The Kane County, Illinois, Health Department held a novel H1N1 second dose clinic at the minor league baseball stadium of the Kane County Cougars. For traditional use, the stadium's capacity is 7,400. The health department's vaccinators took over the suite level at the ballpark and used six of the suites as individual vaccinator PODs or stations and several more suites for Incident Command, supplies, registration, etc. Each of the six suites had a POD Task Force comprised of 13 staff, including four vaccinators and two vaccine preparers.
The primary target group for this clinic was children who had received their first dose from the health department from October 26, 2009 through November 5, 2009 and needed their second dose. Based on feedback from the October mass vaccination clinics, the health department requested to have the team mascot available to entertain children at the clinic. The team provided the mascot at no charge. The team also hired a Santa Claus to be at the stadium on the day of the clinic.
Using the suite level and the ballpark to line people up allowed the clinic to move people in and out in about 25 minutes, including the 5-10 minute post-vaccination wait. "There was just a really quick turnaround with smiling faces and everybody happy," a county health department employee noted.
The health department staff distributed a survey to people at the clinic as they waited their 5-10 minutes post-vaccination and received very positive feedback. Most of these people had been through the health department's first mass clinics in October, which had taken place in high school gymnasiums. At that time, people waited in lines outside - sometimes in the mist - for about two or three hours. In comparison, the stadium vaccination clinic was a much better experience.
The biggest lesson learned - which was an unanticipated benefit of using this venue - was that the stadium logistics staff had a lot of experience in event management. The stadium staff was well-versed in the logistics of getting people in and out, working within space and temperature control. Anything the clinic needed, the stadium staff was able to put their hands on and get almost immediately. It was a different experience than working in a high school or community college settings, where the health department staff normally set up mass clinics. In those settings, public health staff have to manage the logistics on their own or with the school. Although schools routinely host big events such as basketball/football games, they are not always prepared to have an outside group come in and take over an event.
In October, the health department clinic staff experienced many limitations on what space was available for use. Timing was another challenge in terms of dismissing students and bringing in the health department staff and volunteers with sufficient time to set up a mass clinic and open the doors on schedule. At the stadium, health department staff had access to the facility a full day prior to the clinic and were able to pre-set most of the equipment and supplies.
The use of several inter-disciplinary POD Task Forces proved to be helpful in streamlining vaccine administration. As opposed to the October clinics, where screening and vaccine administration were two separate steps conducted by two different people, this clinic combined that role under one individual. The health department staff felt that this reduced error rates and provided a single point of contact for questions and concerns from the person being vaccinated. The vaccinator had all of the information about the person and did not have to rely on another person to do the screening. The vaccinators felt more comfortable administering vaccine under this condition. The POD Task Force ensured that each POD had the supplies, vaccine and information needed to keep the vaccination throughput on track in each POD within a suite.
Another lesson learned was the benefit of having the team mascot and a Santa Claus to interact with the children at the clinics. The health department decided to do this based on its mass vaccination clinic experiences with first doses in October and November. The first time the health department administered H1N1 vaccinations, it held three large-scale mass clinics and administered almost 11,000 vaccinations in five hours. There were a lot of screaming children and a lot of hysterics. As a result, for the second dose clinic, the health department used the team mascot and the Santa Claus to distract the children and got them moving through quickly.
Using the individual suite also provided a greater sense of privacy and control over the situation. Rather than being in a large gymnasium with other scared children, noise and commotion, families could be vaccinated in relative privacy. The stadium staff also turned the TVs in the suites to cartoons, which played all day. This helped immensely to distract the kids.
Finally, the stadium staff provided all of the health staff meals. The health department contracted with the stadium to cook the food for clinic staff. This decreased the burden on the health department logistics team for ordering and coordinating food for the clinic workers.
Overall, the Kane County Health Department felt that the stadium clinic was a very positive experience both from the management side of things and for the public.