摘要：Objectives. To explore whether an emergency preparedness structure is a feasible, efficient, and sustainable way for health care organizations to manage mass vaccination events. Methods. We used the Hospital Incident Command System to conduct a 1-day annual mass influenza vaccination event at Vanderbilt University Medical Center over 5 successive years (2011–2015). Using continuous quality improvement principles, we assessed whether changes in layout, supply management, staffing, and documentation systems improved efficiency. Results. A total of 66 591 influenza vaccines were administered at 5 annual Flulapalooza events; 13 318 vaccines per event on average. Changes to the physical layout, staffing mix, and documentation processes improved vaccination efficiency 74%, from approximately 38 to 67 vaccines per hour per vaccinator, while reducing overall staffing needs by 38%. An unexpected finding was the role of social media in facilitating active engagement. Conclusions. Health care organizations can use a closed point-of-dispensing model and Hospital Incident Command System to conduct mass vaccination events, and can adopt the “Flulapalooza method” as a best practice model to enhance efficiency. In an infectious disease pandemic, public health departments will be challenged to provide vaccination to all sectors of society. 1 Major employers, universities, and other systems with large, well-defined, and geographically concentrated populations can assist in this public health endeavor by conducting closed point-of-dispensing (C-POD) mass vaccination clinics for their populations. Vanderbilt University Medical Center entered into such an agreement with the Nashville Health Department to assume responsibility for the vaccination and treatment of approximately 100 000 people, including employees, their families, and students. In return, the Health Department agreed to allocate pandemic vaccine and supplies received from the Strategic National Stockpile. The most effective approach to the mass delivery of point-of-dispensing vaccinations is not fully known. The challenge is not only to deliver vaccines quickly and efficiently, but also to coordinate logistics and communications on a large scale, to document appropriately, and to deliver the vaccine in a safe and controlled environment. The Hospital Incident Command System (HICS) was previously used to deliver seasonal influenza vaccine as part of an emergency preparedness drill; however, the total number of individuals vaccinated per day in that case was low. 2 In the event of a pandemic or bioterrorism event, we need to accommodate many thousands of patients per day. To test surge capacity for high-volume throughput, enthusiasm was stimulated by promoting the first event as an official challenge to the Guinness World Record for most vaccinations in an 8-hour period. Similar annual mass vaccination exercises took place over the next 4 years. We also describe subsequent process changes based on lessons learned and the impact of such changes on vaccination coverage and process efficiency. Lessons from our experience will help inform the refinement of similar occupational and community pandemic preparedness plans and promote the uptake of influenza vaccinations among employees and students in similar settings.
