First in a Three-Part Series: How to Speed Mass Vaccination
The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.
By Tony Rodriguez and Mike Beauregard
June 3, 2021
Process improvements at Hartford’s Dunkin’ Donuts Park clinic increase COVID-19 vaccination rate by 207% in five weeks.
Emergency use authorization of the Pfizer BioNTech and Moderna vaccines ignited hope for stemming COVID-19 infections and deaths in 2021. It also pushed city health departments’ plans into overdrive to vaccinate their most vulnerable and marginalized residents.
Three months before vaccines became available in January, Hartford began working with the region’s hospital systems, community clinics and volunteers to coordinate its mass-vaccination infrastructure, according to Hartford Health and Human Services (HHS) Director Liany Arroyo.
To speed shots in shoulders, cities’ mass vaccination sites need their processes to flow like warm syrup—smoothly and quickly. To complement the work of its mobile vaccination clinics and expand access, Hartford needed an indoor vaccination site close to all city neighborhoods, bus lines and access to free parking. Leaders of the four-years-new Dunkin’ Donuts Park (home of the Hartford Yard Goats minor league baseball team) offered the stadium’s event space for a clinic.
“Working with the park’s management team, multiple city departments, our community organization partners, regional medical reserve and youth services corps, it took just two weeks to get our first Saturday clinic up and running at Dunkin’ Donuts Park in early February,” Arroyo said. “We then added volunteers from local colleges and universities who had been supporting our mobile vaccination effort.”
Lightning-speed setup of the clinic was challenging. “Our biggest dilemma was how to keep everything appropriately spaced. We tried locating different elements on two floors, then three floors. There was a lot of angst and nervousness among staff and volunteers on how to make it work,” said Arroyo.
To help Hartford’s Department of Health & Human Services offer more vaccinations faster at the Dunkin’ Donuts Park Saturday clinic, the Daniel Penn Associates (DPA) team volunteered our operational expertise to Hartford Mayor Luke Bronin and Vas Srivastava, his chief of staff. They supported the idea and introduced us to Ms. Arroyo.
Applying the lean principles we use to improve our clients’ operations, we identified ways the clinic could make simple, non-cost-intensive changes to shave time from each step of the process, smooth flow and speed up the process throughput. The DPA team helped them apply more visual controls, balance their processes, and eliminate wastes, especially the Waste of Waiting. We helped improve throughput by 207% in five weeks. These improvements set the stage for the Saturday vaccination clinics to nearly quadruple their output. Here’s the story.
The Team Effort
We started working on the process on February 27 at the Dunkin’ Donuts Park clinic.
During our observations and data collection, we met on site with Ms. Arroyo, DHHS Operations Manager Faith Palmer, Dr. Bruce Gould, Hartford Yard Goats President Tim Restall, volunteers from local universities and some of the volunteer nurses and doctors administering the vaccines. The city’s Health and human services staff welcomed us to their team.
Unique Challenges
From the very beginning the city’s health and human services team worked hard to create an efficient vaccination clinic at Dunkin’ Donuts Park. But to improve the operation, they faced challenges. The Saturday prior to our first visit, the Hartford team scheduled and vaccinated 274 patients. The initial goal was 500 vaccinations at each 10 am to 3 pm Saturday clinic. Achieving this goal would require overcoming some constraints:
- Elderly population—Connecticut was still in the 65 and older age brackets for vaccinations.
- Mobility issues—many of the patients had limited mobility and needed assistance.
- Language barriers—some patients spoke no English.
- Space constraints—Dunkin’ Donuts Park is a great place to watch a baseball game. We love it. But it is not optimal as a vaccination clinic site in the late winter or early spring.
- Volunteer-supported processes—while many from Hartford’s professional staff work the vaccination clinic, the bulk of the personnel are volunteers with many changes in faces from week to week.
- Budget constraints—vaccination clinics are important, but city resources are limited.
Initial Effort
We observed the process and broke it down into these steps:
Evaluation 1 (E1) = general evaluation time period of 15 minutes for most people after their vaccination. Evaluation 2 (E2) = 30 minutes post vaccination evaluation period for patients with some medical conditions.
We then collected data on each of the process steps.
This gave an average total cycle time of 36.1 minutes for patients in the 15-minute evaluation grouping and 51.1 minutes for patients requiring a 30-minute evaluation.
Analysis
With a Takt Time of 0.6 min/patient, even with nine stations, registration was the bottleneck. Under the clinic’s initial operating practices, this would limit vaccinations to 403 patients per Saturday session. On the opposite end of the spectrum, the actual vaccination step had far too much capacity. This was supported by other data we captured where random samplings revealed 14.6 vaccination stations idle at any given point during the day.
In Part 2 of this article, we’ll talk about the process bottlenecks we found at the clinic and how we addressed them.
Authors:
Mike Beauregard, International Consultant, Daniel Penn Associates
Mike Beauregard has successfully applied improvement techniques in companies ranging from 10 person start-up companies to Fortune 500 manufacturers. He is a registered Professional Engineer and a Certified Quality Engineer and an eight-time member of the Board of Examiners for the Malcolm Baldridge National Quality Award. He is certified in lean implementation by the Supplier Excellence Alliance (SEA), the aerospace supply-chain consortium, and is certified as a lean-six sigma master black belt by the Management and Strategy Institute.
