The Michigan Medicine drive-thru that’s saving lives and easing hospital burden
The Michigan Medicine team has not been immune to staffing shortages and high patient demand during the pandemic. Nevertheless, one nurse turned an out-of-the-box idea into one of the system’s great successes in treating COVID-19 infections.
Meet Marie Richards, M.S.N., R.N., a senior nursing director with the infusion team within ambulatory care services.
Richards teamed up with Lindsay Petty, M.D., a U-M infectious disease specialist, and Nick Dillman, Pharm.D., a clinical pharmacist specialist in pediatric infectious diseases, to solve a caseload issue.
More COVID-19 patients were coming to their offices at West Ann Arbor and Northville than they could possibly treat with monoclonal antibodies. The infusion treatment, which required just an IV this time last year, was now available as a single shot but was high in time and resource consumption due to wait times following the injections.
So, in early October, as COVID-19 cases continued to rise in Michigan and eligibility expanded to high-risk groups who did not yet test positive, Richards and her team got together during a casual Friday meeting to formulate a solution.
Health agencies have been using the drive-thru method for testing and vaccines, but the monoclonal antibody treatment requires four simultaneous shots and a one-hour wait time.
“We brought it up on a Friday,” Richards said. “And it was implemented four days later on Tuesday. We don’t have that many private rooms in our buildings, but a car can count as a private room. Families will come as a group, or couples, all in one group.”
Therein lies the magic: efficiency. Bringing forward a simple outpatient solution to treat COVID-19, which prevents severe illness and ensuing hospitalization. In the first eight days of this setup, the Michigan Medicine team provided 88 car-side administrations, which was much higher than the average 20 during the week in the office. In all, just four staffers were needed at a time.
For some, hearing the thought of four shots is scary, but it should be thought of as similar to allergy shots with smaller needles. The shots are given on the abdomen, patients wait in the parking lot for one hour for observation, and then they’re sent on their way.
There was some trepidation at the beginning, and as such, Richards wanted to be sure to take credit for any pratfalls that occurred, which meant she led the staffing at the onset.
“If I’m the one who comes up with a bad idea, I can’t bring anyone else down with me,” she said jokingly.
Now that the weather has cooled and the snow has begun falling, the operation has been curtailed to weekend treatments. And with oral treatments coming down the pike, monoclonal antibody treatment may take a slightly different form.
In reflection, Richards was glowing about how the program has progressed.
“I’ve spent a fair amount of time giving monoclonal antibodies and/or figuring out how to give them,” Richards added. “I’m really proud of what our teams have done. That’s my parting shot.”
Ultimately, positive outcomes included better tolerance by the patients due to less discomfort and nausea, while reducing pharmacy demand and infusion chair availability. Additionally, staff and patient exposure to COVID-19 was decreased, while minimizing patient exertion.
Unequivocally, the program has been a success, so much so that the model has been adopted by the State of Michigan health department and other health institutions.
And it’s all thanks to a quick-thinking nurse, an infectious disease doctor and a pharmacist.
Learn more about this story: Monoclonal antibody treatment gains ground in Michigan’s COVID fight (Bridge Michigan)