just to make sure you have somewhere to put your papers that you had just documented on.
00:17:47.680 --> 00:18:03.680
Um and just being fully prepared uh office-wise, you know, whether it's extra pens, extra paper, extra bins, extra paper clips, extra weight holders, um, extra stickers for the patients that don't want um, you know, a sucker.
00:18:04.319 --> 00:18:07.680
So this is how we address some of the challenges and we make it work.
00:18:08.240 --> 00:18:09.119
Well, that's great.
00:18:09.200 --> 00:18:14.400
And you mentioned one of the most favorite things of all kiddos when they visit the doctor's office.
00:18:14.640 --> 00:18:18.480
We obviously have stickers, but also you mentioned suckers.
00:18:18.559 --> 00:18:26.880
But what other treats or um positive reinforcement items do you have for the kiddos that are coming through for the drop-through flu clinics?
00:18:27.039 --> 00:18:29.359
Because I know that you all have some great things.
00:18:29.599 --> 00:18:29.920
Yes.
00:18:30.160 --> 00:18:32.960
And uh last year we trialed this.
00:18:33.039 --> 00:18:37.279
Uh, we had an ice cream truck last year, and we also had a snow cone truck.
00:18:37.519 --> 00:18:39.599
Both were so successful.
00:18:40.000 --> 00:18:44.799
Um, we actually sold out of the ice cream in the ice cream truck.
00:18:44.880 --> 00:18:51.119
Um, and they had to leave, they had to leave a little bit earlier than expected, but it was so great.
00:18:51.279 --> 00:18:53.839
Um, and the kiddos loved it.
00:18:53.920 --> 00:19:00.640
Um, we did get consent from the parents to take pictures of some of the kiddos uh who were enjoying the ice cream.
00:19:00.720 --> 00:19:11.599
But and this year we have an Italian ice truck that comes with all the toppings and including floats and whipped cream and ice cream and all the fun stuff.
00:19:11.759 --> 00:19:15.599
So we're doing it again this year, and I think it's gonna be a huge success.
00:19:15.920 --> 00:19:16.880
That's really exciting.
00:19:16.960 --> 00:19:23.200
Yes, if you think about flu season, it's kind of weird to think about, but it's still warm when you start giving these flu vaccinations.
00:19:23.279 --> 00:19:23.440
Yeah.
00:19:23.680 --> 00:19:25.359
So it's great to have a treat for the kids.
00:19:25.440 --> 00:19:35.680
And I was talking about for my son in particular, but even my daughter who's now two, I do typically have to have a little bit of bribery before we um, you know, get to the location.
00:19:35.759 --> 00:19:38.960
So I think this is very, very, very well thought out.
00:19:39.200 --> 00:19:43.119
It's healthy bribery, even for my staff.
00:19:43.279 --> 00:19:48.640
Um, I come from a very big Italian family, and the way I show love is with food.
00:19:48.799 --> 00:19:55.920
So I cook for them and I bring them water, I bring them coffee and bagels in the morning, I bring them pizza in the afternoon.
00:19:56.079 --> 00:20:00.319
So I feed them uh because it makes them want to work a little bit harder.
00:20:00.400 --> 00:20:02.079
And it is hot outside too.
00:20:02.160 --> 00:20:10.160
I mean, we work long hours, so just to reward them because I think that's one of the most important things, too, is just to show the appreciation to the families and our staff as well.
00:20:10.400 --> 00:20:12.000
I love that you have to take care of them.
00:20:12.079 --> 00:20:15.680
I've always said my giving love language is absolutely food.
00:20:16.000 --> 00:20:20.000
So I've always uh used that um and love to partake myself.
00:20:20.079 --> 00:20:21.680
So I think that's very well thought out.
00:20:22.079 --> 00:20:31.839
So one thing from a logistical standpoint, being outside of the clinic, you know, I've been involved in this from the operation side, but not the nurse and vaccine storage side.
00:20:31.920 --> 00:20:39.680
So tell me a little bit about how you, you know, keep the vaccines out at an event like this and how do you prepare for the storage of those?
00:20:39.920 --> 00:20:50.640
Um, you spoke a little bit to the observation, but maybe even more about the observation of um so we were also talking about that during these months, it could be hot.
00:20:50.799 --> 00:20:59.279
So we have to make sure that the vaccines maintain um proper temperature throughout the entire time of us giving the vaccines.
00:20:59.359 --> 00:21:01.680
Um, and we run this clinic from 8 a.m.
00:21:01.839 --> 00:21:02.720
to 1 p.m.
00:21:03.200 --> 00:21:14.960
So making sure that uh we maintain cold chain temperatures that are safe for handling, as well as having digital data loggers on top of those coolers that we have outside.
00:21:15.200 --> 00:21:18.880
A big part of my job is being a runner as a manager.
00:21:18.960 --> 00:21:25.440
I have to keep observation on the vaccines and not having too much on hand at any given time.
00:21:25.599 --> 00:21:32.400
So I do run upstairs, grab those vaccines from the refrigerator, and bringing them back downstairs into the coolers.
00:21:32.559 --> 00:21:52.319
And another big part of that piece is documentation and those crates that we do have underneath the table, that they are HIPAA compliant, that they are not just papers that anybody can touch that our clinical staff has a handle on once they put those lot numbers on there.
00:21:52.480 --> 00:21:57.920
I do grab those papers and I securely hold them and file them away as needed.
00:21:58.160 --> 00:22:04.559
So HIPAA compliance is a very Big part of that, as well as maintaining proper documentation.
00:22:04.880 --> 00:22:05.359
That's excellent.
00:22:05.440 --> 00:22:08.960
And you all are documenting real time into the EMR too, as you mentioned.
00:22:09.039 --> 00:22:09.680
So that's great.
00:22:09.759 --> 00:22:12.319
So this is just a good backup to help with the flow.
00:22:12.799 --> 00:22:13.519
That's wonderful.
00:22:13.680 --> 00:22:15.039
I think that's so smart.
00:22:15.119 --> 00:22:24.480
And it just helps give everybody an idea of how they can bring the clinic life out into a parking lot or outside to make this so much more effective.
00:22:24.720 --> 00:22:25.680
Yes, for sure.
00:22:25.839 --> 00:22:27.599
And it's it's creative and fun.