Antonio R. (Tony) Rodriguez, CMC, President, Daniel Penn Associates
Antonio (Tony) Rodriguez is a certified management consultant with 35+ years’ experience in encouraging collaboration and progressive thinking to bring about effective change and organizational transformation. With expertise in facilitation/team development, Lean Six Sigma, lean continuous improvement, re-engineering, supply chain optimization, supplier diversity, strategic sourcing, asset management, and productivity improvement, Rodriguez has successfully directed projects for large and medium-sized entities, both public and private, national and international.
(No Ratings Yet)
Loading...
First in a Three-Part Series: How to Speed Mass Vaccination
The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.
By Tony Rodriguez and Mike Beauregard
June 3, 2021
Process improvements at Hartford’s Dunkin’ Donuts Park clinic increase COVID-19 vaccination rate by 207% in five weeks.
Emergency use authorization of the Pfizer BioNTech and Moderna vaccines ignited hope for stemming COVID-19 infections and deaths in 2021. It also pushed city health departments’ plans into overdrive to vaccinate their most vulnerable and marginalized residents.
Three months before vaccines became available in January, Hartford began working with the region’s hospital systems, community clinics and volunteers to coordinate its mass-vaccination infrastructure, according to Hartford Health and Human Services (HHS) Director Liany Arroyo.
To speed shots in shoulders, cities’ mass vaccination sites need their processes to flow like warm syrup—smoothly and quickly. To complement the work of its mobile vaccination clinics and expand access, Hartford needed an indoor vaccination site close to all city neighborhoods, bus lines and access to free parking. Leaders of the four-years-new Dunkin’ Donuts Park (home of the Hartford Yard Goats minor league baseball team) offered the stadium’s event space for a clinic.
“Working with the park’s management team, multiple city departments, our community organization partners, regional medical reserve and youth services corps, it took just two weeks to get our first Saturday clinic up and running at Dunkin’ Donuts Park in early February,” Arroyo said. “We then added volunteers from local colleges and universities who had been supporting our mobile vaccination effort.”
Lightning-speed setup of the clinic was challenging. “Our biggest dilemma was how to keep everything appropriately spaced. We tried locating different elements on two floors, then three floors. There was a lot of angst and nervousness among staff and volunteers on how to make it work,” said Arroyo.
To help Hartford’s Department of Health & Human Services offer more vaccinations faster at the Dunkin’ Donuts Park Saturday clinic, the Daniel Penn Associates (DPA) team volunteered our operational expertise to Hartford Mayor Luke Bronin and Vas Srivastava, his chief of staff. They supported the idea and introduced us to Ms. Arroyo.
Applying the lean principles we use to improve our clients’ operations, we identified ways the clinic could make simple, non-cost-intensive changes to shave time from each step of the process, smooth flow and speed up the process throughput. The DPA team helped them apply more visual controls, balance their processes, and eliminate wastes, especially the Waste of Waiting. We helped improve throughput by 207% in five weeks. These improvements set the stage for the Saturday vaccination clinics to nearly quadruple their output. Here’s the story.
The Team Effort
We started working on the process on February 27 at the Dunkin’ Donuts Park clinic.
During our observations and data collection, we met on site with Ms. Arroyo, DHHS Operations Manager Faith Palmer, Dr. Bruce Gould, Hartford Yard Goats President Tim Restall, volunteers from local universities and some of the volunteer nurses and doctors administering the vaccines. The city’s Health and human services staff welcomed us to their team.
Unique Challenges
From the very beginning the city’s health and human services team worked hard to create an efficient vaccination clinic at Dunkin’ Donuts Park. But to improve the operation, they faced challenges. The Saturday prior to our first visit, the Hartford team scheduled and vaccinated 274 patients. The initial goal was 500 vaccinations at each 10 am to 3 pm Saturday clinic. Achieving this goal would require overcoming some constraints:
Initial Effort
We observed the process and broke it down into these steps:
Evaluation 1 (E1) = general evaluation time period of 15 minutes for most people after their vaccination. Evaluation 2 (E2) = 30 minutes post vaccination evaluation period for patients with some medical conditions.
We then collected data on each of the process steps.
This gave an average total cycle time of 36.1 minutes for patients in the 15-minute evaluation grouping and 51.1 minutes for patients requiring a 30-minute evaluation.
Analysis
With a Takt Time of 0.6 min/patient, even with nine stations, registration was the bottleneck. Under the clinic’s initial operating practices, this would limit vaccinations to 403 patients per Saturday session. On the opposite end of the spectrum, the actual vaccination step had far too much capacity. This was supported by other data we captured where random samplings revealed 14.6 vaccination stations idle at any given point during the day.
In Part 2 of this article, we’ll talk about the process bottlenecks we found at the clinic and how we addressed them.
Authors:
Mike Beauregard, International Consultant, Daniel Penn Associates
Mike Beauregard has successfully applied improvement techniques in companies ranging from 10 person start-up companies to Fortune 500 manufacturers. He is a registered Professional Engineer and a Certified Quality Engineer and an eight-time member of the Board of Examiners for the Malcolm Baldridge National Quality Award. He is certified in lean implementation by the Supplier Excellence Alliance (SEA), the aerospace supply-chain consortium, and is certified as a lean-six sigma master black belt by the Management and Strategy Institute.
Antonio R. (Tony) Rodriguez, CMC, President, Daniel Penn Associates
Antonio (Tony) Rodriguez is a certified management consultant with 35+ years’ experience in encouraging collaboration and progressive thinking to bring about effective change and organizational transformation. With expertise in facilitation/team development, Lean Six Sigma, lean continuous improvement, re-engineering, supply chain optimization, supplier diversity, strategic sourcing, asset management, and productivity improvement, Rodriguez has successfully directed projects for large and medium-sized entities, both public and private, national and international.
Follow Us!