Practice Management Minute | Drive-thru Flu Clinics with Lucinda Vazquez, RN

Drive-through flu clinics can be an effective way to improve vaccine access while minimizing disruption to daily practice operations—but success depends on thoughtful planning and execution. In this episode of The Practice Management Minute, Jessica Ray sits down with pediatric practice manager, Lucinda Vazquez, RN of Heritage Medical Associates (Heritage East), to discuss the operational strategies behind a successful drive-through flu clinic. From selecting the right location and forecasting vaccine inventory to designing patient flow, assigning staff roles, maintaining cold-chain integrity, and documenting vaccinations efficiently, this conversation offers practical guidance for practices considering or refining their own events. Whether you're planning your first drive-through clinic or looking to improve an existing model, this episode provides real-world lessons and proven approaches to help your team deliver a safe, efficient, and positive vaccination experience. 

Key Takeaways

1. Successful drive-through clinics start with thoughtful planning. Choosing the right location, understanding patient demand, and preparing well in advance set the foundation for a smooth event.
2. Clear staff roles keep the clinic running efficiently. Defining responsibilities for check-in, documentation, vaccine administration, and supply management helps maintain patient flow and reduces bottlenecks.
3. Efficiency should never come at the expense of safety. Strong documentation processes, proper vaccine storage and handling, patient verification, and established safety protocols are critical throughout the event.
4. Every clinic is an opportunity to improve the next one. Reviewing what worked, identifying challenges, and refining workflows each year helps create a more efficient and successful vaccination program over time.

Transcript

SPEAKER_00 0:00

Welcome to Cumberland Conversations. This is a place where we talk about the issues that matter most to you, your patients, and your community. We're diving into real conversations with real people, sharing insights you can actually use. Let's get this conversation started. Hi everyone, it's Jessica Ray, Executive Director of the Cumberland Pediatric Foundation. We're back today with our next episode of the Practice Management Minute. Today I'm excited to be talking about one of my favorite topics, and that's drive-thru flu clinics and pop-up clinics. But this is actually going to be a continuation of our vaccine town hall that we started approximately a year ago. And I'm joined today by Lucinda Vasquez, who is the site manager for Peeds East. And I'm going to let her tell a little bit more about her role and talk a little bit about the clinic that she works for.

SPEAKER_01 0:52

Yeah, so uh my name is Lucinda, and I'm so happy to be here. Thank you for inviting me, number one. I am the site manager for our Peeds East locations. We have three locations. We have Mount Juliet, which is our largest location. We also have Hermitage and Lebanon as well. I work with 16 providers and over 60 employees on a day-to-day. And yeah.

SPEAKER_00 1:17

That's wonderful. Well, I'm very familiar with Peads East and think it's just a wonderful um clinic, but I wanted to talk about what you all are doing with your drive-through flu clinic. So can you tell us just a just an overview of how that came to be? Why did you decide to start doing drive-through flu clinics?

SPEAKER_01 1:34

Yeah, so we we started this in 2020, and that was in efforts to try to keep patients out of the clinic as much as possible while maintaining getting vaccinated and protected against the flu for the year. So I think that was uh the intention behind that. And so we just saw a huge success with it over the years. And when I stepped into the role uh as a nurse, I had done it and, you know, performed in the flu drive-thru. And then I became the clinical supervisor uh probably less than a year after being in the role as a nurse. And then about a year after that, I became the site manager. And every year since we've been doing it, we just found so many great positive aspects to continue to do it.

SPEAKER_00 2:25

That's really exciting. And I know we do have several other member clinics who are doing similar events, but there are some of our members who have said, How do we do this? How do we start doing something like that? So I definitely want to dive into that a little deeper. So first I want to talk about just the planning and setup. What goes into making this happen? So, for a clinic who might be considering doing this, what are the most important decisions to make early on?