00:22:27.920 --> 00:22:33.200
The one thing I wanted to go back and touch on actually begins before people even show up for the flu clinic.
00:22:33.359 --> 00:22:38.319
So how do you notify people that you're doing this and how do you get them to register to come?
00:22:38.480 --> 00:22:39.759
Just tell me a little bit about that.
00:22:40.079 --> 00:22:55.200
Yeah, um, over the months leading into flu season, um, we uh contact our HR department, our and and they basically uh send messages out via text message or send emails out.
00:22:55.359 --> 00:23:03.680
We do a really great job with posting beautiful flyers throughout the clinic just to let the parents know who's in for a well visit.
00:23:03.759 --> 00:23:07.759
Let's just say that, hey, we're also running the flu drive-thru on these dates.
00:23:07.920 --> 00:23:09.839
Um, we also have social media.
00:23:10.000 --> 00:23:13.119
Uh, you have to do everything through social media nowadays.
00:23:13.200 --> 00:23:16.799
I feel like that is the biggest outreach that we have on our platform.
00:23:16.960 --> 00:23:24.559
We have a Facebook page and we also have a new Instagram page that we uh opened up about two weeks ago.
00:23:24.880 --> 00:23:25.359
So yeah.
00:23:25.599 --> 00:23:26.160
That's exciting.
00:23:26.400 --> 00:23:30.799
And so we we do a really good job with um with social media.
00:23:31.039 --> 00:23:45.920
Um I manage the Facebook page as well as one of my other clinical staff members, and um every week we just you know advise them to go ahead and make their appointments because again, this is appointment-based, it's not um walk-in based.
00:23:46.000 --> 00:23:51.119
Again, you're gonna have those walk-ins, but we we really do encourage the appointment process to take place.
00:23:51.599 --> 00:23:53.200
And do they cla call the office?
00:23:53.519 --> 00:24:08.319
Yes, they call the office and schedule their appointments, and they could also um reach out to our our medical receptionist if they have any questions, uh, or our triage nurses if they have any questions for legibility.
00:24:08.480 --> 00:24:17.279
Um, because some some new patients that do receive it need a two-dose um vaccine um if it's their first vaccine.
00:24:17.680 --> 00:24:20.799
So just answering those questions and being available is important.
00:24:21.359 --> 00:24:22.160
That's wonderful.
00:24:22.319 --> 00:24:27.440
Well, as we wrap up this conversation, I could talk about this topic for hours on end.
00:24:27.599 --> 00:24:29.680
It is something I'm extremely passionate about.
00:24:29.839 --> 00:24:42.720
But um, I wanted to just ask you again, you know, if there is a clinic that is wanting to get started this coming fall, what are some things that you said you would suggest that they, once they're listening to us on the podcast, what where should they start?
00:24:42.880 --> 00:24:44.480
What's the first thing they should do?
00:24:44.720 --> 00:25:11.599
Yeah, I again I think knowing why they're doing it, if there is a need for it, um, staffing is very important, making sure you have enough staff and as well as forecasting your vaccines, because I think with this model, you you do look at how many vaccines you do give for the vaccine drive-thru, but you also have to have that stash on the back end for the patients that are coming into the clinic as well.
00:25:11.759 --> 00:25:17.200
Um, so just knowing your forecasting for vaccine doses, I think is really important.
00:25:17.599 --> 00:25:26.160
Um, I also say reach out to your community for outreach to see if there's somebody that you can partner with um to get the word out.
00:25:26.319 --> 00:25:34.720
Um, just communicating to anybody who um would be willing to work with you is really important, I think, and make it fun.
00:25:34.960 --> 00:25:42.160
I think just making it a fun process, and if it's a small flu vaccine drive-thru to start, that's how we started.
00:25:42.400 --> 00:25:45.200
Um, and we grew over the years.
00:25:45.359 --> 00:25:51.519
And last year was the most vaccines that we've ever given, and um, within two days, especially.
00:25:51.680 --> 00:25:54.240
Um, and we just expect it to increase every year.
00:25:54.319 --> 00:26:04.799
But as long as we're, you know, working throughout the years and learning from our mistakes and learning to see what could be better um done the year after, that's how we we do.
00:26:04.960 --> 00:26:10.000
But I just say get out in the community and get the word out is the most important.
00:26:10.480 --> 00:26:11.839
So I love that.
00:26:12.000 --> 00:26:14.000
I just I do want to remind our members.
00:26:14.079 --> 00:26:22.880
So for those that are members of the foundation, we do have people on our staff that are previous practice administrators, and obviously we have access to Lucinda as well.
00:26:22.960 --> 00:26:27.599
But if this is something you're wanting to incorporate in your clinic, we would love for you to reach out to us.
00:26:27.680 --> 00:26:30.319
We would be happy to consult you on this.
00:26:30.559 --> 00:26:33.839
Um, it's all free of charge, it's part of your membership.
00:26:33.920 --> 00:26:39.920
And, you know, the pediatric community is, I mean, it's a family, you know, we are all here to serve the patients.
00:26:40.000 --> 00:26:53.279
And so, you know, Lucinda's, we've already talked about her sending me some pictures and graphics of how they make this happen that she's willing to share, you know, and I think that's so important that we all collaborate just to make sure the children are best taken care of.
00:26:53.519 --> 00:26:56.319
So before we wrap up, I just had one last question.
00:26:56.640 --> 00:27:02.640
What is just the one key takeaway that you would want listeners to remember about what we've discussed today?
00:27:03.599 --> 00:27:13.279
I think I know it's not a traditional model to have a nurse come into a car and administer a flu vaccine.
00:27:13.440 --> 00:27:17.359
Um, but just know that it is a safe model.
00:27:17.599 --> 00:27:19.359
It is an effective model.
00:27:19.599 --> 00:27:24.880
And once the parents do it once, they want to do it over and over and over again.
00:27:25.039 --> 00:27:29.680
Um, to the point that every year we get parents asking, can you give me my flu vaccine?
00:27:29.839 --> 00:27:31.519
Um, so giving it a chance.
00:27:31.680 --> 00:27:35.759
And it's not a traditional model, but it's a great model and very effective.
00:27:36.000 --> 00:27:40.319
Well, Lucinda, this has been one, so much fun, but two, so informative.
