Toronto Region Vaccine Human Resource Strategy - Vaccine Clinic Playbook: Models, Roles, Sourcing and Training - Quorum
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Toronto Region Vaccine Human Resource Strategy Vaccine Clinic Playbook: Models, Roles, Sourcing and Training H H R SUB - G R OUP OF T H E T OR ON T O H E A L T H SE C T OR V A C C IN E L E A DE R SH IP T A B L E | MA R C H 9 TH 2 0 2 1
Section 1 • Background and Guiding Principles
• Clinical Models
Section 2 • Role Definitions and Training
• Human Resource Guide and Options to
Section 3 Source
• Model Definitions and Operational
Appendix 1 Guidance Examples
• Additional Information Site identification,
Appendix 2 accessibility, infection prevention and
control
Appendix 3 • Additional resources and links
Section 1: Introduction, Vaccine Distribution Plan, Leadership and Governance
Background • City of Toronto Hospitals, Ontario Health Teams and Primary Care Practices are rapidly scaling up their COVID-19 vaccination efforts in a variety of clinical settings. • In doing so, these clinics need to apply a Health Human Resources Human Capital Planning lens – that is, to ensure the right people with the right skills are providing the right care at the right time. Given the scarcity of HHR due to COVID-19 care and other clinical demands, we must ensure individuals are deployed to work at the top of their scope of practice as well as in innovative care models • This document provides standardized roles based on vaccine clinic model, suggested training for those roles and a link to source these human resources. • Additionally, it provides operational guidance and a list of tools and resources for vaccination clinics
Guiding Principles • OHTs and hospitals will follow guidance on prioritized populations and operationalize plans with partners in their own geographies with flexibility for local implementation • Prioritize areas of high disease prevalence (in local communities) and those at risk for disease and morbidity/ mortality due to sociodemographic characteristics • Balance speed with population health approach and equitable implementation of vaccination plans • Monitor and report back on progress to ensure situational awareness and analysis to support course corrections to maintain alignment with principles of the vaccination plan • Apply a Health Human Resources Human Capital Planning Lens – ensuring the right people with the right skills providing the right care at the right time while adopting an equity lens when recruiting staff • Deliver vaccines without depleting resources across the healthcare system considering innovative models • Optimize full scope of practice and delegation opportunities to support effective resource utilization • Embrace learners to contribute to the programs while supporting a learning environment
Section 2: Clinic Roles, Responsibilities, Training
Clinic Models
Fixed Community Clinics Mobile Response Clinics
Mass Immunization Clinics
Fixed Location, Short-Term, Location Varies, Very Short-
Fixed Location, Long-Term, >40
Clinic Roles
Area of work Role Names
Immunizations Campaign Leader Logistics
Medical Support Administrative Support
Human Resources/Scheduler Epidemiology/Database Support
Campaign and
Clinical Planning Finance IT Support
Logistics Specialist Support Functions: Supply
clerk and Supply Vaccine clerk
Communications Officer
Clinic Manager Syringe Pre-Loaders
Administrative Manager Runners
Parking Lot Attendants Clinic Flow Monitors/Line Monitors
Security Immunizers
On-Site Clinic Clinic Leaders Medical Support
Activity
Clinic Floaters Post- immunization waiting monitors
Greeters Administrative Support
Screeners Clinic Specialist Support
Registration (Appointment Check/Door) Community Ambassador
Onsite Support Translators/interpreters Custodial Staff/Aftercare Cleaners
Campaign and Clinical Planning Related Roles
Campaign and Clinical Planning
Immunization Campaign Leader
Role Responsibilities :
• Overall operations of the clinic.
• Ensures assigned staff attend clinic and record attendance for payment
purposes (may include signing time sheets).
• Ensures staff are aware of their assigned roles and oversees and monitors all
clinic staff activity.
• Provides onsite clinic orientation/staff education prior to the start of the clinic
and facilitates staff debrief at the end of the clinic, if these activities are being
done at the clinic site.
• Confirms that staff and clinic protocols are followed.
• Supports infection prevention and control, occupational health and safety, cold
chain and vaccine inventory monitoring functions (if separate staff not
assigned to the Clinic Specialized Support role).
• Serves as the onsite media spokesperson.
• Responds to questions from clients during the screening or registration
process, including clients with questions about the vaccine or immunization
process, or clients who fail the COVID-19 screening, are not eligible for
immunization based on the criteria of the clinic or have contraindications.
• Trouble-shoots problems/concerns that arise.
• Supports and promotes cultural safety, diversity, and inclusion in serving
clients and among staff.
Qualifications/options to source: Training available:
Primary Care COVID-19 Immunization
Toolkit - COVID-19 Immunization Toolkit
• Role often performed by a director or (covidtoolkit.ca)
manager with experience in
immunization Health System News Building Vaccine
Confidence (oha.com)
• Understanding of pandemic guidelines,
legislative and reporting requirements COVID-19 vaccination in Canada: an
educational series for primary care
professionals | Department of Family &
• Experienced leader to support effective Community Medicine (utoronto.ca)
team and program outcomesMedical Support
Role Responsibilities :
• Writes the medical directives under which vaccines are administered for health
care professionals who require delegation to immunize.
• Writes the medical directive for the management of anaphylaxis and advises on
polices to manage other medical issues that may occur at a clinics such as
fainting.
• Creates or approves the Vaccine Information Sheets, Consent Forms and After-
Care Sheets for clients.
• Creates or approves training materials/in-services, particularly for Immunizers,
Syringe Pre-Loaders and other health care providers, including on fainting and
anaphylaxis management.
