NSF INTERNATIONAL: Prior to the pandemic, Paul Medeiros, managing director of consulting and technical services for North America, worked primarily helping food and hospitality customers with food safety. But that expertise in maintaining public health led his team to confront the impact of COVID-19 on businesses and Medeiros led the reopening plan for the Detroit Institute of Arts and Michigan Science Center in the middle of the pandemic and helped develop the safety protocols for the Dlectricity light show event to be held in Midtown this September. His department also led the state of Michigan's COVID-19 ambassador plan, which inspected and certified restaurants and other businesses with special status for adhering to heightened safety protocols. Now Medeiros and his team have reorganized around assisting local health departments in getting vaccine rollout right as the volume of those needing a shot grows exponentially.
How did a food safety team get involved in COVID-19 protocols?
My personal part of the world was heading the North American consulting tactical services in the food division of NSF. We look at what can make people sick in food and food preparation. Then COVID-19 came along. Businesses needed help with their COVID-19 protocols so they could stay open and protect their employees and customers. So it became a natural extension to help food businesses in those areas. I am a former health inspector and most of my team (of 50) has a health background. We understand microbial risk. A lot of those principles around sanitation, hygiene and foodborne disease spread are very similar to the transmission of COVID-19. This is just another avenue of risk assessment.
How did that translate to working with health departments on vaccine rollout?
We're a public health safety nonprofit. We focus on the areas that are going to have the biggest impact. Right now, we just got to get people vaccinated. So when I was reaching out to my public health colleague, a general manager of a health department, to talk about our ambassador program (certifying businesses that trained in COVID-19 safety protocols) they said what they really needed help with is vaccine rollout. So we just started to talk. While (health departments) are familiar with doing flu shots, they are now having to implement a mass vaccination program. I mean, some of these vaccine sites are going into arenas. These health departments are used to throughput of hundreds of vaccines per day, maybe, but now it's thousands per day. They want to maximize safety and give public confidence they are doing this safely. That's where we specialize.
Who are you working with?
Right now we're working onsite with Lambton County Public Health in Sarnia (Ontario). We're also working with others on remote work advisory. But we're out visiting those sites now, me and one of our specialists that's a Six Sigma black belt and lean expert. We're focusing on maximizing throughput, understanding infection control and inventory controls with a lot of process management. Really understanding the flows and the throughput. It's very similar to the work we've done with restaurants and casinos and hotels. Bringing people together safely and effectively.
What recommendations are you providing?
We do risk assessment. At any kind of vaccine clinic, what can go wrong? That's anything from power outages to managing lines as the weather turns hotter in the summer. Theft can be another risk. Vaccines are a rare commodity. Things that are rare and expensive make them a target. But some of the recommendations without getting too specific are around anything they can do to reduce waste of the vaccine and maximize throughput. We recognize there is a certain percentage of the population who register and not show up. As high as 20 percent. So we are recommending departments consider having a separate queue. A small and manageable list of people who can come in when there are no-shows. We're also using surveys, asking customers how the registration was and how it can be improved. Really to improve the patient experience. Such as reaching out the no-shows as to why they did not come. Understanding why people are not coming is critical to improving efficiency.
What are some problems vaccine sites are facing?
No-shows are what's really causing frustration. Whether it's for their second dose or their first dose, people aren't showing up. That's really important for anybody who is managing this, to understand why they are not showing up. There needs to be more communication. The real challenges on site are people having so many questions and slowing things down. If the vaccine sites are giving 10 to 15 minutes per vaccine, people are taking more time with questions. If everyone extends their time (at a clinic) by 25 percent, then you're doing 25 percent fewer vaccines. The lines grow and frustration grows. One simple thing to do at all vaccine clinics is use any time waiting to answer these frequently asked questions. Whether that be digital signage, pamphlets, whatever. Any opportunity to answer a question before the face-to-face interaction is critical to maximizing throughput.
What's been the biggest pitfall?
Waste. It makes the headlines, the doses going unused. One health agency that was administering the Pfizer vaccine was wasting a dose out of every vial. You need a special syringe to get the sixth dose out and they weren't using that tool and throwing out a dose with every vial. That's causing part of the frustrating delays and leads to second doses getting canceled and longer lines. None of that is surprising to me. What I find is whether you're public health or private industry, we can all do a better job when we plan out these sites and are doing that risk assessment. Someone has to be there to ask what hasn't worked well and what can go wrong. Not just a couple of people in the room, but bring in the stakeholders to apply best practices.
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