Mass Vaccinations at the United States Naval Academy.

We analyzed the mass influenza vaccination clinic process at the United States Naval Academy to identify gaps and implement changes for improvement. The Lean Six Sigma methodology was employed. Total number of staff members working the clinic and total hours worked were measured at baseline in August 2013 and after implementation in August 2014 to determine improvement. The clinic was moved from a hallway to an auditorium, and a linear patient flow was established. Staff members wore vests for easy identification, and the supply box was reorganized. Training was standardized and given to all staff members before working in the clinic. These changes decreased the number of staff members required to work in the clinic from 62 to 40 (-35.5%) and decreased the total number of hours worked from 558 to 360 (-35.5%). The changes successfully improved the mass vaccination clinic by decreasing staffing and hours required. These changes can be adopted in other settings to increase community capacity and readiness.

Using Lean Six Sigma Methodology to Improve a Mass Immunizations Process at the United States Naval Academy.

Lean Six Sigma (LSS) is a process improvement methodology developed in the manufacturing industry to increase process efficiency while maintaining product quality. The efficacy of LSS application to the health care setting has not been adequately studied. This article presents a quality improvement project at the U.S. Naval Academy that uses LSS to improve the mass immunizations process for Midshipmen during in-processing. The process was standardized to give all vaccinations at one station instead of giving a different vaccination at each station. After project implementation, the average immunizations lead time decreased by 79% and staffing decreased by 10%. The process was shown to be in control with a capability index of 1.18 and performance index of 1.10, resulting in a defect rate of 0.04%. This project demonstrates that the LSS methodology can be applied successfully to the health care setting to make sustainable process improvements if used correctly and completely.

Knowledge, attitudes, and practices of school personnel regarding influenza, vaccinations, and school outbreaks.

BACKGROUND: School personnel are important for communicating with parents about school vaccination programs and recognizing influenza outbreaks. This study examined knowledge, attitudes, and practices of school personnel regarding seasonal and 2009 H1N1 influenza, vaccinations, and school outbreak investigations. METHODS: Data were analyzed from survey interviews of 58 elementary and middle school personnel in 2010. RESULTS: Principals, assistant principals, and nurses have higher knowledge than front office clerks regarding seasonal (odds ratio [OR]: 2.50, 95% confidence interval [CI]: 1.15-5.42) and 2009 H1N1 influenza (OR: 2.04, 95% CI: 1.19-3.71). During 2009-2010, 63.8 and 19.0% of school personnel received seasonal and 2009 H1N1 influenza vaccine, respectively. Personnel were more likely to be vaccinated against seasonal influenza if they believed the vaccine was safe (OR: 2.26, 95% CI: 1.21-4.19). Of those unvaccinated against 2009 H1N1, 48.9% also cited safety concerns. While every principal, assistant principal, and nurse received both infectious diseases and outbreak trainings, only 42.5 and 27.5% of clerks received these trainings, respectively (p < .001), and 30% of clerks believed outbreak recognition was not their responsibility. CONCLUSION: The level of knowledge regarding influenza illness, vaccination, and outbreaks among subjects was low overall. Education of school personnel may improve school vaccination programs and control of influenza outbreaks.