• Reviews reported adverse events following immunization and provides
recommendations regarding the second vaccine dose (if that is needed).
• If Medical Support if not available at the clinics, available by telephone to assist
with questions, including with regard to contraindications and precautions.
• Advises on COVID-19 related screening protocols and infection prevention and
control precautions.
Qualifications/options to Training available:
source: Primary Care COVID-19 Immunization Toolkit -
COVID-19 Immunization Toolkit (covidtoolkit.ca)
Medical Health Officer Health System News Building Vaccine
Physician or Confidence (oha.com)
Nurse Practitioner COVID-19 vaccination in Canada: an
educational series for primary care professionals
| Department of Family & Community Medicine
(utoronto.ca)Human Resources/Scheduler
Role Responsibilities :
• Supports recruitment of necessary external staff and volunteers.
• Ensures appropriate information needed for onboarding is obtained from
external staff members who will be working at the clinics.
• Obtains and verifies credentials of external regulated health professionals.
• Obtains staff immunization information and hepatitis B titre results for new
staff and existing staff if results not already on file (if possible and available),
and promotes appropriate immunization for volunteers. This function can be
performed by occupational health if that role is available.
• Verifies current cardio-pulmonary certification (CPR) for health care providers
(as per provincial/territorial requirements).
• Ensures staff and volunteers are aware of the need for and can wear personal
protective equipment (i.e., mask and eye protection) throughout the clinic
shift.
• Schedules all the required staff and volunteers for each clinic and ensures that
staff and volunteers are aware of the date, time and location of clinics they are
scheduled for and who to contact if changes to a scheduled shift are required.
• Manages any schedule changes among staff and volunteers. Develops
contingency plans for last minute sick calls or when staff or volunteers do not
show up for their shift, such as a roster of urgently available staff.
• Ensures staff and volunteer liability issues are addressed.
Qualifications/options to source: Training available:
COVID-19 vaccination in Canada: an educational
Role often performed by a Staffing Office, series for primary care professionals |
supervisor or Human Resources assistant. Department of Family & Community Medicine
(utoronto.ca)
• Understanding of relevant legislations
including Employment Standards Act,
Human Rights, and Occupational Health
and Safety Act
• Strong understanding of scheduling
practices
• Excellent computer skills
• Detailed orientedFinance
Role Responsibilities :
• Supports the procurement of the necessary equipment, supplies and site
locations for the clinics.
• Creates forms and processes to track compensation (e.g., for external staff,
overtime).
• Ensures that financial matters are addressed according to procedures.
• Collects and processes time sheets and invoices.
• Track's spending and seeks appropriate budget approval as needed.
Qualifications/options to source: Training available:
Primary Care COVID-19 Immunization Toolkit -
COVID-19 Immunization Toolkit (covidtoolkit.ca)
Role often performed by a Financial
Analyst COVID-19 vaccination in Canada: an educational
series for primary care professionals |
• Understanding of relevant financial Department of Family & Community Medicine
reporting requirements for various (utoronto.ca)
stakeholders
• Strong understanding of financial
reports
• Excellent computer skills
• Detailed orientedLogistics
Role Responsibilities :
• Oversees and manages logistical planning and operations of clinics
including clinic site selection, pre-planning clinic site set-up if possible, and
setting up clinics in fixed sites in advance of the clinics starting, including any
accessibility accommodations
• Acquiring supplies and vaccines (in collaboration with Immunization Campaign
Leader and Specialized Support Functions)
• Packing supplies for initial set-up and re-supplying of the clinics
• Transportation of supplies and vaccines to and from clinics, including how to
accommodate the need for urgent supplies and/or vaccines
• Equipment and processes for cold chain management of vaccines
• Biomedical waste management (e.g., of sharps containers)
• Telephone translation services if on site translators are not available
Qualifications/options to source: Training available:
Primary Care COVID-19 Immunization Toolkit -
COVID-19 Immunization Toolkit (covidtoolkit.ca)
Role can be performed by someone
with logistical experience who COVID-19 vaccination in Canada: an educational
understands procurement, series for primary care professionals |
immunization, the organization and the Department of Family & Community Medicine
community (utoronto.ca)
• Awareness of logistics processes www.health.gov.on.ca/en/pro/programs/publiche
alth/oph_standards/docs/reference/vaccine
related to immunization program
_storage_handling_guidelines_en.pdf
• Understanding of AODA and other
legislative requirements including
Occupational Health and Safety Act
• Detailed awareness of Broader
Public Sector procurement practicesAdministrative Support
Role Responsibilities :
• Provides administrative support to the clinic planners, as required.
• Involved in ordering, packing and organizing clinic supplies and forms.
