Vaccine team joins together to protect the community
Everyone knew a COVID-19 vaccine was eventually coming, but when? What type? And exactly how was everyone going to get the shots? Those were the burning questions for the better part of 2020.
Way back in May, “Operation Warp Speed” fast tracked the manufacture of six promising vaccines before FDA approval. At that time, Chief Medical Officer Jeff Desmond, M.D., established a charter for the COVID-19 Vaccine and Therapeutics Taskforce (CVTT) and began recruiting leaders — but with no details and no operational team yet in place, it became a waiting game. It wasn’t until the end of the year that the word came: Pfizer was ready to ship.
It was time to bring the team together.
Finally, a call to action
“In early December, several of us got the call that vaccines would be coming and we needed help with operations,” said Elly Samuels, who was asked to redeploy full-time from her role as chief department administrator of otolaryngology and co-lead the COVID-19 Vaccine Coordination Office (CVCO). “A significant amount of work had been done to prepare, by many different groups. We jumped in to help support the delivery of shots into arms as quickly as possible. From Day 1, the strength of teamwork has been like nothing else I’ve ever experienced.”
Samuels’ co-leads of the CVCO were Jessie DeVito and Robert Chang, M.D. Chang also headed information technology and analytics efforts, which were critical to building Blue Queue, the vaccine delivery database and operational platform.
Dozens of other subject matter experts and community partners were brought together to support the vaccination plans. In total, approximately 75 core team members, representing almost every Michigan Medicine department, were dedicated to immunizing the workforce and community. And that does not count the many vaccinators and volunteers who have stepped up, as well as others behind the scenes who did their part to make sure doses were administered as quickly and safely as possible.
The first doses arrived Monday, Dec. 14, which Dana Habers, co-chair of the CVTT, described as “a powerful milestone and symbol of hope” for the newly assembled team.
“I will never forget the first time I spoke with Stan Kent, our chief pharmacy officer and fellow co-chair, after he received the first shipment and his team moved it from the docks into our freezer,” Habers said. “Their excitement was contagious. The day was the culmination of our investment in scientific exploration and research; our empowerment of talent to pull off miraculous operational feats; and our ability to step up and lead in the community.”
The first vaccines were administered in the lobby of Ford Auditorium. Tom Mann, manager of Occupational Health Services, helped set up the Ford site, hired the original vaccinator workforce, deployed training on the new vaccine and has been part of workflow and quality optimization ever since.
Challenges mount as shipments increase
Once the initial excitement of building the team and receiving the vaccine wore off, there came many challenges.
“All of our training, in whatever area we specialize in, prepared us to a certain extent — but you’re never truly prepared for the immense scope of this work,” said Sandro Cinti, M.D., professor of internal medicine who serves as the third co-chair of the task force. “Just like the pandemic itself challenged our system, the vaccine brought us so many obstacles, including dealing with scarce resources and people who were worried or unhappy with the way we were required to prioritize the vaccination.”
Habers agreed: “Our biggest challenges have been prioritization and vaccine supply. Both variables were outside of our direct control, and have been the bucket of water thrown on the flame of the breakthroughs that led to the vaccine.”
She added that the team has heard positive news about vaccine supply, so there is hope that the team will be able to be utilized to its full potential soon.
“The team has built an A+ mass vaccination delivery system, but it has so far been underutilized by many across our community,” Habers said.
For Amanda Sedlik, senior director of clinical and operational applications at HITS, the challenges were more technical.
With a lead time of just hours from the FDA’s announcement to arrival of the vaccine, the OHS and Quality Analytics teams worked to quickly create a strong solution to schedule and administer the first doses through the MiCart application. As the landscape continued to shift regarding new vaccines, vaccine availability and targeted populations, a new solution was needed to meet the rapidly-changing environment. Over the holidays, teams pulled together to identify the next phase for scheduling and documenting the vaccines.
“It was amazing to watch groups from all over the organization come together. Teams spent countless hours, evenings and weekends to identify the best way forward to meet the vaccine demand and create a new workflow within MiChart to keep operations moving as smoothly as possible,” said Sedlik.
The new solution allowed the organization to vaccinate broad populations on a massive scale, but training became a new challenge, according to Sedlik.
Typically, staff receive access to MiChart after training, but there was no time to create materials and use that approach. The HITS team went onsite to perform just-in-time training. Vaccinators received access, learned the system and asked questions in real-time, allowing vaccinations to continue with minimal impact.
“We had to act fast, but it was a success. It was amazing teamwork,” she said.
The enrollment and registration process also involved a lot of teamwork from the revenue cycle team. Chief officer of revenue cycle management, Benjie Johnson, estimated that approximately 65 team members were involved in creating Medical Record Numbers (MRNs), activating portal accounts and supporting billing, documentation and compliance requirements, as well as reporting.
“The speed and flexibility necessary as changes occurred on a daily basis was a challenge, but having central groups like the CVCO make communication and issue gathering/resolving easier,” Johnson said. “The team understood the need to work together — otherwise we would not have been able to vaccinate thousands of people in such a short period of time. We all knew what was at stake.”
Leaning on teamwork
The stakes have been high for everyone, according to Fiona Linn, strategic advisor to the chief medical officer. Linn was tapped to co-lead population strategy for the vaccination team.
“The vaccine is very personal for everyone,” she said. “Everyone’s desire to get themselves and their loved ones vaccinated ASAP generates a fair amount of scrutiny and ‘Monday morning quarterbacking’ around what in reality is both a highly constrained and immensely complicated balancing act. Part of our challenge as a team has been to find ways to be kind to ourselves and support each other through that, as well as to encourage each other to maintain some semblance of work-life balance when everything about the vaccination effort feels immediate and urgent.”
All team members agreed that together they leaned on the organization’s core value of teamwork to survive the challenges.
“Everyone stepped in and did whatever it took – it truly was a multidisciplinary miracle,” said Jessie Devito, another CVCO co-lead, who joined from her day job running UMMG’s virtual care platform.
“Every day, every interaction, everything we’ve built reflects this value,” Habers said. “We could not have done what we have without leaning on one another and merging our talents along this entire journey.”
There are many more people who work tirelessly on this project. We cannot begin to acknowledge them all here. Their rewards are few, other than the gratitude they receive from the members of our community who they continue to serve through this pandemic.