Throughput times for adults and children during two drive-through influenza vaccination clinics.

OBJECTIVES: Successful planning for public health emergencies requires knowledge of effective methods for mass distribution of medication and supplies to the public. We measured the time required for the key components of 2 drive-through vaccination clinics and summarized the results as they applied to providing medical countermeasures to large populations of children and adults. We hypothesized that vaccinating children in addition to adults would affect throughput time. METHODS: Using 2 separate drive-through vaccination clinics, we measured elapsed time for vehicle flow and vaccination procedures. We calculated the median length of stay and the time to administer vaccinations based on the number of individual vaccinations given per vehicle, and compared the vehicles in which children (aged 9-18 years) were vaccinated to those in which only adults were vaccinated. RESULTS: A total of 2174 vaccinations and 1275 vehicles were timed during the 2 clinics. The number of vaccinations and vehicles per hour varied during the course of the day; the maximums were 200 and 361 per hour, respectively. The median throughput time was 5 minutes, and the median vaccination time was 48 seconds. Flow over time varied by the hour, and the optimum number of vaccinations per vehicle to maximize efficiency was between 3 and 4. Our findings showed that the presence of children raised the total number of vaccinations given per vehicle and, therefore, the total vaccination processing time per vehicle. However, the median individual procedure time in the vehicles with children was not significantly increased, indicating no need to calculate increased times for processing children 9 years of age or older during emergency planning. CONCLUSIONS: Drive-through clinics can provide a large number of seasonal influenza vaccinations in a relatively efficient manner; provide needed experience for students and practitioners in techniques for mass administration of medical countermeasures; and assist public health and emergency management personnel with disaster planning. Including children older than 9 years does not reduce efficiency. (Disaster Med Public Health Preparedness. 2013;0:1-7).

Effective healthcare system response to consecutive Florida hurricanes.

In September 2004, two consecutive hurricanes (Hurricane Frances and Hurricane Jeanne) made landfall in Stuart, FL, and created healthcare needs that overtaxed the capacity of the local healthcare system. To determine the character and structure of the response to these hurricanes, researchers from the University of New Mexico, Center for Disaster Medicine conducted both a structured written survey of employees and a guided group interview with healthcare system management. The written survey queried staff on topics related to their ability and willingness to get to work and stay at work during the storms. The roundtable interview with leadership resulted in analysis of the preexisting Emergency Operations Plan and its use during the storms, including preparation and execution of plans for staffing, facility operation, communication, community resource utilization, and recovery. In addition, the interaction with federally deployed Disaster Medical Assistance Teams was documented and reviewed. In general, prior planning on the part of the healthcare system in Stuart, FL, resulted in a successful response to both hurricanes. Employees were willing and able to provide the necessary care for patients during the hurricanes, overcoming many physical and emotional barriers that arose during the month-long response. These barriers included concern for the safety of family and pets, inoperable or insufficient communication methods, and damage to employees' personal property and homes. Recommendations for healthcare system preparedness and response were formulated by the researchers based on this healthcare system's successful response to back-to-back hurricanes, including recommendations for interacting with disaster medical resources.