Qualifications/options to source: Training available:
Primary Care COVID-19 Immunization Toolkit -
COVID-19 Immunization Toolkit (covidtoolkit.ca)
Role often performed by administrative
assistants or COVID-19 vaccination in Canada: an
clinical/medical secretaries. educational series for primary care professionals
| Department of Family & Community Medicine
• Excellent computer skills (utoronto.ca)
• Well-developed customer service
and communications skillsIT Support
Role Responsibilities :
If clinics are using electronic recording and information systems, IT
support will be required to ensure:
• internet connectivity
• appropriate equipment
• proper functioning of the equipment
• privacy and security of the information
• back-up systems
• access to rapid support when issues arise
Qualifications/options to source: Training available:
Primary Care COVID-19 Immunization Toolkit -
COVID-19 Immunization Toolkit (covidtoolkit.ca)
• Role often performed by a Help
Desk or Help Desk Supervisor. COVID-19 vaccination in Canada: an
educational series for primary care professionals
| Department of Family & Community Medicine
• Possess basic technical knowledge (utoronto.ca)
of hardware and software to assist
in the deployment, maintenance
and support of optimization of the
available technology
• Current registration in a college or
university information technology
program or equivalent programSpecialized Support Functions
Role Responsibilities :
• Supports planning for specialized functions which can include:
• infection prevention and control/ occupational health and
safety
• cold chain management (particularly for vaccines with specific
cold chain requirements) and supports training of other staff
regarding cold chain management requirements including
management of dry ice if required
• vaccine inventory management (in collaboration with Logistics
and Immunization Campaign Leader)
Qualifications/options to source: Training available:
Primary Care COVID-19 Immunization Toolkit -
COVID-19 Immunization Toolkit (covidtoolkit.ca)
• Role can be performed by a health
care provider familiar with COVID-19 vaccination in Canada: an educational
infection prevention control or series for primary care professionals |
Department of Family & Community Medicine
occupational health and safety and (utoronto.ca)
cold chain management
• Understanding of relevant health
and safety legislation
• Understanding of Infection,
Prevention and Control guidelinesCommunications Officer
Role Responsibilities :
• Develops communications materials regarding the immunization campaign
which may include media briefings, websites, social media and media buys.
• Advises media outlets, updates the websites and uses social media to advise
the public regarding eligibility criteria for the clinics (if available vaccine doses
are limited), clinic locations, dates, hours, need for appointments or not, what
to bring with them, the accessibility of the site and other relevant information.
• Serves as first point of contact with media and arranges media interviews with
the appropriate spokespersons.
• Develops a media/communications protocol to ensure clinic staff/volunteers
are apprised of how to respond to media visits to the clinic and/or questions.
• Ensures that written materials are translated into appropriate languages, are
culturally appropriate and written at an appropriate reading level.
• Informs local emergency personnel and nearby hospitals of the dates, times
and locations or each clinic.
Qualifications/options to source: Training available:
Primary Care COVID-19 Immunization Toolkit -
COVID-19 Immunization Toolkit (covidtoolkit.ca)
• Role often performed by Marketing
and Communications consultant from COVID-19 vaccination in Canada: an educational
a health service provider. series for primary care professionals |
Department of Family & Community Medicine
• Understanding of relevant (utoronto.ca)
communication reporting requireme
nts for various stakeholders Health System News Building Vaccine
Confidence (oha.com)
• Excellent written and verbal
communications skills
• Strong understanding of current
media outlets
• Excellent computer skills
• Detailed orientedOn-site Clinic Activity Related Roles
Administrative Manager
Role Responsibilities :
• Oversees the non-health-care-provider staff and volunteers
providing screening, registration, and outtake.
• Assigns duties and provides just-in-time training to the non-health-
care-provider staff.
• Super-User on COVaxON and the main point of contact to the
COVaxON helpdesk.
• Escalation for patients with concerns or special requests.
• Ensures non-clinical staff receive breaks, rotate duties, and sign off at
end of shift
Qualifications/options to source: Training available:
Primary Care COVID-19 Immunization Toolkit -
COVID-19 Immunization Toolkit (covidtoolkit.ca)
• Role often performed by someone
with experience managing large COVID-19 vaccination in Canada: an educational
administrative teams, Volunteer series for primary care professionals |
Services, or an Department of Family & Community Medicine
(utoronto.ca)
Admissions/Registration Office.
• Understanding of pandemic Health System News Building Vaccine
guidelines, legislative Confidence (oha.com)
and reporting requirements
• Experienced leader to support
effective team and program
outcomesClinic Manager
Role Responsibilities :
• Works collaboratively with all stakeholders to provide oversight for
the day-to-day activities of the MWT-OHT vaccination pop up site,
with a focus on excellence in client service delivery
• Ensures safe, high quality, and efficient delivery for the services,
including effective utilization of resources (e.g., staffing and
equipment)
• Identifies and resolve disputes, concerns, and/or problems within
the team in a manner that is fair and consistent
• Promotes and maintains a healthy and safe work environment by
encouraging staff compliance with pertinent guidelines and ensure
that health and safety awareness is incorporated in day-to-day
activities
Qualifications/options to source: Training available:
Primary Care COVID-19 Immunization Toolkit -
COVID-19 Immunization Toolkit (covidtoolkit.ca)
• Role often performed COVID-19 vaccination in Canada: an educational
an Outpatient or Emergency Room series for primary care professionals |
Manager with experience in high Department of Family & Community Medicine
volume health services. (utoronto.ca)
• Understanding of pandemic Health System News Building Vaccine
guidelines, legislative Confidence (oha.com)
and reporting requirements
www.health.gov.on.ca/en/pro/programs/publiche
• Experienced leader to support alth/oph_standards/docs/reference/vaccine
effective team and program _storage_handling_guidelines_en.pdf
outcomesCommunity Ambassador
Role Responsibilities :
• Provide outreach to vulnerable clients and community residents who are at
high risk for acquiring or transmitting COVID-19
• Inform residents about community resources and programs
• Share reliable information about COVID-19 within the community
• Acts as an on-site liaison to the Vaccination Team
• Works collaboratively with leaders to inform practice, program and
communication with stakeholders
• Identifies opportunities and risks to proactively support a successful
vaccination program
• Attend training sessions, meetings and participate in other activities as needed
• Assists the Vaccination Team as requested with community/site specific
requirements
Qualifications/Options to Source: Training available:
COVID-19 vaccination in Canada: an educational
series for primary care professionals | Department
• A member of the community or of Family & Community Medicine (utoronto.ca)
organization where the clinic is Health System News Building Vaccine Confidence
being held (oha.com)
• Experience working with
members of the community or
organization where the clinic is
being heldParking Lot Attendants
Role Responsibilities :
• Maintains parking lot traffic flow.
