Evaluating SARS-CoV-2 Saliva and Dried Blood Spot Surveillance Strategies in a Congregate Population.

The optimal approach to COVID-19 surveillance in congregate populations remains unclear. Our study at the US Naval Academy in Annapolis, Maryland, USA, assessed the concordance of antibody prevalence in longitudinally collected dried blood spots and saliva in a setting of frequent PCR-based testing. Our findings highlight the utility of salivary-based surveillance.

Impact of Nonpharmaceutical Interventions During the COVID-19 Pandemic on Medically Attended Acute Respiratory Infection: The U.S. Naval Academy Experience.

INTRODUCTION: Medically attended acute respiratory infections (MAARI) at the U.S. Naval Academy increase during Plebe Summer, a training program for incoming freshmen. Because of COVID-19, extensive nonpharmaceutical interventions (NPI) were implemented during 2020 Plebe Summer. METHODS: We reviewed MAARI counts in weeks 22-45 from 2012 to 2020 and compared counts in pandemic (2020) vs. pre-pandemic (2012-2019) periods. RESULTS: From 2012 to 2019, an average of 1,642 MAARI cases occurred annually. In 2020, 443 MAARI cases occurred. NPI use was associated with a 77% reduction in MAARI. CONCLUSIONS: During a high-risk military training period, routine NPI use was associated with a major reduction in MAARI.

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.