Section B: Delayed Response, Coordination, and Follow-up of Homebound Vaccine Referrals

In response to the challenge of delayed response, coordination, and follow-up of homebound vaccine referrals, it is imperative that CFH takes proactive measures to ensure a more efficient and timely process. Instances were identified where referrals from the County escalated due to extended response times. To address this issue, CFH is implementing a mitigation strategy focused on improving our homebound vaccination referral response and coordination. This strategy is designed to enhance our communication, streamline the coordination process, and provide timely vaccine services to our residents in need. Through a series of well-defined steps and a commitment to continuous improvement, CFH aims to eliminate delays in our response and deliver high-quality care to our homebound population.

Mitigation Strategy B1: Improving Homebound Vaccine Referral Response and Coordination

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B1.1: Referral Receipt and Acknowledgment

Upon receiving a homebound vaccine referral from the County, the designated Homebound Vaccine Coordinator at CFH will promptly acknowledge the receipt of the referral. This acknowledgment should occur within 24 hours of receiving the referral.

B1.2: Homebound Tracking Sheet

Both county and Champions for Health utilize the Homebound Tracking Sheet as a central tool for coordination. This sheet serves as a repository for patient information, including contact details, vaccine preferences, and outreach notes. When we receive a referral list from the County, we promptly transfer the non-duplicate patients to this tracking sheet.

In addition to tracking basic patient information, we have updated our color-coded markers to prioritize our outreach efforts. Patients with high elevation status marked in bright red. Non high elevation patients in the 2-week timeframe are highlighted in faded red, indicating the second-highest priority for outreach. Those in the 1-week wait period are marked in pink, while patients added less than a week ago are left with no color or in white.

We have introduced a column to record the date of referral receipt, facilitating our adherence to the 2-week timeline communicated to the patients by the County homebound team. These enhancements to our tracking protocols ensure a more organized and efficient approach to homebound vaccination coordination.

B1.3: Patient Assessment and Eligibility

Within two days of acknowledging the referral, the Homebound Coordinator will conduct a comprehensive assessment of the resident's vaccination needs and eligibility. This assessment will include vaccine eligibility screening through CAIR2, and insurance eligibility through Office Ally. They will chart their responses and the date the screenings were completed on the tracking sheet. Priority will be given to identified high elevation patients.

B1.4: Scheduling and Confirmation

Once the patient is approved to receive a vaccine, the Homebound Coordinator will initiate contact to discuss scheduling options, wait times, and vaccine availability. The coordinator will also inquire about any specific accommodations required due to mobility or medical conditions. The date of contact and the patient’s responses will be charted.

B1.5: Homebound Scheduling Week Sheet:

To facilitate the scheduling and coordination of homebound vaccine appointments, we utilize a Homebound Scheduling Week Sheet as a central tool. When a patient's appointment is confirmed, the homebound coordinator adds their details to this sheet. Here, our Champions for Health homebound team develops the schedule for homebound blocks, ensuring efficient allocation of clinical capacity. Additionally, the County homebound team has access to view upcoming or completed appointments on this sheet.

Our homebound team meets weekly to assess available dates on the Connecteam schedule where we have sufficient clinical capacity to add a homebound block. These dates are updated on the Homebound Scheduling Week Sheet to indicate their availability for scheduling. Once a patient is confirmed for a specific date and time frame, we include their contact information, the names of additional household members receiving the vaccine, the approved vaccine types, and any patient preferences or notes to ensure a smooth and organized homebound vaccination process.

The sheet has an automation to notify county and Champions for Health Homebound team members via email when changes are made to the sheet.

B1.5.1:

Homebound Scheduling Week Sheet⁠

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B1.6: Follow-Up and Reminder

To ensure a smooth vaccination process, the Homebound Vaccine Coordinator conducts follow-up communications with the resident leading up to the scheduled appointment. This includes making reminder calls and confirming the appointment details.

B1.7: On-Site Vaccination

On the scheduled date, CFH's vaccination team will visit the resident's home to administer the vaccine. The team will ensure that all necessary supplies and documentation are prepared the day before to minimize any delays.

B1.8: Post-Vaccination Documentation

After the vaccination, the Homebound Coordinator will update the Homebound Scheduling Week sheet to indicate if the patient received the vaccine, or if there was a cancellation. The Homebound Coordinator will review the Hourly Temperature Log, Patient Forms, and the CAIR2 Homebound Cover Sheet which are uploaded to the End of Day Shift Sheet by a Quality Assurance Consultant. Any patients who were identified as cancelling or asking to reschedule, would be contacted the following week to reschedule.

B1.8.1: CAIR2 Homebound Cover Sheet:

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CAIR2 Homebound Coversheet 12042023.docx

51 kB

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B1.9: Continuous Monitoring

CFH will implement a system for continuous monitoring of homebound vaccine referrals and responses. Regular reports will be generated to track the status of each referral, ensuring that timely responses and vaccinations occur.

B1.10: Staff Training and Resources

Additional training and resources will be provided to the Homebound Coordinators, such as scripting for initial calls and follow-ups.

B1.11: Feedback and Quality Improvement

CFH will continue to encourage feedback to gather input and insights from residents, staff, and the County regarding the homebound vaccination process. This feedback will be used to continuously improve the response and coordination protocols.

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