Consideration 7

7_Efficiencies

7. Build efficiencies into your OSCTC

Appointments

Consideration

Appointments can ensure OSCTCs have a steady flow of patients.

Pre-registration can save time, leading to a quicker visit at the OSCTC.

Voices from the Field

“If you don’t make an appointment down there, then there is going to be two hundred people waiting in the morning.”
“Appointment only patients go through our application and finish the entire onboarding before coming. So, when they come in, they just show up, we swab them, and they are out of the door. That is why it is so efficient because there's no paperwork there.”

Online data entry ​

Consideration

Conducting the screening and registration process online can minimize staff time and potentially reduce data entry errors.

Voices from the Field

“They essentially complete an online screening questionnaire [that generates] the lab order…that accompanies that sample”

Using data

Consideration

Thoughtful collection, compilation, and analysis of data can identify problems and build in efficiencies to your OSCTC.

Voices from the Field

“We have a number of process measures we’re hoping to capture really to understand the efficiency of our system: What's working? What's not?”
"We have an entire team [whose] job is just to watch the data and watch the numbers. So, from that QA … they’re watching that we really drive everything we do based off of the numbers that we see."
“We have an integrity process where we validate data that will be shared with organizations to make sure we’re capturing accurate data and sharing that data with the groups that we need to send it too.”

Quality improvement processes

Consideration

Regularly review your OSCTC procedures to identify improvements and add efficiencies.

Gain and incorporate patient and staff feedback.

Build in competency trainings for OSCTC staff.

Consider periodic audits of OSCTC processes.

Voices from the Field

“We are constantly making adjustments to our plan to ensure that we’re not letting anything slip through the cracks trying to catch every gap…”
“We are constantly troubleshooting the process itself to increase expediency. Things like, the way labels are printed on site can be problematic sometimes, so we will go through a QI process to figure out what the most streamlined approach to that is…at every turn, we are looking to shave minutes off it and remove redundancies”.
“It would behoove us to take that look and analyze our processes about every two weeks, because things can get lost in the shuffle or a new person will come in and they will notice something…”
“Any time anyone had an idea or hey, let’s do this differently, or let's try this, we would put it up there, come together as a group and make a decision and it was real time process improvement…sometimes people lose the agility out of either fear or tradition, or not being sure to do that. I think … why we were so successful and could stand things up so rapidly is because we had really bright people thinking about all the different pieces and making decisions on the spot and implementing them real time. And you have to be able to let yourself do that even if it might mess up.”
“Questions we received from patients, questions we received from team members … we will review our workflow and our operation.”
“…from our pop-up testing locations, we did 2 PDSA cycles.”
“...nurses from perioperative procedure areas… put in some efficiencies and worked on efficiencies … that have allowed us to really standardize how it's done.”
“We put a competency in place so that the nurses who are new to the process site are signed off on a competency to make sure that were doing it in a consistent manner."
“We audit so many visits per week. We audit the providers for swabbing technique…”

Playbooks and process flow maps

Consideration

Create playbooks and process flow maps to add clarity, streamline protocols, and facilitate the set-up of future OSCTCs.

Consider bringing in experts to engineer processes and build additional efficiencies.

Voices from the Field

“we created a playbook … to document the process flow… We built the playbook down to very, very, specific levels of detail … we evolved that playbook, as we built different models out with different partners in different shapes and sizes… we have run dozens of different plays from that playbook with each play relating to a different kind of model that we operate.”
“we brought system engineer people from the health systems that had set up these sites for the health systems to come in and we engineered everything to a second like, we need this many tents, or this is our volume, … we really started thinking through this in a very detailed manner to try to make it the most efficient”
“there's a fair amount of work that goes into setting one of these up so you want to make sure you get some runway out of it or actually, hopefully, people will be able to benefit from the work you're doing and be able to replicate the best practices”

Start small

Consideration

Start with a smaller site to develop and improve processes before deploying larger sites. 

Voices from the Field

“…we created this process and mapped it out in our smaller healthcare setting … for maybe a week and ½, 2 weeks. It wasn't long before we stood up our larger drive-thru testing centers. And what we did was we took the process that we had developed in the smaller setting and expanded it in the larger setting with multiple teams.”

Team communication ​

Consideration

Strong communication processes built within internal teams and between external partners can allow sites to quickly adapt to problems.

Voices from the Field

“We had really good relationships with each other … if something happened, if something did not go the way it was intended, like a couple of times there were some rainstorms and operations had to shut down quickly, we knew right away, and we knew what the plan was going to be. So, that internal team communication was so important.”
“...there's just a lot of collaboration happening behind the scenes through this kind of Joint Task Force function and so that our labs and our testing sites are all working together and coordinating our strategies so that we can problem solve in the moment when, when we need to problem solve.”
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Off-Site COVID-19 Testing Project home page
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1. Identify and prioritize the population to be tested
2. Identify and mobilize your partners
3. Determine the type of OSCTC
4. Offer the right type of test
5. Adapt to variations in laboratory capacity and turnaround time
6. Staff Required for OSCTC
7. Build efficiencies into your OSCTC
8. Promote positive patient experience and community awareness
9. Address potential patient access limitations
10. Manage patient results​
11. Plan for weather extremes
12. Provide PPE to staff
13. Financial viability/ sustainability
14. Explore a broader role for your OSCTC
Methodology
Additional Resources
Acknowledgements