00:27:40.559 --> 00:27:42.160
What you all are doing is amazing.
00:27:42.400 --> 00:27:42.640
Thank you.
00:27:42.799 --> 00:27:49.759
I think the impact to your patients and the families and their overall health and protection through six season is just wonderful.
00:27:49.920 --> 00:27:51.440
I'm grateful for your time.
00:27:51.599 --> 00:27:58.960
I know it's very difficult to step away from the clinic, but we value your all's partnership and and participation in what we do.
00:27:59.039 --> 00:28:02.640
And just thank you for sharing your knowledge and experience that you've had.
00:28:02.799 --> 00:28:03.440
This has been great.
00:28:03.519 --> 00:28:05.279
I seriously could talk about it forever.
00:28:05.440 --> 00:28:10.960
So again, um, thank you for joining us for today's episode of Practice Management Minute.
00:28:11.039 --> 00:28:12.240
We hope you'll join us again.
00:28:12.400 --> 00:28:12.960
Thank you.
00:28:13.279 --> 00:28:15.839
Thank you for joining Cumberland Conversations.
00:28:16.000 --> 00:28:19.359
We're proud to support the people who care for Tennessee's children.
00:28:19.519 --> 00:28:28.079
Don't forget to subscribe so you never miss an episode and stay connected with CPF for more tools, trainings, and community updates.
00:28:28.240 --> 00:28:30.160
Until next time, take care.
00:00:00.080 --> 00:00:02.240
Welcome to Cumberland Conversations.
00:00:02.399 --> 00:00:08.800
This is a place where we talk about the issues that matter most to you, your patients, and your community.
00:00:08.880 --> 00:00:14.800
We're diving into real conversations with real people, sharing insights you can actually use.
00:00:15.039 --> 00:00:17.359
Let's get this conversation started.
00:00:17.679 --> 00:00:22.879
Hi everyone, it's Jessica Ray, Executive Director of the Cumberland Pediatric Foundation.
00:00:23.039 --> 00:00:26.879
We're back today with our next episode of the Practice Management Minute.
00:00:27.039 --> 00:00:33.920
Today I'm excited to be talking about one of my favorite topics, and that's drive-thru flu clinics and pop-up clinics.
00:00:34.079 --> 00:00:40.640
But this is actually going to be a continuation of our vaccine town hall that we started approximately a year ago.
00:00:40.799 --> 00:00:46.000
And I'm joined today by Lucinda Vasquez, who is the site manager for Peeds East.
00:00:46.079 --> 00:00:52.079
And I'm going to let her tell a little bit more about her role and talk a little bit about the clinic that she works for.
00:00:52.320 --> 00:00:56.479
Yeah, so uh my name is Lucinda, and I'm so happy to be here.
00:00:56.640 --> 00:00:58.640
Thank you for inviting me, number one.
00:00:58.960 --> 00:01:02.719
I am the site manager for our Peeds East locations.
00:01:02.799 --> 00:01:03.840
We have three locations.
00:01:04.000 --> 00:01:06.799
We have Mount Juliet, which is our largest location.
00:01:06.959 --> 00:01:10.000
We also have Hermitage and Lebanon as well.
00:01:10.319 --> 00:01:15.439
I work with 16 providers and over 60 employees on a day-to-day.
00:01:15.840 --> 00:01:16.640
And yeah.
00:01:17.040 --> 00:01:17.840
That's wonderful.
00:01:18.000 --> 00:01:26.480
Well, I'm very familiar with Peads East and think it's just a wonderful um clinic, but I wanted to talk about what you all are doing with your drive-through flu clinic.
00:01:26.719 --> 00:01:30.879
So can you tell us just a just an overview of how that came to be?
00:01:31.040 --> 00:01:33.920
Why did you decide to start doing drive-through flu clinics?
00:01:34.159 --> 00:01:49.280
Yeah, so we we started this in 2020, and that was in efforts to try to keep patients out of the clinic as much as possible while maintaining getting vaccinated and protected against the flu for the year.
00:01:49.840 --> 00:01:52.799
So I think that was uh the intention behind that.
00:01:52.959 --> 00:01:56.079
And so we just saw a huge success with it over the years.
00:01:56.239 --> 00:02:06.159
And when I stepped into the role uh as a nurse, I had done it and, you know, performed in the flu drive-thru.
00:02:06.480 --> 00:02:13.280
And then I became the clinical supervisor uh probably less than a year after being in the role as a nurse.
00:02:13.439 --> 00:02:17.280
And then about a year after that, I became the site manager.
00:02:17.439 --> 00:02:24.719
And every year since we've been doing it, we just found so many great positive aspects to continue to do it.
00:02:25.039 --> 00:02:26.159
That's really exciting.
00:02:26.240 --> 00:02:33.360
And I know we do have several other member clinics who are doing similar events, but there are some of our members who have said, How do we do this?
00:02:33.520 --> 00:02:35.199
How do we start doing something like that?
00:02:35.360 --> 00:02:37.919
So I definitely want to dive into that a little deeper.
00:02:38.159 --> 00:02:40.960
So first I want to talk about just the planning and setup.
00:02:41.039 --> 00:02:42.879
What goes into making this happen?
00:02:43.039 --> 00:02:50.159
So, for a clinic who might be considering doing this, what are the most important decisions to make early on?
00:02:50.479 --> 00:02:55.599
I think the first thing you have to think about is looking at the goals and why you're doing it.
00:02:55.759 --> 00:03:00.960
And I tell this to my staff as well when they're performing things in the clinic, is look at the why.
00:03:01.120 --> 00:03:03.039
Why are you doing things in the clinic?
00:03:03.199 --> 00:03:06.159
What is the what leads you to your decision?
00:03:06.319 --> 00:03:09.199
And in our clinic, is there a need for it?
00:03:09.280 --> 00:03:10.800
I think that's the biggest thing.
00:03:11.039 --> 00:03:16.719
Do we have a large population of parents that are going to be getting their children vaccinated?
00:03:16.879 --> 00:03:18.879
So for us, there is a huge need.
00:03:18.960 --> 00:03:23.680
We have three clinics, um, and there is a huge need for children to become vaccinated.
00:03:23.840 --> 00:03:27.199
So the first thing that we look at is we choose the right dates.
