Due to COVID-19, reducing the spread of respiratory illnesses like flu and getting a flu vaccine this fall and winter are more important than ever. Health centers across the country are responding with innovative strategies such as drive-thru flu clinics, flu strike teams, and IT solutions that find and map communities in need of flu vaccines. They are testing and refining these strategies to ensure that vaccines are administered safely and quickly amidst the challenges of the COVID-19 pandemic.
Many health centers are closely assessing their flu vaccine strategies, data, communication and education campaigns, and staff training with a focus on microplanning for the COVID-19 vaccination rollout when the vaccine becomes available.
And nurses have a significant seat at the table, playing a key role in microplanning for immunizations and responding to public health crises given the intersection of clinical, operations, quality, and patient-centered care. Year of the Nurse 2020 is a reminder of that.
The October 15th “Nurses on the Front Lines” webinar featured Mary Blankson, Chief Nursing Officer, Community Health Center, Inc., Nate Peña, Registered Nurse Care Manager, Esperanza Health Center, and Anthony Fortenberry, Chief Nursing Officer, Callen-Lorde Community Health Center. This panel of nursing leaders shared lessons learned from their 2020 flu vaccine season strategies and key considerations for developing COVID-19 vaccination implementation microplans. You can read about these lessons learned and considerations here.
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COMMUNITY HEALTH CENTERS IN ACTION
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EHR COVID-19 SYMPTOM TRACKER FLOWSHEET: A Game Changer for Nursing Follow-Up
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CHALLENGE
As cases surged during the early weeks of the COVID-19 pandemic access to testing kits and supplies and understanding of the virus were limited. The South Boston Community Health Center’s (SBCHC) strong nursing team addressed their patient care needs head on. They called patients every 1-2 days to check on their symptoms and clinical status using a custom-built master report in SBCHC’s EHR that automated updates of their COVID-19 symptoms, treatment, and testing status. Utilizing this report and trying to organize follow-up was very labor intensive and became inefficient as more patients were added to this registry.
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SOLUTION
Nurses and providers needed to track COVID-19 symptoms more efficiently and safely prioritize follow-up calls so that the growing number of COVID-19-related patient cases would not fall through the cracks.
Led by Cheralyn Johnson, QI Director, a cross-functional SBCHC team developed a COVID-19 Symptom Tracker Flowsheet that they built into the EHR system. The flowsheet enabled the nurses to use an Active Tracking approach to track patient’s progress more easily and quickly over time. They could also compare cases, prioritize follow-up calls, and schedule future calls.
The flowsheet allowed them to catch more serious cases early for referrals and freed
up time for nurses to provide care.
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MULTI-STATE QUALITY IMPROVEMENT EFFORT
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Health centers across the country continue to respond, recover, and reimagine care as they prepare for a potential surge in COVID-19 cases expected this fall and winter. Building reusable infrastructure for collecting, analyzing, and sharing data and outcomes among community health centers is critically important to enhance their pandemic response and improve patient care for this crisis and the one that follows.
With support from a CDC cooperative agreement, NACHC will work with partners
to support better use of existing data, systems, and data collection on their patient populations. This will help NACHC and partners to better describe the health burden, disparities, and overall impact of COVID-19 on community health centers. NACHC is building an enduring health information technology (HIT) infrastructure to
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support public health data aggregation and analytics. Six Health Center Controlled Networks (HCCN) and Primary Care Association (PCA) partners are providing deidentified, patient-level data about the patient risks, outcomes, and responses to the COVID-19 pandemic. Partners will take an active role in data quality improvement using a Human-Centered Design approach to examine real-world clinical and data workflows in different health centers across the United States. Finally, each partner will select additional HIT innovation opportunities to extend their data capacity and reporting abilities.
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CRISIS BUSINESS CONTINUITY PLANNING
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The COVID-19 pandemic has disrupted nearly every aspect of health centers’ infrastructure, clinical care, and people, including staff and patients. Among the many challenges faced, clinical care, operations, and leadership teams had to quickly create new patient care procedures and processes, address staff's mental, emotional and physical stress, and find new revenue streams when traditional ones were temporarily on hold.
“Crisis business continuity planning is critical for health centers facing such challenges with
the need to quickly prioritize, pivot, and respond effectively to a public health crisis," says Gervean Williams, NACHC’s Director, Health Care Financial Training. “Prepared in advance, these plans can help health center leaders stay focused on delivering value-driven models
of care to their patients.”
NACHC is partnering with the Primary Care Development Corporation (PCDC)—a non-profit provider of capital, technical assistance, and advocacy for safety net primary care providers—to develop a Crisis Business Continuity Planning Curriculum and Action Guide with tools and customizable templates and lessons learned from the field. This Crisis Business Continuity Planning Action Guide will assist health center leadership teams in developing and improving their preparation and plans for responding to COVID-19 as the winter months approach, as well as other future public health crises. The action guide will be available on the NACHC website in the beginning of 2021.
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Jointly released in September by the Department of Health and Human Services (HHS) and the Department of Defense (DOD), this document outlines the federal government’s macro-strategy for delivering and administering a COVID-19 vaccine once one is approved.
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Published by CDC, this Playbook contains information for states, territories, and local public health organizations and their partners to guide them in planning for the distribution of a COVID-19 vaccine.
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UPCOMING NACHC LEARNING EVENTS
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This publication is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $2,000,000, with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.
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