Preparing for an influenza pandemic: model of an immunization clinic in an urban family practice

Abstract

Problem addressed: The surge in patient demand for the H1N1 influenza vaccine during the 2009 pandemic.

Objective of the program: To facilitate timely delivery of the 2009 H1N1 influenza vaccine to a family practice population while preserving regular clinic function and to create a model of effective vaccination delivery for future outbreaks.

Program description: An academic family practice in Toronto, Ont, adopted a process-improvement approach and implemented 3 Saturday stand-alone H1N1 vaccination clinics to accommodate increased demand for the vaccine. Medical directives were developed to give nurses the authority to vaccinate patients. Consent forms with eligibility criteria and risks versus benefits sheets were provided to patients in the waiting area to make optimal use of time. The clinic with "appointment blocks" for patients had improved efficiency (ie, fewer bottlenecks from waiting area to vaccination room), which was satisfactory to both staff and patients.

Conclusion: During a pandemic, when patient demand for vaccination is high, such stand-alone vaccination clinics in conjunction with family practices can deliver vaccines to patients in a timely and acceptable manner while promoting continuity of care. This model requires the commitment of extra staffing resources if regular primary care delivery is to be maintained.

Figure 1.

Diagram of walk-in vaccination clinic flow Inj—injector, LR—line runner, O—observer, PP—patient puller, Pt—patient, S—secretary, SC—supply controller. Arrows represent movement of people.