00:03:27.360 --> 00:03:29.120
We have to choose the right time.
00:03:29.360 --> 00:03:32.719
Um, I think that is the first and foremost.
00:03:32.960 --> 00:03:35.599
The next thing we have to look at is the location.
00:03:35.680 --> 00:03:39.759
Uh, I think the location is a big deal because you want to make sure that it is safe.
00:03:39.919 --> 00:03:41.039
It's a safe location.
00:03:41.280 --> 00:03:45.280
You also want to make sure that it's easy in and easy out.
00:03:45.360 --> 00:03:48.719
Is the traffic flow easy for parents to get in and out?
00:03:48.800 --> 00:04:01.360
Um, as well as just making sure that it's a large enough location so that for uh the patients that come in just to make sure that they have a large parking lot for traffic.
00:04:01.759 --> 00:04:12.639
Um I also think one of the most important things prior to getting any of the dates on the schedule is making sure that you're working with your rep.
00:04:13.039 --> 00:04:24.480
Whoever your rep is, you have to make sure that you have enough of the vaccine delivered to your location prior to those dates because you're also going to be giving flu vaccines in the clinic as well.
00:04:24.720 --> 00:04:39.680
Um, and I think for me, over the years, I have learned some tips and tricks, and one of those is ordering pre-filled syringes in advance as opposed to the single dose vials, because when you're drawing up, it takes time.
00:04:39.839 --> 00:04:45.680
So if you have those pre-filled syringes, it's a lot less time to draw those up and get those prepared.
00:04:46.000 --> 00:04:58.160
Also, another thing that I learned coming into the manager role and being on the nursing side of it too, one of the most important things is making sure that your lot numbers are kind of the same.
00:04:58.240 --> 00:05:06.319
Um, and that helps the clinical staff because when they're drawing up and I have my nurses documenting, uh, they can memorize that lot number.
00:05:06.639 --> 00:05:11.920
Um, so I think that for efficiency is very important so that they're not taking too much time.
00:05:12.160 --> 00:05:13.120
Well, that's fantastic.
00:05:13.279 --> 00:05:15.600
And actually, I wanted to talk about efficiency.
00:05:15.759 --> 00:05:18.319
So let's go ahead and skip to that a little bit.
00:05:18.480 --> 00:05:18.720
Yeah.
00:05:18.879 --> 00:05:25.759
Um, so can you walk us through the ideal patient flow from arrival to departure whenever people are coming in?
00:05:25.920 --> 00:05:31.199
Because we did talk about under, you know, planning, making sure your locations have easy in and out.
00:05:31.439 --> 00:05:33.839
But can you just talk us through what that flow looks like?
00:05:34.000 --> 00:05:38.399
I've experienced it myself, and yeah, I know you all have it nailed down and very efficient.
00:05:38.560 --> 00:05:39.920
So tell us a little bit about that.
00:05:40.319 --> 00:05:54.480
So, well, prior to that, I have my clinical staff make neon signs to um pretty much show where the event is going to be so off the road they can see exactly where it is if they've never been to the location.
00:05:54.720 --> 00:06:19.120
Um so we have signs, we have um the cars will come in through one way, and we have two to three lines of vaccine traffic that we have, you know, it doesn't matter what lane they're in, but they come in and we have our medical receptionists check them in and verify insurance, making sure that we have the guarantor with them as well.
00:06:19.360 --> 00:06:25.199
Um and uh after everything has been verified there, they give us a yellow sheet.
00:06:25.279 --> 00:06:31.600
Um, well, the medical receptionists give us a yellow sheet, and that yellow sheet then goes to my clinical staff.
00:06:31.839 --> 00:06:35.120
That yellow sheet has demographic information.
00:06:35.279 --> 00:06:40.879
It also has what type of vaccine they're gonna be getting if they are 10 care versus private insurance.
00:06:41.040 --> 00:06:48.480
That's a really big important factor for when our nurses draw up uh the vaccine to make sure that it's the right um the right vaccine.
00:06:48.639 --> 00:06:54.720
Um, and then uh just making sure that uh afterwards they have an easy exit.
00:06:54.959 --> 00:06:57.279
So yeah, that's pretty quick.
00:06:57.519 --> 00:06:58.000
That's great.
00:06:58.639 --> 00:06:59.839
It's been very efficient.
00:07:00.000 --> 00:07:06.240
Um I know that I feel like I pulled in and within 10 minutes we were pulling back out of the parking lot.
00:07:06.319 --> 00:07:11.920
Um and so that makes it a lot easier to handle hundreds of patients in one day.
00:07:12.079 --> 00:07:21.360
This is kind of, you know, not in the line of questions I planned on asking, but what is the typical amount of patients that you do um see in one of these um drive-through fluid clinics?
00:07:21.519 --> 00:07:30.639
Yeah, so it's funny that you asked that because I was actually forecasting for the amount of vaccines that we had to order this year based on last year's numbers.
00:07:30.800 --> 00:07:35.680
And last year in our Lebanon location, for one date from 8 a.m.
00:07:35.920 --> 00:07:40.480
to 1 p.m., we had 291 vaccines that we gave.
00:07:40.720 --> 00:07:41.040
Wow.
00:07:41.199 --> 00:07:47.439
Yes, and in Mount Juliet, in one day, we had 430 vaccines that we gave that day.
00:07:47.759 --> 00:07:48.480
That's amazing.
00:07:48.720 --> 00:07:52.959
Yeah, so within two days, we gave a total of 721 vaccines.
00:07:53.120 --> 00:08:01.360
Um, and I broke it down because I just, you know, I like to kind of do the math, and that we did 72 vaccines per hour.
00:08:01.519 --> 00:08:13.120
Um, because if we added up both hours, uh, we did 10 hours of of work time, and that's about 72 vaccines per hour, and about six vaccines per five minutes.
00:08:13.360 --> 00:08:16.319
So our staff were very efficient, very busy.
00:08:16.639 --> 00:08:18.399
That's amazing, very safe.
00:08:18.639 --> 00:08:26.720
I think that's a very big important that's one of our most important factors is maintaining patient safety during all of this because it's a quick process.
00:08:27.040 --> 00:08:28.480
It is a very quick process.
00:08:28.639 --> 00:08:32.559
What are some of the protections that you put put in place to maintain safety?
