Mitigating COVID-19 Vaccine Waste Through a Multidisciplinary Inpatient Vaccination Initiative.

ABSTRACT: A multidisciplinary team at a tertiary care Veterans Health Administration medical center created a standardized process to identify medically stable inpatients, to notify inpatient staff of available COVID-19 vaccine doses, and to coordinate inpatient vaccine administration. The team's goals were to mitigate vaccine waste while safely vaccinating as many patients as possible. Using a unique set of exclusion criteria and clinical judgment, a quality improvement team reviewed patients admitted to medicine teams to determine medical stability. Eligible, interested patients were listed in a secure shared file, and outpatient vaccine clinic staff communicated with inpatient nurse leaders regarding the availability of unadministered doses. Doses were transported to the hospital from the clinic and administered by inpatient nurses. Between January 8 and April 26, 2021, 105 patients were vaccinated with either the Moderna or the Pfizer-BioNTech COVID-19 vaccine during admission. Sixty-nine percent of the patients received a first dose, 27% received a second dose, and 4% received both doses. Forty-two percent of the patients vaccinated while inpatient identified as Black or African American compared with 28% of the vaccinated outpatients. No vaccine-related safety events were reported. This process demonstrates a viable approach to mitigating waste of COVID-19 vaccines and safely, efficiently, and equitably vaccinating an inpatient population.

Small-Group Discussion Sessions on Imposter Syndrome.

Introduction: The Accreditation Council for Graduate Medical Education requires residency programs to support residents' well-being via established policies and programs. Imposter syndrome has been linked to burnout in residents, and understanding how to combat it may help improve resiliency in residents. Methods: We held a facilitator-guided, interactive discussion session for internal medicine residents on the topic of imposter syndrome as part of a larger series of discussion sessions on resident wellness. We repeated the session to capture a different group of residents. A psychologist or chief resident led each 30- to 45-minute session with the option to include an attending physician. Residents, faculty, and a clinical psychologist developed instructions for leading this session. At the end of each session, the facilitator provided attendees with a handout with take-home points and an optional postsurvey to assess learning objectives and ask whether they felt this was an effective intervention to promote resident wellness. Results: We collected data from 21 residents who attended the small-group discussion sessions. Ninety-six percent of residents felt comfortable recognizing imposter syndrome in themselves, and 62% knew the appropriate next steps after identifying imposter syndrome. Eighty-one percent of residents felt that the imposter syndrome wellness session was an effective intervention to promote resident wellness. Discussion: Imposter syndrome has been linked to resident burnout, and discussing imposter syndrome was viewed as an effective intervention to promote resident wellness and resiliency. When creating wellness interventions, other programs should consider addressing imposter syndrome.