Becker's Hospital Review

54 CMO / CARE DELIVERY Mount Sinai exec: What we learned about setting up COVID-19 vaccination sites By Hannah Mitchell M ount Sinai Morningside Hospital employed lean management tech- niques to design its vaccination site, according to a March 12 article published in Harvard Business Review. Lucy Xenophon, MD, chief transformation offi- cer at the New York City-based hospital shared five steps Mount Sinai took to get started: 1. Define the challenge. Mount Sinai Morn- ingside's journey to create an efficient vacci- nation site started with a problem statement: We need to vaccinate X number of people per day at Y location with Z resources. 2. Understand the current state. Adminis- trators gathered data on available storage ca- pacity at the pharmacy, the number of people trained to vaccinate, how it would schedule and register patients, the number of pharma- cists available to reconstitute the drug, the number of doses expected per vial and the shelf life of the reconstituted vaccine. Next, they planned their vaccination location site by observing the path vaccines and pa- tients would need to take. ey chose their auditorium, Dr. Xenophon said. 3. Map the process. e hospital identified the roles it needed to fill and outlined the steps each role would take. Process maps al- lowed the different roles to visualize potential obstacles, define roles and plan for things like efficient storage. 4. Define the Standard Work. Steps were cre- ated for each role by the people responsible for that role. For example, a vaccinator is a registered nurse, physician's assistant, nurse practitioner, or physician who administers injections. e vaccinators are trained to use the ambulatory care version of the electronic health record to document the encounter and must have an active New York State license and active ba- sic-life-support certification. 5. Execution considerations. Simulation of the vaccination process allowed for design considerations. Each bay has standard sup- plies, and a printed set-up diagram is hung in each bay. Because vaccinators rotate, this process made it easy for the people on duty to assemble the space. e diagram mini- mizes the delays caused by missing items or excessive items. n Alaska hospital cited for infection control deficiencies By Erica Carbajal S tate regulators cited Juneau, Alaska-based Bartlett Regional Hospital in February after a January inspection found issues related to screening and infection prevention procedures at the hospital, local news station KTOO reported March 15. The inspection was sparked by a staff member's complaints, according to KTOO. Inspectors reported that some people weren't following through on all steps of the COVID-19 screening process at the hospital's front entrance, with some skipping out on using the hand sanitiz- er. The inspection also found some of the hospital staff were not routinely filling out a symptom screening worksheet at the start of their shifts. "They did find that we had good policies, but we weren't 100 per- cent in following all of our safe practices," Charlee Gribbon, BSN, RN, infection preventionist at Bartlett, told KTOO. In one instance, a staff member who showed up feeling sick was not directed to go home. The employee later tested positive for COVID-19. Ms. Gribbon said the employee and other hospital staff had been vaccinated around that time, so she believed it could've been side effects from the vaccine. After receiving notice of the violations, Kevin Benson, Bartlett's act- ing CEO, told the board of directors that the hospital had to devel- op a plan detailing how it would correct the issues within 10 days. "It was a learning experience and I thought it was really validating for the importance of the little things," Ms. Gribbon said. n 5+ early symptoms may predict 'long COVID,' study finds By Mackenzie Bean P eople who have more than five symptoms of COVID-19 during the first week of illness may be more likely to develop prolonged health issues, known as "long COVID," according to a study published March 10 in Nature Medicine. Researchers analyzed data on 4,182 COVID-19 cases in which patients self-reported symptoms through an app. About 13 percent of patients re- ported virus symptoms lasting 28 days or more, and 4.5 percent had symptoms for eight weeks or more. Another 2.3 percent reported symptoms for at least 12 weeks. Symptoms included fatigue, headache, difficulty breathing and loss of taste or smell. Patients with prolonged symptoms were more likely to be older, female or have a higher body mass index compared to those who had symptoms for 10 days or less. Based on these findings, researchers created a predictive model to distinguish between short and long COVID-19 within a week of illness. Researchers said the study's findings could help identify people at risk of long COVID and aid pre- vention, treatment and rehabilitation efforts. n

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