• Supports patients/clients to remain in their vehicle until
appointment time to decrease and manage line ups
• Directs clients appropriately.
• Can help with obtaining assistance from clinic nurses/Medical
Support if clients are waiting in their vehicles post-immunization and
need assistance, along with the Post-Immunization Waiting Area
Monitors who would be monitoring the parking lot in this model.
Qualifications/options to source: Training available:
COVID-19 vaccination in Canada: an educational
series for primary care professionals | Department
of Family & Community Medicine (utoronto.ca)
• Role can be performed by a
volunteer, security guard or non-
health care provider staff
memberSecurity
Role Responsibilities :
• Facilitates safety of staff, volunteers and clients, as well as the clinic
property and equipment.
• Assists in maintaining physical distancing, crowd control and clinic
flow.
• Intervenes as required if security issues arise.
• Ensures that all staff/clients have left the site after clinic hours.
• Ensures security of the clinic location, onsite vaccine and other
supplies and equipment after the clinic has ended.
• At least two security guards are recommended per clinic.
Qualifications: Training available:
COVID-19 vaccination in Canada: an educational
series for primary care professionals | Department
Role can be performed by a hired of Family & Community Medicine (utoronto.ca)
security guard or provided by the siteClinic Leaders
Role Responsibilities :
• Responsible for the overall operations of the clinic.
• Ensures assigned staff attend clinic and record attendance for payment purposes (may
include signing time sheets).
• Ensures staff are aware of their assigned roles and oversees and monitors all clinic staff
activity.
• Provides onsite clinic orientation/staff education prior to the start of the clinic and facilitates
staff debrief at the end of the clinic, if these activities are being done at the clinic site.
• Confirms that staff and clinic protocols are followed.
• Can support infection prevention and control, occupational health and safety, cold chain and
vaccine inventory monitoring functions (if separate staff not assigned to the Clinic
Specialized Support role).
• Serves as the onsite media spokesperson.
• Responds to questions from clients during the screening or registration process, including
clients with questions about the vaccine or immunization process, or clients who fail the
COVID-19 screening, are not eligible for immunization based on the criteria of the clinic or
have contraindications.
• Trouble-shoots problems/concerns that arise.
Qualifications/options to source: Training available:
Primary Care COVID-19 Immunization
Toolkit - COVID-19 Immunization Toolkit
• Role often performed by managers or (covidtoolkit.ca)
senior nurses or other nurses
with immunization experience with a COVID-19 vaccination in Canada: an
regulated health professional background educational series for primary care
professionals | Department of Family &
Community Medicine (utoronto.ca)
• Role can be performed by a physician,
Health System News Building Vaccine
nurse practitioner, registered nurse or Confidence (oha.com)
registered practical nurse or other
regulated health professional www.health.gov.on.ca/en/pro/programs/p
specifically assigned to this role ublichealth/oph_standards/docs/reference
/vaccine
_storage_handling_guidelines_en.pdfClinic Floaters
Role Responsibilities :
• Assists the Clinic Leaders in their role and can serve as Clinic Leader if needed.
• Ensures that protocols are followed during clinic activities.
• Provides support to newer Immunizers.
• Trouble-shoots and responds to medical questions or concerns from clients, staff and
volunteers.
• Lead contact for post-immunization adverse events (e.g., fainting and anaphylaxis
management) and other medical emergencies (if a separate Medical Support staff is not
assigned or available). Reports adverse events such as anaphylaxis that occur during the
clinic to the appropriate public health officials if indicated.
• Responds to questions from clients during the screening or registration process, including
clients with questions about the vaccine or immunization process, or clients who fail the
COVID-19 screening, are not eligible for immunization based on the criteria of the clinic or
have contraindications.
• Can support infection prevention and control, occupational health and safety, cold chain and
vaccine inventory monitoring functions (if separate staff not assigned to the Clinic
Specialized Support role).
• If needed, can provide back-up as Immunizer or Syringe Pre-Loader.
Qualifications/options to source: Training available:
COVID-19 vaccination in Canada: an
• Role often performed by managers or educational series for primary care
senior nurses or other nurses professionals | Department of Family &
with immunization experience Community Medicine (utoronto.ca)
COVAX Registration (2).mp4
• Role can be performed by a physician,
nurse practitioner, registered nurse or COVAX Registration YouTube Video
registered practical nurse or other
regulated health professional specifically
assigned to this role
• Regulated Health ProfessionalGreeters
Role Responsibilities :
• Welcomes clients and monitors line-ups to maintain physical distancing.
• Asks if client has an appointment (if clinic is appointment-based) and if client meets the
eligibility criteria for the clinic (if there are eligibility criteria for the clinic based on who is
being prioritized for immunization).
• Screens for any COVID-19 related symptoms as per the clinic and jurisdiction's active and
passive screening protocols.
• Refers clients who fail the screening protocol or have questions to the appropriate staff
member (e.g., Clinic Leader, Clinic Floater, Medical Support).
• Ensures clients arriving at the clinic are wearing a mask (unless less than 2 years of age or
cannot wear a mask) and that they clean their hand with alcohol-based hand rub. Provide a
mask to clients who do not have one.
• Determines whether the client has any accessibility needs (e.g., mobility issues, sight or
hearing impaired, need for a translator) that require additional supports and refers to the
appropriate staff member (e.g., Clinic Leader, Clinic Floater, Medical Support).