00:08:32.799 --> 00:08:42.399
Yeah, one of the biggest things is making sure that your staff are comfortable doing a model like this because some staff will clearly communicate to me that they do not feel comfortable.
00:08:42.480 --> 00:08:51.840
Um, and in in my setting as a manager, I communicate sometimes a little bit too much to my staff because I do need to know do you feel comfortable?
00:08:52.000 --> 00:08:56.559
We also have Saturday Vaccine Clinic uh that runs during those hours too.
00:08:56.639 --> 00:09:05.840
So if somebody doesn't feel comfortable but they're on the schedule, I can swap um, you know, a nurse for who's working the floor versus who wants to work in the vaccine clinic.
00:09:06.000 --> 00:09:10.720
Um so um that is that is one of the most important things.
00:09:10.879 --> 00:09:26.480
Um making sure I think that the parents have a conversation with the kiddos that can understand that they're gonna get a vaccine because them just showing up to our clinic and seeing a needle uh reaching into the car could be a little bit scary.
00:09:26.639 --> 00:09:28.879
Um so the parents do such a great job with that.
00:09:28.960 --> 00:09:32.639
I've noticed that you know they do communicate with the patients prior to.
00:09:32.960 --> 00:09:38.960
Um, and obviously, PPE, our nurses wear PPE with every single patient.
00:09:39.200 --> 00:10:04.080
Um, and I am on site for all of these dates throughout the whole time just to make sure that if there is a patient that is screaming or crying or really just not prepared to get it that day, I will call it off and just make sure that, you know, both the patient is safe as well as my clinical staff because the last thing we need is, you know, for something to happen to the patient or this the staff.
00:10:04.320 --> 00:10:13.039
We don't we allow the parents to jump in and kind of you know help hold, but we don't rely on the parents because it's not their job.
00:10:13.200 --> 00:10:18.879
And they're also, you know, trying to maintain maybe a far car full of other children.
00:10:19.039 --> 00:10:25.679
So I've I've experienced it myself, and I love your point about, you know, kind of coaching the parents to prepare their children for this.
00:10:25.840 --> 00:10:33.120
Um my son, I believe, was three or four when we went through the drive-thru flu clinic the last time, and it was extremely efficient.
00:10:33.200 --> 00:10:38.000
But I had prepared him and told him what was going to happen, and there were no tears.
00:10:38.240 --> 00:10:39.200
He sat still.
00:10:39.360 --> 00:10:40.799
I wasn't having to hold him.
00:10:40.960 --> 00:10:46.080
I will say nurses have some very strategic holding uh processes in the car.
00:10:46.480 --> 00:10:49.600
I was very, very impressed with that when we were there.
00:10:49.759 --> 00:10:58.799
But I think it's so important to speak to the safety, but um I did want to go back to the efficiency because again, I think that is so important.
00:10:58.960 --> 00:11:08.159
And we were talking about with the efficiency, um, you know, having come from clinic operations previously, I know how important those time slots are in clinics.
00:11:08.320 --> 00:11:11.039
So I did want to talk about how do you all pair this?
00:11:11.120 --> 00:11:19.200
Because obviously you didn't vaccinate every single patient at your drive-thru flu clinic, although you knocked out a very large amount of those.
00:11:19.679 --> 00:11:26.080
But how do you handle that along with just your regular in in-house vaccinations for for appointments?
00:11:26.159 --> 00:11:29.200
And you mentioned your Saturday clinics, but in addition to that.
00:11:29.600 --> 00:11:45.840
Well, we, you know, the goal for this whole flu drive-thru was to improve accessibility for patients, for clinical staff, for providers, and especially keeping in mind that during six season, you could see many different other things besides the flu.
00:11:46.000 --> 00:11:54.320
Um, those those spots are gonna get taken up pretty quickly, as well as having just a well visit on the schedule for a patient to be seen by a provider.
00:11:54.799 --> 00:12:07.279
So we really wanted to knock out as many vaccines as we could, as well as just making it easy for the parent that they didn't have to take their kiddo out of a car seat, come up the stairs, and have to wait for a an injection.
00:12:07.679 --> 00:12:16.720
Um we do have nurse visit-only appointments that allow for for this to um take place if they didn't make it to the flu drive-thru.
00:12:17.120 --> 00:12:26.720
Um, but it really knocks out the need for the nurses to step away from their regular day to um, you know, administer the flu vaccine.
00:12:26.879 --> 00:12:31.600
But in addition, yes, we have the flu vaccine um nurse visit only option.
00:12:31.919 --> 00:12:41.279
We also pair it with the well visits, and we also had a flu clinic that we offer on but we did it last year.
00:12:41.360 --> 00:12:47.759
Uh, we don't know if we're gonna do it this year just because there wasn't a need for it on Wednesdays and Fridays.
00:12:47.919 --> 00:12:53.200
So we allow a certain amount of time for patients to come in and we call it the flu clinic.
00:12:53.279 --> 00:12:58.240
Um, they come into our Mount Juliet location and we have a nurse available for four hours throughout the day.
00:12:58.559 --> 00:12:59.200
That's amazing.
00:12:59.679 --> 00:13:12.159
Oh, we we alluded to staffing, and you were talking about staff who may be comfortable in this model, and yeah, there's always those who are, you know, able to work more efficiently or quickly, and again, just don't mind giving vaccinations.
00:13:12.399 --> 00:13:16.960
I've worked with some nurses that you know are always a little hesitant, especially with some of the littles.
00:13:17.120 --> 00:13:21.679
But yeah, and will you tell me a little bit about how you prepare your staffing model for an event like this?
00:13:21.919 --> 00:13:35.039
Yeah, so uh the staffing model is probably one of the most important because you want to make sure that you have enough staff, but not that you're overstaffed, because again, you're you know, it's it has to be a very uh strategic operational model.
00:13:35.519 --> 00:13:42.799
So for us, uh we have two to three medical receptionists just to be ready, prepared for the cars coming in.
00:13:42.960 --> 00:13:52.799
Um, and we have two lanes normally, and one receptionist per lane uh where they identify the insurance and the guarantor.
00:13:52.960 --> 00:13:56.080
And then we have a runner if needed for those yellow sheets.
