Becker's Hospital Review

22 POPULATION HEALTH 22 CEO / STRATEGY Dr. Atul Gawande: Mass vaccinations at stadiums, convention centers are crucial By Molly Gamble T he pace and scale of COVID-19 vaccination needed to curb the pan- demic requires the use of conventional healthcare sites and high-throughput, mass vaccination events at stadiums, arenas and convention centers, Atul Gawande, MD, and colleagues wrote for the New England Journal of Medicine. ere are several reasons effective, swi and high-volume COVID-19 vaccine administra- tion can overpower conventional healthcare sites and practices, three being: 1. At least 25 percent of Americans lack a primary care provider, making the nation's primary care network and infrastructure un- fit for the mass outreach needed to vaccinate millions of Americans as quickly as possible. 2. Routine vaccinations are oen deliv- ered as a convenient add-on to existing ap- pointments due to the shelf-stable standby supply of vaccines. e current scarcity of COVID-19 vaccine supply, however, means every last dose in multidose vials must be used, and allocations need to get in the arms of those in high-priority groups. 3. Limited reimbursement for vaccinations may prevent smaller practices from devel- oping financially viable models for deliver- ing shots outside existing visits. For exam- ple, Medicare reimbursement rates are not enough to cover setup costs of vaccine site requirements — temperature and storage, observation staffing and space, scheduling, and follow-up — if volume is limited. "Mass vaccination sites offer a logical solu- tion that addresses each of these challenges," wrote the authors, pointing to events at Gil- lette Stadium in Foxborough, Mass., Dodger Stadium in Los Angeles and State Farm Sta- dium in Glendale, Ariz., as models. e Gillette event, which the authors are in- volved with, rolled out with customer experi- ence designers, systems engineers, medical di- rectors, informaticists, clinical and nonclinical staffing and scheduling experts, emergency medical services professionals, infection-pre- vention officers, and communications special- ists — an entire suite of skills and staff that is rarely found in health systems alone. Mass vaccination sites should also be part of an overall plan — not one-off events — with involvement from state, regional and local officials and public and private stakeholders, the authors maintain, and smart site plan- ning can help meet states' and cities' equita- ble distribution goals. Dr. Gawande is the former CEO of Haven and served as a member of President Joe Biden's COVID-19 task force during the presidential transition. He is currently a professor at Har- vard Medical School and surgeon at Brigham and Women's Hospital, both in Boston. His co-authors for the New England Journal of Medicine piece are Eric Goralnick, MD, med- ical director of the Brigham Health Access Center and Emergency Preparedness in Bos- ton, and Christoph Kaufmann, PhD, lead vac- cine coordinator at CIC Health, a subsidiary of Cambridge (Mass.) Innovation Center. n How competing Cleveland Clinic, University Hospitals CEOs view partnership post-pandemic By Hannah Mitchell C leveland Clinic and University Hospitals severed a historical rivalry when they began collaborating shortly before the COVID-19 pandemic. Both CEOs discussed four ways a partnership can benefit both health- care systems post-pandemic during a March 9 radio seg- ment on Radio Advisory. Cleveland Clinic and University Hospitals, both based in Cleveland, are two of the largest healthcare systems in Northeast Ohio — and they're direct competitors. Tom Mihaljevic, MD, CEO and president of the Cleve- land Clinic, and Cliff Megerian, MD, the president and CEO of University Hospitals, first began discuss- ing a collaboration before the pandemic in hopes their combined resources could create synergy, and they've rolled out several joint initiatives to com- bat COVID-19 in the last year, including Ohio's first drive-thru testing site. Four ways a hospital partnership can be beneficial: 1. With their resources combined, both CEOs felt their health systems were better aligned to be awarded grants, citing winning a training grant by the National Institutes of Health. 2. The partnership enables recruitment. Dr. Megerian said when they recruit people who have spouses and his hos- pital cannot hire both, they can look for a position in the other system. 3. Noncompetitive areas like supply chains and laundry can create back office resources the hospitals can use to give each other advantages. 4. The partnership could result in an increase in mean- ingful research output by combined resources and research professionals. n

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