• Directs clients to registration.
• Facilitates crowd control and clinic flow, ensuring physical distancing of at least 2 metres is
maintained between clients while waiting in line to enter the clinic or in the pre-registration
area (although clients from the same household can remain together) with the aid of
markings on the ground.
• Ensures that signage is in place and visible, including COVID-19 screening protocols,
eligibility criteria, clinic instructions and clinic flow, as appropriate.
Qualifications/options to source: Training available:
COVID-19 vaccination in Canada: an
educational series for primary care
Role can be performed by a non-health professionals | Department of Family &
care provider staff member or Community Medicine (utoronto.ca)
volunteer; could also be done by an COVAX Registration (2).mp4
unregistered health care provider
COVAX Registration YouTube VideoRegistration
Role Responsibilities :
• Verifies the client's appointment (if the clinic is appointment-based).
• Depending on the registration process used by the clinic, verifies
registration documents (e.g., Consent Form) have been completed
online, or assists with their electronic completion or provides paper
documents for completion. If required for registration, checks the
health card or other identification.
• Refers clients to appropriate clinic staff members for discussion of
any potential contraindications to immunization or questions (e.g.,
Clinic Leader, Clinic Floater, Medical Support).
Qualifications/options to source: Training available:
COVID-19 vaccination in Canada: an
• Role often performed by administrative educational series for primary care
professionals | Department of Family &
assistant or
Community Medicine (utoronto.ca)
clinical/medical secretaries.
• Excellent computer skills COVAX Registration (2).mp4
COVAX Registration YouTube VideoSyringe Pre-Loaders
Role Responsibilities :
(Only needed in clinics where pre-loading occurs by non-immunizers)
• Mixes vaccine with appropriate diluent or adjuvant (depending on
the vaccine) using appropriate aseptic technique as per the Canadian
Immunization Guide.
• Pre-loads the syringe with the appropriate dose and attaches the
needle for administration using appropriate aseptic technique as per
the Canadian Immunization Guide.
• Ensures that sufficient vaccine is pre-loaded to keep the clinic
running efficiently, but not too much is preloaded in order to prevent
wastage.
• Ensures vaccines are kept according to appropriate cold chain
requirements during the mixing and pre-loading processes and after
pre-loading, with appropriate temperature monitoring and
recording.
Qualifications/options to source: Training available:
COVID-19 vaccination in Canada: an educational
series for primary care professionals | Department
• Role could be performed by a registered of Family & Community Medicine (utoronto.ca)
nurse, registered practical nurse,
pharmacist, physician, www.health.gov.on.ca/en/pro/programs/publicheal
OR th/oph_standards/docs/reference/vaccine
• by medical trainees, nursing students and _storage_handling_guidelines_en.pdf
pharmacy technicians if under supervision
COVAX Registration (2).mp4
of registered health professional
COVAX Registration YouTube Video
Note: with appropriate training and oversight
a variety of health care providers could There are 4 vaccine approved in canada the
perform this function videos currently available are only for Pfizer.
Perhaps best approach is to let people use the
spec rather than providing videosRunners
Role Responsibilities :
• In clinics where syringe pre-loading occurs by non-Immunizers,
monitors the supplies of pre-loaded syringes that each Immunizer
has and needs, and delivers preloaded syringes with the attached
needle from the Syringe Pre-Loader to the Immunizers in a container
(e.g., small box with no lid).
• Monitors and delivers other required equipment to Immunizer or
Syringe Pre-Loaders and responds to staff requests.
• If using a paper-based system, collects completed consent forms
from Immunizers.
• At the end of the clinic, completes inventory count for ancillary
supplies, forms and other equipment and provides replenishment
numbers needed for the next day's clinic (if using the same site) to
Administrative Support (below).
Qualifications/options to source: Training available:
COVID-19 vaccination in Canada: an educational
series for primary care professionals |
• Role could be performed by Department of Family & Community Medicine
administrative assistants, non- (utoronto.ca)
COVAX Registration (2).mp4
health care provider staff members
or volunteers. Role often performed COVAX Registration YouTube Video
by clinical/medical secretaries.
• Well-developed customer service
and communications skillsClient Flow Monitors
Role Responsibilities :
• Directs clients who have registered to the next available Immunizer.
• Ensures clients waiting in line for the next Immunizer are physically
distanced with the aid of markings on the floor indicating where to
stand and/or where chairs are placed to sit.
• If clinic is operating by calling pre-registered clients in from their
vehicle or outside, performs this function.
Qualifications/options to source: Training available:
COVID-19 vaccination in Canada: an
educational series for primary care
• Role could be performed by professionals | Department of Family &
volunteers, unregistered or non- Community Medicine (utoronto.ca)
health care provider COVAX Registration (2).mp4
staff members
COVAC Registration YouTube VideoImmunizers
Role Responsibilities :
• If syringes are pre-loaded by Syringe Pre-Loaders, verifies volume in the syringe. If Immunizer is
loading the syringes, verifies that they have sufficient supply for the next client.
• Signals that they are ready for the next client using a flag, waving their hand or other mechanism.
• Verifies client matches the consent form information and that informed consent has been obtained;
screens for illness and any contraindications and answers client's questions or concerns.
• Assesses client to determine if they have a history of fainting during medical procedures, or look
anxious, pale or sweaty. These clients may require immunization lying down on a mat in the First Aid
Area or in a reclining chair (if available) to prevent fainting and injury.
• Using appropriate techniques (including hand hygiene, land-marking), immunizes the client.