00:13:56.159 --> 00:14:06.000
If there's a yellow sheet backed up, we have the medical receptionist runner to, you know, transfer those yellow sheets between the medical receptionist and then the clinical staff for the next step.
00:14:06.159 --> 00:14:11.519
Um, so then I have about two to three nurses who are documenting the vaccines.
00:14:11.679 --> 00:14:18.399
Um, we work very closely with IT to make sure that we have our hotspots available because again, this is outside of the clinic.
00:14:18.480 --> 00:14:23.440
Um so we have to make sure that we have connection to our database.
00:14:23.840 --> 00:14:24.399
Right, false.
00:14:24.799 --> 00:14:26.960
So, yeah, that is a very important thing.
00:14:27.360 --> 00:14:29.759
Um, because we do everything in real time.
00:14:30.080 --> 00:14:39.600
Um, so making sure that the hotspots set up, two to three nurses documenting, they just sit down the entire time and document these um flu vaccines given.
00:14:39.759 --> 00:14:50.480
And then we have about three to five nurses who are doing the injecting, um, including myself, when if we were to ever get backed up, and normally that doesn't happen, um, but I'm available too to inject.
00:14:50.559 --> 00:15:02.480
But three to five nurses, um, because we have again two lanes, and sometimes you may need two nurses per car to help out because sometimes you may get one patient, sometimes you'll get seven, you know.
00:15:02.720 --> 00:15:06.080
Uh, and we I think seven was our most that we've gotten in a car.
00:15:06.240 --> 00:15:08.799
Sometimes we've had families bring two cars for families.
00:15:09.039 --> 00:15:09.360
Oh wow.
00:15:09.440 --> 00:15:11.679
I was gonna say they must have had a 15-passenger van.
00:15:12.000 --> 00:15:12.720
It's so convenient.
00:15:12.799 --> 00:15:13.600
Why would you not?
00:15:13.759 --> 00:15:16.000
So it is convenient, it is convenient.
00:15:16.159 --> 00:15:16.720
It is really great.
00:15:16.879 --> 00:15:28.080
And then again, I'm always on as a site manager because um, God forbid, any adverse effect, any type of um um, you know, issue that's a very important thing.
00:15:28.480 --> 00:15:31.519
Yes, and thankfully we have not had to, you know, deal with that.
00:15:31.600 --> 00:15:44.879
But um, and I make it fun because, you know, when they're doing the hard stuff, I try to keep the parent busy um and ask the parent questions as well as asking, you know, maybe the second one who's about to get their flu vaccine a question about their sports.
00:15:44.960 --> 00:15:49.200
Sometimes they're in uniforms going somewhere else afterwards, so I'll try to keep them distracted.
00:15:49.360 --> 00:15:51.120
Um, so I just try to do that as well.
00:15:51.279 --> 00:15:52.080
And then yeah.
00:15:52.320 --> 00:15:53.039
That's very smart.
00:15:53.120 --> 00:15:57.200
And you alluded to the fact when you have to jump in because you got might get a little behind.
00:15:57.360 --> 00:15:57.519
Yeah.
00:15:57.679 --> 00:16:03.200
So tell me what are some things that sometimes can cause delays or make things slow down?
00:16:03.279 --> 00:16:12.240
And along those lines, let's also talk about how do you prepare for unexpected, you know, challenges like the weather and things along those lines.
00:16:12.320 --> 00:16:14.480
So if you kind of want to touch on both of those together.
00:16:14.799 --> 00:16:26.240
So, for one of the challenges that we may face is when um if somebody's not on the schedule and if they're not on the schedule, we know that we can add them fairly quickly.
00:16:26.399 --> 00:16:32.240
We just have a blank yellow sheet that we have them fill out and we get them on the schedule right away.
00:16:32.480 --> 00:16:49.519
And maybe another challenge that we face, and um this happens every year as well, is you have an unconsolable child that is just not ready for the vaccine and knowing when to say it's not a safe environment.
00:16:49.679 --> 00:17:00.639
So sometimes we spend a lot of time with someone who's visibly upset in the car, and we give it a lot of time until we make that executive decision, and that's when I jump in.
00:17:00.879 --> 00:17:03.440
But just maintaining patient safety is the most important.
00:17:03.600 --> 00:17:10.240
So if I need to call it off for that for that moment, we may just have them come into the clinic at a later date.
00:17:10.480 --> 00:17:19.680
Um, and then you face the weather, you face heat challenges, you also face the rain challenges, and we come up with a plan.
00:17:19.759 --> 00:17:25.119
We do have tents that we have our staff under, especially for the computer system.
00:17:25.200 --> 00:17:28.640
We have them uh covered, as well as our medical receptionists.
00:17:28.720 --> 00:17:30.880
You have to also prepare for things like wind.
00:17:31.200 --> 00:17:35.200
Um that was was learned through trial and error.
00:17:35.359 --> 00:17:47.519
Um, just making sure you have paper weights, as simple as you know, paper clips to keep everything together, um, baskets underneath your chairs just to make sure you have somewhere to put your papers that you had just documented on.
00:17:47.680 --> 00:18:03.680
Um and just being fully prepared uh office-wise, you know, whether it's extra pens, extra paper, extra bins, extra paper clips, extra weight holders, um, extra stickers for the patients that don't want um, you know, a sucker.
00:18:04.319 --> 00:18:07.680
So this is how we address some of the challenges and we make it work.
00:18:08.240 --> 00:18:09.119
Well, that's great.
00:18:09.200 --> 00:18:14.400
And you mentioned one of the most favorite things of all kiddos when they visit the doctor's office.
00:18:14.640 --> 00:18:18.480
We obviously have stickers, but also you mentioned suckers.
00:18:18.559 --> 00:18:26.880
But what other treats or um positive reinforcement items do you have for the kiddos that are coming through for the drop-through flu clinics?
00:18:27.039 --> 00:18:29.359
Because I know that you all have some great things.
00:18:29.599 --> 00:18:29.920
Yes.
00:18:30.160 --> 00:18:32.960
And uh last year we trialed this.
00:18:33.039 --> 00:18:37.279
Uh, we had an ice cream truck last year, and we also had a snow cone truck.
00:18:37.519 --> 00:18:39.599
Both were so successful.
00:18:40.000 --> 00:18:44.799
Um, we actually sold out of the ice cream in the ice cream truck.
