Evaluation of COVID-19 vaccine implementation in a large safety net health system

被引:2
作者
Chen, Jennifer C. [1 ,2 ]
Gutierrez, Griselda [3 ,4 ]
Kamran, Rachel [5 ]
Terry, Jill [6 ,7 ]
Telliyan, Armenui [8 ,9 ]
Zaks, Camilo [10 ]
Carson, Savanna L. [11 ]
Brown, Arleen [11 ]
Kim, Karen [12 ,13 ]
机构
[1] Los Angeles Cty Dept Hlth Serv, Ambulatory Care Network, Los Angeles, CA 90012 USA
[2] Univ Calif Los Angeles, David Geffen Sch Med, Dept Emergency Med, Los Angeles, CA 90095 USA
[3] Harbor UCLA Med Ctr, Los Angeles Cty Dept Hlth Serv, Los Angeles, CA USA
[4] Univ Calif Los Angeles, David Geffen Sch Med, Dept Obstet & Gynecol, Los Angeles, CA USA
[5] Univ Calif Los Angeles, Fielding Sch Publ Hlth Grad Program, Los Angeles, CA USA
[6] Los Angeles Cty Dept Hlth Serv, Pharm Affairs, Los Angeles, CA USA
[7] USC Sch Pharm, Los Angeles, CA USA
[8] Glendale Community Coll, Glendale, CA USA
[9] West Coast Univ, Los Angeles, CA USA
[10] Keck Sch Med USC, Div St Med, Los Angeles, CA USA
[11] Univ Calif Los Angeles, David Geffen Sch Med, Div Gen Internal Med & Hlth Serv Res, Los Angeles, CA USA
[12] Los Angeles Cty Dept Hlth Serv, Populat Hlth Management, Los Angeles, CA USA
[13] Univ Calif Los Angeles, Dept Med, David Geffen Sch Med, Los Angeles, CA USA
来源
FRONTIERS IN HEALTH SERVICES | 2023年 / 3卷
基金
美国国家卫生研究院;
关键词
COVID-19; vaccine; vaccine distribution; implementation; leadership; communication; integrated delivery of health care; equity; PROGRAM;
D O I
10.3389/frhs.2023.1152523
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
ObjectivesTo evaluate rapid COVID-19 vaccine clinic implementation from January-April 2021 in the Los Angeles County Department of Health Services (LACDHS), the second-largest US safety net health system. During initial vaccine clinic implementation, LACDHS vaccinated 59,898 outpatients, 69% of whom were Latinx (exceeding the LA County Latinx population of 46%). LACDHS is a unique safety net setting to evaluate rapid vaccine implementation due to system size, geographic breadth, language/racial/ethnic diversity, limited health staffing resources, and socioeconomic complexity of patients.MethodsImplementation factors were assessed through semi-structured interviews of staff from all twelve LACDHS vaccine clinics from August-November 2021 using the Consolidated Framework for Implementation Research (CFIR) and themes analyzed using rapid qualitative analysis.ResultsOf 40 potential participants, 25 health professionals completed an interview (27% clinical providers/medical directors, 23% pharmacist, 15% nursing staff, and 35% other). Qualitative analysis of participant interviews yielded ten narrative themes. Implementation facilitators included bidirectional communication between system leadership and clinics, multidisciplinary leadership and operations teams, expanded use of standing orders, teamwork culture, use of active and passive communication structures, and development of patient-centered engagement strategies. Barriers to implementation included vaccine scarcity, underestimation of resources needed for patient outreach, and numerous process challenges encountered.ConclusionPrevious studies focused on robust advance planning as a facilitator and understaffing and high staff turnover as barriers to implementation in safety net health systems. This study found facilitators that can mitigate lack of advance planning and staffing challenges present during public health emergencies such as the COVID-19 pandemic. The ten identified themes may inform future implementations in safety net health systems.
引用
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页数:12
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