• Following immunization, activates safety engineered device and then immediately disposes of the
needle and syringe in the sharps container.
• Completes documentation for the clinic record and for the client.
• Provides client with their Immunization Record and After-Care Sheet.
• Counsels' clients about post-immunization waiting period, monitoring for adverse events, what to do
if adverse events develop, need for and timing of a second dose (if needed), and the need to
continue to follow COVID-19 precautions (e.g., physical distancing, mask use) on an ongoing basis as
per public health recommendations.
• Ensure clients can safely proceed to the Post-Immunization Waiting Area.
• Responds to adverse events if required; documents and reports adverse events and informs
appropriate clinic staff (e.g., Clinic Leader, Clinic Floater, Medical Support).
Qualifications/options to source : Training available:
COVID-19 vaccination in Canada: an
• Role can be performed by physicians, educational series for primary care
nurse practitioners, registered professionals | Department of Family &
nurses, registered practical Community Medicine (utoronto.ca)
nurses, paramedics, pharmacists,
dentists OR COVAX Registration (2).mp4
COVAX Registration YouTube Video
• by medical trainees and nursing students if
under supervision of appropriate
regulated health professionalMedical Support
Role Responsibilities :
• Responds to questions from clients during the screening or
registration process, including clients with questions about the
vaccine or immunization process, or clients who fail the screening,
are not eligible for immunization based on the criteria of the clinic or
have contraindications.
• Monitors/responds to post-immunization adverse events and other
medical emergencies.
• Supervises clients who need extra medical attention after
immunization.
• Manage needle stick injuries by assisting to arrange testing of the
source person and discussing the needs for post-exposure
management in the exposed person
Qualifications/options to source: Training available:
COVID-19 vaccination in Canada: an
educational series for primary care
• Role can be performed by a
professionals | Department of Family &
physician, nurse Community Medicine (utoronto.ca)
practitioner, registered nurse or
registered practical COVAX Registration (2).mp4
nurse specifically assigned to this COVAC Registration You Tube Video
role OR
Monitoring Side Effects and Adverse Events -
• by medical trainees and nursing COVID-19 Immunization Toolkit
(covidtoolkit.ca)
students if under supervision of
appropriate regulated
health professionalPost-Immunization Waiting Area Monitors
Role Responsibilities :
• Monitors Post-Immunization Waiting Area, including for clients who may be
unwell and need assistance after immunization.
• Ensures that clients maintain 2 metre distance and continue to wear their
masks.
• If clients are waiting in their vehicles or outside after immunization, monitors
this outside area.
• If role is performed by non-health care providers, informs a clinic health care
provider (e.g., Clinic Leader, Clinic Floater, Medical Support) immediately if a
client needs medical attention.
• Advises clients to use alcohol-based hand rub on exiting the clinic.
Qualifications/options to source: Training available:
COVID-19 vaccination in Canada: an
educational series for primary care
• Role can be performed by health professionals | Department of Family &
care providers or by non-health care Community Medicine (utoronto.ca)
provider staff members or Monitoring Side Effects and Adverse Events -
volunteers who have immediate COVID-19 Immunization Toolkit
access to and inform health care (covidtoolkit.ca)
providers if assistance is neededAdministrative Support
Role Responsibilities :
• Performs or oversees registration process.
• Collects all documentation including consent forms and adverse event forms (if paper-based
systems are being used).
• Enters any forms that are used into electronic system, depending on processes used at the
clinic.
• Ensures that medical information and Consent Forms are secured and remain confidential.
• Provides training and oversight to volunteers who are performing the roles of Parking Lot
Attendants, Greeters, Client Flow Monitors and Post-Immunization Waiting Area Monitors.
• Assists with data collection for the clinic information including numbers vaccinated, and
supplies and vaccines used and needed.
• With Runners, at the end of the clinic, prepares re-order forms for ancillary supplies, client
forms and other equipment that require replenishing for the next day's clinic if using the
same site.
• Assists Clinic Leaders with tracking staff attendance and collecting time sheets, and tracking
volunteer attendance.
Qualifications/options to source: Training available:
COVID-19 vaccination in Canada: an
• Role often performed by clinical/medical educational series for primary care
professionals | Department of Family &
secretaries.
Community Medicine (utoronto.ca)
• Excellent computer skills
• Well developed customer service and
communications skillsClinic Specialized Support
Role Responsibilities :
Supports:
• infection prevention and control/occupational health and
safety at the clinic
• cold chain management (particularly for vaccines with specific
cold chain requirements including the appropriate handling of
dry ice, if required)
• vaccine inventory management at the clinic
• collaborates with custodial staff regarding cleaning and
disinfection protocols
• Other functions such as answering client's questions, assisting with
managing fainting or anaphylaxis and monitoring the Post-
Immunization Waiting area
Qualifications/options to source: Training available:
COVID-19 vaccination in Canada: an
educational series for primary care
• Role can be performed by a staff professionals | Department of Family &
member familiar with infection Community Medicine (utoronto.ca)
prevention control or occupational
health and safety and cold chain Wrapping Up Your Immunization Clinic -
management COVID-19 Immunization Toolkit
• Understanding of relevant health and (covidtoolkit.ca)
safety legislation
• Understanding of Infection, Prevention
and Control guidelinesOnsite Support Roles
Translators/Interpreters
Role Responsibilities :
• Assists clients in understanding the immunization information and
processes in their specific language.
• Particularly important in clinics serving diverse population who many
not speak English or French (depending on jurisdiction).
• If onsite translators/interpreters are not available, telephone
translation services can be used.