00:18:44.880 --> 00:18:51.119
Um, and they had to leave, they had to leave a little bit earlier than expected, but it was so great.
00:18:51.279 --> 00:18:53.839
Um, and the kiddos loved it.
00:18:53.920 --> 00:19:00.640
Um, we did get consent from the parents to take pictures of some of the kiddos uh who were enjoying the ice cream.
00:19:00.720 --> 00:19:11.599
But and this year we have an Italian ice truck that comes with all the toppings and including floats and whipped cream and ice cream and all the fun stuff.
00:19:11.759 --> 00:19:15.599
So we're doing it again this year, and I think it's gonna be a huge success.
00:19:15.920 --> 00:19:16.880
That's really exciting.
00:19:16.960 --> 00:19:23.200
Yes, if you think about flu season, it's kind of weird to think about, but it's still warm when you start giving these flu vaccinations.
00:19:23.279 --> 00:19:23.440
Yeah.
00:19:23.680 --> 00:19:25.359
So it's great to have a treat for the kids.
00:19:25.440 --> 00:19:35.680
And I was talking about for my son in particular, but even my daughter who's now two, I do typically have to have a little bit of bribery before we um, you know, get to the location.
00:19:35.759 --> 00:19:38.960
So I think this is very, very, very well thought out.
00:19:39.200 --> 00:19:43.119
It's healthy bribery, even for my staff.
00:19:43.279 --> 00:19:48.640
Um, I come from a very big Italian family, and the way I show love is with food.
00:19:48.799 --> 00:19:55.920
So I cook for them and I bring them water, I bring them coffee and bagels in the morning, I bring them pizza in the afternoon.
00:19:56.079 --> 00:20:00.319
So I feed them uh because it makes them want to work a little bit harder.
00:20:00.400 --> 00:20:02.079
And it is hot outside too.
00:20:02.160 --> 00:20:10.160
I mean, we work long hours, so just to reward them because I think that's one of the most important things, too, is just to show the appreciation to the families and our staff as well.
00:20:10.400 --> 00:20:12.000
I love that you have to take care of them.
00:20:12.079 --> 00:20:15.680
I've always said my giving love language is absolutely food.
00:20:16.000 --> 00:20:20.000
So I've always uh used that um and love to partake myself.
00:20:20.079 --> 00:20:21.680
So I think that's very well thought out.
00:20:22.079 --> 00:20:31.839
So one thing from a logistical standpoint, being outside of the clinic, you know, I've been involved in this from the operation side, but not the nurse and vaccine storage side.
00:20:31.920 --> 00:20:39.680
So tell me a little bit about how you, you know, keep the vaccines out at an event like this and how do you prepare for the storage of those?
00:20:39.920 --> 00:20:50.640
Um, you spoke a little bit to the observation, but maybe even more about the observation of um so we were also talking about that during these months, it could be hot.
00:20:50.799 --> 00:20:59.279
So we have to make sure that the vaccines maintain um proper temperature throughout the entire time of us giving the vaccines.
00:20:59.359 --> 00:21:01.680
Um, and we run this clinic from 8 a.m.
00:21:01.839 --> 00:21:02.720
to 1 p.m.
00:21:03.200 --> 00:21:14.960
So making sure that uh we maintain cold chain temperatures that are safe for handling, as well as having digital data loggers on top of those coolers that we have outside.
00:21:15.200 --> 00:21:18.880
A big part of my job is being a runner as a manager.
00:21:18.960 --> 00:21:25.440
I have to keep observation on the vaccines and not having too much on hand at any given time.
00:21:25.599 --> 00:21:32.400
So I do run upstairs, grab those vaccines from the refrigerator, and bringing them back downstairs into the coolers.
00:21:32.559 --> 00:21:52.319
And another big part of that piece is documentation and those crates that we do have underneath the table, that they are HIPAA compliant, that they are not just papers that anybody can touch that our clinical staff has a handle on once they put those lot numbers on there.
00:21:52.480 --> 00:21:57.920
I do grab those papers and I securely hold them and file them away as needed.
00:21:58.160 --> 00:22:04.559
So HIPAA compliance is a very Big part of that, as well as maintaining proper documentation.
00:22:04.880 --> 00:22:05.359
That's excellent.
00:22:05.440 --> 00:22:08.960
And you all are documenting real time into the EMR too, as you mentioned.
00:22:09.039 --> 00:22:09.680
So that's great.
00:22:09.759 --> 00:22:12.319
So this is just a good backup to help with the flow.
00:22:12.799 --> 00:22:13.519
That's wonderful.
00:22:13.680 --> 00:22:15.039
I think that's so smart.
00:22:15.119 --> 00:22:24.480
And it just helps give everybody an idea of how they can bring the clinic life out into a parking lot or outside to make this so much more effective.
00:22:24.720 --> 00:22:25.680
Yes, for sure.
00:22:25.839 --> 00:22:27.599
And it's it's creative and fun.
00:22:27.920 --> 00:22:33.200
The one thing I wanted to go back and touch on actually begins before people even show up for the flu clinic.
00:22:33.359 --> 00:22:38.319
So how do you notify people that you're doing this and how do you get them to register to come?
00:22:38.480 --> 00:22:39.759
Just tell me a little bit about that.
00:22:40.079 --> 00:22:55.200
Yeah, um, over the months leading into flu season, um, we uh contact our HR department, our and and they basically uh send messages out via text message or send emails out.
00:22:55.359 --> 00:23:03.680
We do a really great job with posting beautiful flyers throughout the clinic just to let the parents know who's in for a well visit.
00:23:03.759 --> 00:23:07.759
Let's just say that, hey, we're also running the flu drive-thru on these dates.
00:23:07.920 --> 00:23:09.839
Um, we also have social media.
00:23:10.000 --> 00:23:13.119
Uh, you have to do everything through social media nowadays.
00:23:13.200 --> 00:23:16.799
I feel like that is the biggest outreach that we have on our platform.
00:23:16.960 --> 00:23:24.559
We have a Facebook page and we also have a new Instagram page that we uh opened up about two weeks ago.
00:23:24.880 --> 00:23:25.359
So yeah.
00:23:25.599 --> 00:23:26.160
That's exciting.
00:23:26.400 --> 00:23:30.799
And so we we do a really good job with um with social media.
