Mitigation Plan

Contract 568312 - Champions for Health: Mitigation Plan

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Section A.: Excessive Lateness, No-Shows, Partner Communication Breakdown, and Lack of Preparedness for Scheduled Vaccination Events

Low Vaccine Inventory Communication

In our commitment to providing essential immunization services to our community, CFH recognizes the importance of maintaining an adequate vaccine inventory at all times. However, CFH acknowledges that managing vaccine supplies, ensuring their availability, and communicating effectively about inventory levels can be challenging. To address this challenge and ensure a seamless vaccine supply chain, CFH has developed a comprehensive mitigation strategy. This strategy encompasses real-time inventory monitoring, regular inventory review meetings, and proactive communication with our vaccine suppliers. By implementing these steps and integrating technology where needed, CFH aims to enhance our vaccine inventory management, minimize the risk of shortages, and continue delivering essential vaccinations to those in need.

A4: Low Vaccine Inventory Communication

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Mitigation Strategy A4: Low Vaccine Inventory Communication

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A4.1 Real-Time Inventory Monitoring:

Our commitment to maintaining accurate vaccine inventory is exemplified through our CAIR2 team's dedicated efforts. They oversee vaccine inventory not only in our storage units but also during the numerous mobile vaccination events CFH conducts daily. To address the unique challenges posed by the frequency of these events and the need for accurate inventory management, our CAIR2 team has implemented a real-time monitoring system supported by Smartsheet software and manual counts.

Working closely with Smartsheet engineers, our CAIR2 leads have customized an inventory tracking sheet that captures various funding codes and provides daily, weekly, and monthly totals. This sheet is continually updated to accommodate the expansion of our vaccine inventory, including VFC vaccines and privately purchased ones. See A4.1.1. for an example of the Vaccine Inventory sheet.

Our CAIR2 leads have introduced Sunday evening shifts to perform manual counts at the end of each work week, ensuring accurate inventory levels. Additionally, our End of Shift report, completed by clinic leads and CAIR2 representatives, includes event details and vaccine dose information, which is crucial for maintaining precise inventory records. See A4.1.2 for the End of Shift Report link:

As CFH grows, we're planning to add a dedicated CAIR2 team member responsible for daily vaccine inventory tracking, further enhancing our inventory management

A4.1.1:

Vaccine Inventory Smartsheet⁠

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A4.1.2:

CFH Flu Inventory Report⁠

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A4.1.3:

317 Reporting Sheet⁠

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A4.2: Inventory Review Meetings:

Inventory Review Meetings are conducted by our CAIR2 leads. These meetings take place on a weekly basis and serve as a checkpoint for reviewing reporting deadlines and vaccine inventory levels. During these sessions, our team examines any discrepancies identified by our quality assurance consultants, allowing us to promptly address and resolve inventory issues.

CFH also determines the quantity of vaccine needed for reordering. The responsibility for vaccine orders primarily lies with our Quality Assurance Manager, who handles all orders, with the exception of privately purchased COVID-19 and Influenza vaccines. For these specific vaccines, requests are communicated to our Director of Community Health, who oversees the ordering process. To ensure seamless logistics, estimated shipment arrival times are logged on our CAIR2 calendar, ensuring that designated personnel are scheduled to receive the incoming vaccines

A4.3: Threshold Alerts:

To maintain a proactive approach to vaccine inventory management, CFH have established threshold levels that serve as triggers for initiating vaccine orders. These threshold levels are set based on each vaccine brand's demand and usage patterns. Currently, our threshold levels are as follows: 500 for State-funded flu vaccines, 50 for Hepatitis A vaccines, 40 for MPX vaccines, 100 for Private COVID-19 vaccines, and 100 for BAP vaccines. These thresholds are subject to adjustment as CFH closely monitors vaccine demand trends and expand our outreach efforts to target populations for specific vaccines.

When a threshold is met, our dedicated team promptly places orders in the following quantities: 500 for State Funded Flu, 100 for Hepatitis A, 80 for MPX, 200 for Private COVID, and 250 for BAP. This ordering strategy ensures a sufficient vaccine inventory for upcoming events, with consideration for potential delivery delays due to holidays or adverse weather conditions.

A4.4: Order Placement Protocol:

Objective: To ensure the timely and accurate placement of vaccine orders in accordance with inventory thresholds and demand trends.

Responsibilities:

Quality Assurance Manager (QAM):

Monitors vaccine inventory levels on a regular basis, including reviewing threshold levels.

Coordinates with the Director of Community Health (DCH) to initiate vaccine orders when thresholds are met.

Maintains awareness of holidays and potential weather-related delays that may affect order deliveries.

Communicates any special vaccine requirements or considerations to the DCH.

Director of Community Health (DCH):

Collaborates with the QAM to assess inventory status and order requirements.

Places vaccine orders based on the agreed-upon quantities and thresholds.

Coordinates with vaccine suppliers or distributors to ensure timely delivery.

Communicates estimated shipment arrival times to the team and schedules someone to receive the vaccines upon delivery.