Qualifications/options to source: Training available:
COVID-19 vaccination in Canada: an educational
series for primary care professionals |
• Trained translators optimal Department of Family & Community Medicine
• Health care providers or volunteers (utoronto.ca)
who speak the required language.Custodial Staff
Role Responsibilities :
• Ensures that site is clean and in proper working order (e.g.
washrooms are cleaned and stocked, garbage is collected).
• Frequently cleans and disinfects commonly touched surfaces.
Qualifications/options to source: Training available:
COVID-19 vaccination in Canada: an educational
series for primary care professionals | Department
• Role can be provided by the facility of Family & Community Medicine (utoronto.ca)
operating the siteSection 3:Human Resource Guide and Option to Source
Health Human Resources Resource Guide
Health Human Resources Resource Guide How to Use the HHR Resource Guide: The guide is intended to be a resource for Vaccination Clinics to support local recruitment and staff sourcing efforts. Procedure: 1. Identify the roles required based on ‘Job Family’ (Options: Leadership, Clinical, Administrative, Support, Translation) 2. Choose ‘Supply Source’ from list of available sources (Options: recruitment, redeployment, learner, volunteer, agency, employment resources, service provider) 3. Use ‘Contact Information’ to request staffing support 4. Utilize ‘Tools and Resources’ where applicable 5. For clinical roles ensure that appropriate ‘Practice/Delegation Structure’ and appropriate professional liability insurance can be in place for delivery of injection HHR Resource guide HERE
Contact information Vaccine Clinics already
in operation
OHT Site Name Site Contact
Scarborough • Carefirst Seniors & Community Glyn Boatswain
Services Association gboatswain@shn.ca
• Centennial College Progress
Campus
• SHN Centenary
East • Michael Garron Hospital Shabina Rangarej
• Warden Hilltop Community Shabina.Rangarej@tehn.ca
Centre
Downtown East • St Michael’s Hospital Linda Jackson
linda.jackson@unityhealth.to
Mid-West • MaRS Clinic Leanna Graham: leanna.graham@uhn.ca
• Michener Clinic
• Krembil Discovery Tower
• CAMH amanda.robins@camh.ca
West • St Joseph’s Health Centre Dale Clement
dale.clement@unityhealth.to
North • Sunnybrook Andrew Kennedy
Andrew.Kennedy@sunnybrook.ca
North West • Humber River Hospital – Wilson Vanessa Burkoski: vburkoski@hrh.ca
Ave
North York • North York Family Health Team Sue Griffis
sgriffis@nyfht.com
James Schembri
• North York General Hospital James.Schembri@nygh.on.ca
Sean Molloy
• Seneca College Sean.Molloy@nygh.on.ca
• Women's College Johana Amar
Johana.Amar@wchospital.caAppendix 1: Model definitions and Operational Guidance Examples
Clinic Model – Mass Immunization Clinics
Mass Immunization Clinic
Fixed Location, Long-Term,
>40 Vaccinators, Large
Footprint
Onsite Clinics
Drive Through Clinics
Operational Guidance for:
• Floor plan
• Process Map
• Staffing
• Equipment and SuppliesMass Immunization Floor Plan Example 1
Mass Immunization Floor Plan Example 2
Mass Immunization Floor Plan Example 2 - Arena (Credit to Newmarket Ray Twinney Arena Site)
Process Map Example 1
Mass ImmunizationMass
Immunization
Staffing Example 1Mass
Immunization
Equipment & Supplies Example 1Mass Immunization Equipment & Supplies Example 2
Mass Immunization Drive Through Example 1 Drive-Through Parking Lots at Big Box Stores, School/Colleges, Stadiums
Clinic Model –Fixed Community Clinics Fixed Community Clinics Fixed Location, Short-Term,
Fixed Community
12 Immunizers Clinics
= 168 Patients per Hour
(@ 14 Patients per Immunizer Hour)
Key Considerations
• Flow (Entrance → Vaccination → Observation → Checkout → Exit)
• Some cross traffic from vaccination to observation (negative)
• Pharmacy ease of access to sink (via IN door), vaccination stations, and storage
• Clear space around perimeter
• Central open space for navigation
Tweaks
• Add or remove space from Help Area
• Could direct all patients to go from vaccination stations to north end of the gym to
prevent cross-flow
Floor Plan
Example 1Fixed Community
Clinics
Floor Plan
Example 2Fixed Community
Clinics
Floor Plan
Example 3Fixed Community
Clinics
Process Map
Example 1Determining Clinic Fixed Community
Capacity Clinics
Covidtoolkit.caFixed Community
Clinics
Staffing Example 1: 1000/dayFixed Community
Clinics
Staffing Example 2
At full capacity 12 vaccination
stations with a throughput of 800-
1000 (in a 7-hour day).