00:23:31.039 --> 00:23:45.920
Um I manage the Facebook page as well as one of my other clinical staff members, and um every week we just you know advise them to go ahead and make their appointments because again, this is appointment-based, it's not um walk-in based.
00:23:46.000 --> 00:23:51.119
Again, you're gonna have those walk-ins, but we we really do encourage the appointment process to take place.
00:23:51.599 --> 00:23:53.200
And do they cla call the office?
00:23:53.519 --> 00:24:08.319
Yes, they call the office and schedule their appointments, and they could also um reach out to our our medical receptionist if they have any questions, uh, or our triage nurses if they have any questions for legibility.
00:24:08.480 --> 00:24:17.279
Um, because some some new patients that do receive it need a two-dose um vaccine um if it's their first vaccine.
00:24:17.680 --> 00:24:20.799
So just answering those questions and being available is important.
00:24:21.359 --> 00:24:22.160
That's wonderful.
00:24:22.319 --> 00:24:27.440
Well, as we wrap up this conversation, I could talk about this topic for hours on end.
00:24:27.599 --> 00:24:29.680
It is something I'm extremely passionate about.
00:24:29.839 --> 00:24:42.720
But um, I wanted to just ask you again, you know, if there is a clinic that is wanting to get started this coming fall, what are some things that you said you would suggest that they, once they're listening to us on the podcast, what where should they start?
00:24:42.880 --> 00:24:44.480
What's the first thing they should do?
00:24:44.720 --> 00:25:11.599
Yeah, I again I think knowing why they're doing it, if there is a need for it, um, staffing is very important, making sure you have enough staff and as well as forecasting your vaccines, because I think with this model, you you do look at how many vaccines you do give for the vaccine drive-thru, but you also have to have that stash on the back end for the patients that are coming into the clinic as well.
00:25:11.759 --> 00:25:17.200
Um, so just knowing your forecasting for vaccine doses, I think is really important.
00:25:17.599 --> 00:25:26.160
Um, I also say reach out to your community for outreach to see if there's somebody that you can partner with um to get the word out.
00:25:26.319 --> 00:25:34.720
Um, just communicating to anybody who um would be willing to work with you is really important, I think, and make it fun.
00:25:34.960 --> 00:25:42.160
I think just making it a fun process, and if it's a small flu vaccine drive-thru to start, that's how we started.
00:25:42.400 --> 00:25:45.200
Um, and we grew over the years.
00:25:45.359 --> 00:25:51.519
And last year was the most vaccines that we've ever given, and um, within two days, especially.
00:25:51.680 --> 00:25:54.240
Um, and we just expect it to increase every year.
00:25:54.319 --> 00:26:04.799
But as long as we're, you know, working throughout the years and learning from our mistakes and learning to see what could be better um done the year after, that's how we we do.
00:26:04.960 --> 00:26:10.000
But I just say get out in the community and get the word out is the most important.
00:26:10.480 --> 00:26:11.839
So I love that.
00:26:12.000 --> 00:26:14.000
I just I do want to remind our members.
00:26:14.079 --> 00:26:22.880
So for those that are members of the foundation, we do have people on our staff that are previous practice administrators, and obviously we have access to Lucinda as well.
00:26:22.960 --> 00:26:27.599
But if this is something you're wanting to incorporate in your clinic, we would love for you to reach out to us.
00:26:27.680 --> 00:26:30.319
We would be happy to consult you on this.
00:26:30.559 --> 00:26:33.839
Um, it's all free of charge, it's part of your membership.
00:26:33.920 --> 00:26:39.920
And, you know, the pediatric community is, I mean, it's a family, you know, we are all here to serve the patients.
00:26:40.000 --> 00:26:53.279
And so, you know, Lucinda's, we've already talked about her sending me some pictures and graphics of how they make this happen that she's willing to share, you know, and I think that's so important that we all collaborate just to make sure the children are best taken care of.
00:26:53.519 --> 00:26:56.319
So before we wrap up, I just had one last question.
00:26:56.640 --> 00:27:02.640
What is just the one key takeaway that you would want listeners to remember about what we've discussed today?
00:27:03.599 --> 00:27:13.279
I think I know it's not a traditional model to have a nurse come into a car and administer a flu vaccine.
00:27:13.440 --> 00:27:17.359
Um, but just know that it is a safe model.
00:27:17.599 --> 00:27:19.359
It is an effective model.
00:27:19.599 --> 00:27:24.880
And once the parents do it once, they want to do it over and over and over again.
00:27:25.039 --> 00:27:29.680
Um, to the point that every year we get parents asking, can you give me my flu vaccine?
00:27:29.839 --> 00:27:31.519
Um, so giving it a chance.
00:27:31.680 --> 00:27:35.759
And it's not a traditional model, but it's a great model and very effective.
00:27:36.000 --> 00:27:40.319
Well, Lucinda, this has been one, so much fun, but two, so informative.
00:27:40.559 --> 00:27:42.160
What you all are doing is amazing.
00:27:42.400 --> 00:27:42.640
Thank you.
00:27:42.799 --> 00:27:49.759
I think the impact to your patients and the families and their overall health and protection through six season is just wonderful.
00:27:49.920 --> 00:27:51.440
I'm grateful for your time.
00:27:51.599 --> 00:27:58.960
I know it's very difficult to step away from the clinic, but we value your all's partnership and and participation in what we do.
00:27:59.039 --> 00:28:02.640
And just thank you for sharing your knowledge and experience that you've had.
00:28:02.799 --> 00:28:03.440
This has been great.
00:28:03.519 --> 00:28:05.279
I seriously could talk about it forever.
00:28:05.440 --> 00:28:10.960
So again, um, thank you for joining us for today's episode of Practice Management Minute.
00:28:11.039 --> 00:28:12.240
We hope you'll join us again.
00:28:12.400 --> 00:28:12.960
Thank you.
00:28:13.279 --> 00:28:15.839
Thank you for joining Cumberland Conversations.
00:28:16.000 --> 00:28:19.359
We're proud to support the people who care for Tennessee's children.
00:28:19.519 --> 00:28:28.079
Don't forget to subscribe so you never miss an episode and stay connected with CPF for more tools, trainings, and community updates.
00:28:28.240 --> 00:28:30.160
Until next time, take care.
