Help us fix our clinic flow

[facg4]

I work in a county public health department. We do walk in immunizations on wednesday afternoons and are going to expand the hours. The problem is the flow of this clinic. Clients are given forms to fill out in the waiting room, they are then directed to a desk where we pull their records and insurance information, they are then sent down the hall to wait their turn with a nurse, that nurse interviews for needed vaccines, vaccines required/recommended, cost, follow ups, payment etc, in a room, they then wait there until two other nurses get them and give them their vaccines in another room.

This is the way "it's always been done". Our clinic is getting busier and busier as more physicians in our county are not giving vaccines. So how do you organize your large walk in immunization clinics? All ideas and tips please.

[MandaRN94]

In our clinic walk- ins are taken care of 1st at the the front desk. They take care of the cost, insurance, paperwork, etc.. We call them them back review the chart then give them the vaccines or walk in care they need. Seems like your clinic needs to stream line the check in process.

[mariebailey, MSN, RN]

• Go to offering vaccines by appointment only.
  
• You will have to market/outreach like crazy & accommodate walk-ins for a month or so following the change.
  
• Allocate 1 slot every 15 minutes per nurse available; as you get your flow down, you can add an extra slot every 30 minutes or so to account for anticipated no-shows.
  
• When people call for appointments, look up/review their record, & determine what they need in advance of the clinic. If they are not in your state registry or other vaccine record on file, encourage them to come early with their records.
  
• Reinforce to admin staff to tell every client every time to bring their record with them 15 minutes prior to their scheduled appointment.
  
• Laminate screening forms from Vaccination Resources - Screening for Contraindications and Precautions for them to review while vaccines are being drawn up/prepared. Ask them to review the questions, and ask them if they respond “yes” to any questions (assessing literacy, language, of course)
  
• Keep VIS laminated on a metal ring for them to review with a notice across them that reads “individual copies are available upon request”. They can also review these while vaccines are being prepared.
  
• Have them pay on their way out, after the vaccines are administered. We did this at my last job, and we did not lose revenue as a result. It just wasted less time exchanging $ when vaccines were added or subtracted.
  
• When we went to appointment-only, we had a backlog for a while. Eventually, however, we were able to accommodate same-day requests for appointments and increased client capacity by 1000 per year in our busiest office. Average wait time was well under 15 minutes.