Vaccine Floater
Throughput Day Clinical Booking Registra Flow Check Oversight Vaccine (for
(7 hr Clinic) Manager Lead Manager Security Screener Check in tion Router out Observer Lead Preparation Scribe Vaccination breaks)
400 1 1 1 2 1 1 3 3 2 2 1 4 6 6 2
800 1 1 1 2 2 2 5 3 4 3 1 6 12 12 2Fixed Community
Clinics
Equipment & Supplies
Example 1:
1000/DayClinic Models – Mobile Response Clinics Mobile Response Clinics Location Varies, Very Short- Term,
Mobile Response
Clinics
Floor Plan
Guidance – Example 1Mobile Response
Mobile Vaccination Team - Process Flow
Clinics
Planning team holds initial Planning team emails Shelter completes Final prep meeting – Day
engagement huddle consolidated documentation and sends before overview of roles
minimum 3 days prior to documentation and back to planning team for and responsibilities for
vaccination day* process to shelter upload to COVax clinical and shelter team
Vaccine pickup and Clinic set-up – rest of clinical
Drawing team begin Team Huddle – Huddle
supplies arrive with the team arrives 1 hour before
planned start time to
prep of doses - requires with clinical and shelter
Team Leads 1.5 hours separate, ideally quiet team 30 minutes prior to
complete set up and ensure
prior to planned start of COVax aligned to correct site space start for final review of
Process Map –
clinic roles and flow
Example 1
Individual registered/checked-in, Adverse event flow – After 15 minutes, individuals
Shelter team leads
receives vaccination and then confirm supplies on site, leave observation area to
clients to centralized
directed to post-vaccine observation site to call 911, work with create room for new
location and forms
area doctor on site if something individuals
queue
happens
*A single planning meeting is possible but ideal to have multiple engagements – the first to engage, plan, and 19
provide overview, the 2nd to walk through final day of logisticsMobile Response
Clinics
Staffing Example 1Mobile Response
Clinics
Pods Model of Care Example
• Pods are scalable units of clinical staff. Staff will be pre-assigned a
Pod. Where possible, Pod assignments will stay the same, being
deployed to different sites
• Assumptions:
• Each Pod can provide 10 vaccinations per hour. In an 8-hour
day, one Pod can provide 80 vaccinations
• The number of Pods needed for one vaccine clinic will be
scaled to number of expected doses to be administered
• Each Pod is comprised of:
• 1 immunizer
• 1 COVax Super User
• 1 to 2 clinical helpers (1 helper for a Fixed Clinic and 2
helpers for Door-to-Door)
**Ideally, one Pod member will be able to speak the
primary language of the residents to be vaccinated
in a given buildingMobile Response
Clinics
Staffing Example 2Mobile Response
Clinics
Equipment and Supplies: Example 1Mobile Response
Clinics
Equipment and Supplies: Example 2Mobile Response
Clinics
Equipment and Supplies: Example 3,
250/Day
Equipment and Supplies
Medical Supplies Qty General Supplies Qty IT Supplies Qty
Gloves TBD Data entry forms TBD Laptops 6
Epi-Pens 6 Tables TBD Internet Connectivity Yes
First Aid Kits 2 Chairs TBD iPad 12
Face Shields 10 Dollies 0 Chargers TBD
N-95 Respirators 12/day Storage Equipment TBD Electric Generators (if necessary) TBD
Alcohol Swabs 1000/day Refrigerators & Freezers TBD Handheld Land-Mobile Radios 12
Syringes 500/day Bathroom facilities Yes
Vaccination Record Cards 300/day Signage TBD Drive-Through Requirements
Variable message signs TBD
Traffic Cones 150
Tents/Shelter TBDAppendix 2: Additional Information • Site identification and accessibility • Site Safety • Infection Prevention and Control Resources • Other Considerations
Additional Consideration for Site
Identification and Accessibility
When selecting a location to hold vaccination clinics several factors need
to be considered, especially for mass immunization and fixed community
clinics where the patients must enter a building to receive their
vaccination. These include:
• Accessibility of clinic sites:
• Is the site wheelchair and walker accessible?
• Can service dogs be accommodated?
• Can communication be posted or provided in accessible ways?
• Are the restrooms also accessible?
• Transportation of clients
• Are transport chairs available or be made available on site?
• Can handicap buses and vans pull up (ideally into a covered area) for drop off
and pick up?
• Parking
• Is there adequate parking and is there ample handicap parking? (spaces can be
temporary if marked)
• Accessible spaces should be large enough for mobility devices, 8 feet wide and
5-foot access aisle and van accessible spaces are 8 feet wide and 8-foot access
aisle
• Can a route be kept free for those who are being dropped off and picked up?
• Can patients' text or call when they arrive if they require assistance?Accessibility Checklist Examples
Site Safety Review Example from the Michael Garron Site Safety Review checklist
Infection Prevention and Control Several guidelines and training modules exist, and all human resources should be trained in basic infection prevention and control methods. • Infection Prevention and Control Guidance for COVID-19 Immunization Clinics • Infection Prevention and Control Assessment for Primary Care, Specialty and Walk-in Clinics during COVID-19 • COVID-19 Vaccine Clinic Operations Planning Checklist
Additional thingsDuring
toImmunization
Pre Immunization Process
consider: Post Immunization Process
Scheduling Vaccine Preparation Wait period
Parking Vaccine Administration (before, Check out
during and after)
Line-Ups Documentation
Greeters
COVID-Screening
Vaccine Screening and Consent
Registration
In addition, consideration should be given to
how to manage adverse events (roles, access
to medical care, medical directives) and site
close out (communications, storage and
management of remaining supplies, disposal
of sharps etc.).
Government of Canada website
provides helpful resource related
to all of the above items!
Planning guidance for
immunization clinics for COVID-
19 vaccinesSection 3: Additional Resources and Links
Sample
Content
PlaybooksLinks to additional resources • Toronto Region Vaccine Clinics HHR Resource Guide • Primary Care COVID-19 Immunization Toolkit - COVID-19 Immunization Toolkit (covidtoolkit.ca) • MOH COVID-19 Vaccine Clinic Operations Planning Checklist • MOH COVID-19 Relevant Information and Planning Resources • Government of Canada: Planning guidance for immunization clinics for COVID-19 vaccines • North York Family Health Team Influenza Vaccine Strategy 2020-2021: On-Site Parking Lot Drive-Through clinics
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