Order Placement Steps:

Monitoring Inventory:

The QAM regularly reviews vaccine inventory levels, including tracking the usage of different vaccine brands.

Threshold levels for each vaccine brand are closely monitored for any indications that they are approaching or have been met.

Threshold Assessment:

When the QAM identifies that a threshold level has been met for any vaccine brand, they initiate the order placement process.

Order Quantity Determination:

The QAM and DCH collaborate to determine the appropriate order quantities based on the specific vaccine brand and its threshold.

Consideration is given to maintaining sufficient inventory for upcoming events and potential delays due to holidays or adverse weather conditions.

Order Placement:

The DCH places the vaccine order with the respective suppliers or distributors, ensuring that all necessary details, such as vaccine brand, quantity, and delivery address, are accurate.

Delivery Coordination:

Estimated shipment arrival times are communicated to the team and recorded on the CAIR2 calendar.

A designated team member is scheduled to receive the vaccine shipment upon delivery.

Documentation:

The QAM maintains records of vaccine inventory levels, order placements, and any special considerations.

Any changes or adjustments to threshold levels are documented for future reference.

Communication:

The QAM and DCH maintain open communication throughout the order placement process to ensure a smooth and timely execution of orders.

Review and Adjustment:

The protocol is periodically reviewed to assess its effectiveness and efficiency.

Adjustments may be made to threshold levels, order quantities, or other aspects of the protocol based on evolving demand trends or operational requirements.

A4.5: Supplier Communication:

CFH has created a contact list of our vaccine suppliers and CFH maintains open and regular communication to ensure a seamless supply chain. This includes ongoing dialogue with our vaccine distributors such as MyCAVax, MedLine, Pfizer Prime, and County Immunization Branch to stay informed about vaccine availability, delivery schedules, and any potential supply chain disruptions. This proactive approach allows us to anticipate and address any challenges that may arise, helping to maintain a consistent and reliable vaccine inventory. Our goal is to foster strong partnerships with our suppliers to support the success of our immunization efforts and meet the healthcare needs of our community

A4.6: Emergency Response Plan:

Section 1: Leveraging Partnerships and Resources

Step 1: Partner Collaboration

In the event of unexpected high demand or vaccine shortages, CFH leverages our strong relationships with the Immunization Branch and other immunization providers.

Step 2: Request for Support

If faced with an unforeseen surge in demand, CFH reaches out to our network of partners for potential support and vaccine transfers. This step involves effective communication and coordination with partner organizations.

Step 3: Documentation

All vaccine transfers and collaborations are documented meticulously. This includes maintaining records of digital data logger reports and sharing the details of vaccine transfers with the county's vaccine program representative for record-keeping and awareness.

Section 2: Utilizing MyCAVax Marketplace

Step 1: Marketplace Utilization

CFH will utilize the MyCAVax marketplace, which allows immunization providers to indicate the availability of surplus vaccines.

Step 2: Seeking Matched Providers

If a provider in the marketplace indicates surplus vaccines that match our needs, CFH will initiate contact and assess the feasibility of a vaccine transfer.

Step 3: Documenting Transactions

Any vaccine transfers facilitated through the MyCAVax marketplace are meticulously documented. This includes recording the details of the transaction for transparency and accountability.

Section 3: On-Site Emergency Response

Step 1: Monitoring Vaccine Supply

During ongoing vaccination events, CFH will monitor vaccine supply levels closely to detect any potential shortages.

Step 2: Immediate Communication

If a shortage is detected, CFH will initiate immediate communication with the warehouse technician on duty and the Director of Community Health.

Step 3: Coordinated Delivery

The warehouse technician and the Director of Community Health work together to coordinate the prompt delivery of additional vaccines from our main storage unit to the event site.

Step 4: Detailed Documentation

All additional vaccine doses delivered during an event are documented in the hourly temperature log and end-of-shift reports. This comprehensive documentation ensures accuracy and adherence to protocols.

A4.7: Technology Integration:

CFH will continue to use innovative technologies to track and store vaccine inventory. CFH will explore the integration of an advanced cost effective inventory management technology, such as a professional warehouse management system, as our clinic capacity increases. CFH has found that many systems are not optimal for the meticulous tracking needs of vaccine management, or have additional costly features that would not pertain to our line of work. CFH will continue to evaluate the potential benefits of automation in optimizing vaccine supply management.

A4.8: Documentation and Reporting:

CAIR2 leads will maintain detailed documentation of all inventory-related activities, including order history, receipt records, and vaccine usage. Our tracking systems can generate regular reports to assess inventory trends and identify opportunities for improvement.

A4.9:Training and Awareness:

CAIR2 will continue to provide training to staff involved in vaccine inventory management on the proper use of the monitoring system, order placement procedures, and emergency response protocols. They will raise awareness among team members about the critical importance of timely and accurate vaccine supply management.

A4.10: Continuous Improvement:

CFH will continue to foster a culture of continuous improvement by regularly reviewing vaccine supply processes and seeking feedback from staff. CAIR2 leads will identify areas for enhancement and make necessary adjustments to ensure optimal inventory management.

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