Mitchell Rothholz, RPh, MBA: As we talk to pharmacists about recovering vaccines that have been shelved during COVID-19, one of the things we hear a lot is the added workload of that and the time to have those discussions. Are there any hints any of you could give our audience in terms of whether you’re trying to do it all at once or in steps? Since we are approaching flu season, are you trying to re-enter the flu discussion with the COVID-19 discussion? Or do you do the full range? What are your suggestions?
Randy McDonough, PharmD, MS, BCGP, BCPS, FAPhA: We realized we had to make this work within our workflow. We are a busy community pharmacy and COVID-19 has made us realize that we can do things differently, including using an appointment-based model. How do we synchronize our patient population so that we are not reactive within the workflow for patients coming in and getting medicines when they need it, but rather we are proactive and make sure they are synchronized with their medicines and take advantage of that appointment-based model?
We implemented technology during COVID-19 for patients to continue [the website] to schedule a vaccination appointment. That is now mandatory for us. It’s harder for us to get things done when people walk in. In addition, we want to make sure that we have accurate information that the patient fills out in advance so that we are ready to give them the vaccine when they come in.
If you set up your practice and sync patients and take advantage of the appointment-based model, where patients pre-register for appointments, it becomes a lot easier on the flow and you can still do quite a bit of vaccines. Another challenge with COVID-19 is how many patients can we safely bring to the pharmacy? How do we keep them socially distant from each other so that we don’t pass on the virus if someone has the virus? We were able to step up the number of patients coming in at once. They would also be scheduled in our system that way. If pharmacists are going to do this, they need to be organised. They need to make sure they figure out how to do this within the workflow and use the technology to their advantage to make sure they can handle the flow.
Jeff Goad, PharmD, MPH: Along with the staff too; many of our pharmacists were pushed to the limit by the increased bandwidth associated with COVID-19 vaccination. We saw that we need more staff. We need technicians and student pharmacists who give vaccines. In California and many other places you have dentists and optometrists [giving vaccines]. We need a lot of people to give the magnitude of the vaccines that we had to do. But addressing the staffing issues within a pharmacy is critical to maintaining our workforce, so people stay engaged and willing to provide the clinical services they’ve been trained for.
John Beckner, RP: I agree with Jeff and Randy. Burnout is a very real problem that many people face. Different pharmacies will have different models for dealing with vaccinations. One of the great benefits of medication synchronization, as Randy noted, is that it becomes an opportunity to engage and deliver other clinical services during the medication synchronization appointment. The public has become very accustomed to making vaccine agreements. But we must not lose sight of the fact that we have to make it easy for people. If someone comes in for a flu vaccine and they don’t have an appointment, it’s probably a good idea to try and accommodate them, as they may not come back. We must continue to make it easy and convenient for people, while at the same time paying attention to staffing and workflow issues.
Randy McDonough, PharmD, MS, BCGP, BCPS, FAPhA: We also need to be aware of security. When we didn’t have appointments yet, there were lines outside the pharmacy. We have to be smart about it. We don’t refuse anyone when they come in, but we need to get them into the system, so we give them access to the website via tablet so they can fill in the information they need to fill in for us. We try to make it easy for them. We also do remote clinics so we can go where the patient is.
Jeff, I appreciate you talking about the staff. We took full advantage when they came out with the EUA [Emergency Use Authorization], where technicians can be trained. Each of our technicians, by their will, became immunizers for us and went through certification. Now that it has become an ordinance, they remain immunizers for us. That gave us the opportunity to go to more remote clinics, to where the patients are, because we had adequate help at the pharmacy that didn’t exist before. I appreciate those comments.
Jeff Goad, PharmD, MPH: In California, we have waived some regulations to allow higher student-to-pharmacist ratios for interprofessional supervision, so that the physician can supervise the pharmacy student and the pharmacist can supervise the medical student. And some will stick around. Hopefully a lot of these things that we have proven we can do safely in the past 2 years will become law. There will be some silver linings to the pandemic for our ability to deliver vaccines through the pharmacy.
Mitchell Rothholz, RPh, MBA: At least this upcoming flu season, the PREP [Public Readiness and Emergency Preparedness] Act will still exist. Some of those authorities will still be there, so we won’t be dependent on the states. That’s a plus.
Transcription edited for clarity.