SPEAKER_01 2:50

I think the first thing you have to think about is looking at the goals and why you're doing it. And I tell this to my staff as well when they're performing things in the clinic, is look at the why. Why are you doing things in the clinic? What is the what leads you to your decision? And in our clinic, is there a need for it? I think that's the biggest thing. Do we have a large population of parents that are going to be getting their children vaccinated? So for us, there is a huge need. We have three clinics, um, and there is a huge need for children to become vaccinated. So the first thing that we look at is we choose the right dates. We have to choose the right time. Um, I think that is the first and foremost. The next thing we have to look at is the location. Uh, I think the location is a big deal because you want to make sure that it is safe. It's a safe location. You also want to make sure that it's easy in and easy out. Is the traffic flow easy for parents to get in and out? Um, as well as just making sure that it's a large enough location so that for uh the patients that come in just to make sure that they have a large parking lot for traffic. Um I also think one of the most important things prior to getting any of the dates on the schedule is making sure that you're working with your rep. Whoever your rep is, you have to make sure that you have enough of the vaccine delivered to your location prior to those dates because you're also going to be giving flu vaccines in the clinic as well. Um, and I think for me, over the years, I have learned some tips and tricks, and one of those is ordering pre-filled syringes in advance as opposed to the single dose vials, because when you're drawing up, it takes time. So if you have those pre-filled syringes, it's a lot less time to draw those up and get those prepared. Also, another thing that I learned coming into the manager role and being on the nursing side of it too, one of the most important things is making sure that your lot numbers are kind of the same. Um, and that helps the clinical staff because when they're drawing up and I have my nurses documenting, uh, they can memorize that lot number. Um, so I think that for efficiency is very important so that they're not taking too much time.

SPEAKER_00 5:12

Well, that's fantastic. And actually, I wanted to talk about efficiency. So let's go ahead and skip to that a little bit. Yeah. Um, so can you walk us through the ideal patient flow from arrival to departure whenever people are coming in? Because we did talk about under, you know, planning, making sure your locations have easy in and out. But can you just talk us through what that flow looks like? I've experienced it myself, and yeah, I know you all have it nailed down and very efficient. So tell us a little bit about that.

SPEAKER_01 5:40

So, well, prior to that, I have my clinical staff make neon signs to um pretty much show where the event is going to be so off the road they can see exactly where it is if they've never been to the location. Um so we have signs, we have um the cars will come in through one way, and we have two to three lines of vaccine traffic that we have, you know, it doesn't matter what lane they're in, but they come in and we have our medical receptionists check them in and verify insurance, making sure that we have the guarantor with them as well. Um and uh after everything has been verified there, they give us a yellow sheet. Um, well, the medical receptionists give us a yellow sheet, and that yellow sheet then goes to my clinical staff. That yellow sheet has demographic information. It also has what type of vaccine they're gonna be getting if they are 10 care versus private insurance. That's a really big important factor for when our nurses draw up uh the vaccine to make sure that it's the right um the right vaccine. Um, and then uh just making sure that uh afterwards they have an easy exit. So yeah, that's pretty quick.

SPEAKER_00 6:57

That's great. It's been very efficient. Um I know that I feel like I pulled in and within 10 minutes we were pulling back out of the parking lot. Um and so that makes it a lot easier to handle hundreds of patients in one day. This is kind of, you know, not in the line of questions I planned on asking, but what is the typical amount of patients that you do um see in one of these um drive-through fluid clinics?

SPEAKER_01 7:21

Yeah, so it's funny that you asked that because I was actually forecasting for the amount of vaccines that we had to order this year based on last year's numbers. And last year in our Lebanon location, for one date from 8 a.m. to 1 p.m., we had 291 vaccines that we gave. Wow. Yes, and in Mount Juliet, in one day, we had 430 vaccines that we gave that day. That's amazing. Yeah, so within two days, we gave a total of 721 vaccines. Um, and I broke it down because I just, you know, I like to kind of do the math, and that we did 72 vaccines per hour. Um, because if we added up both hours, uh, we did 10 hours of of work time, and that's about 72 vaccines per hour, and about six vaccines per five minutes. So our staff were very efficient, very busy. That's amazing, very safe. I think that's a very big important that's one of our most important factors is maintaining patient safety during all of this because it's a quick process.

SPEAKER_00 8:27

It is a very quick process. What are some of the protections that you put put in place to maintain safety?

SPEAKER_01 8:32

Yeah, one of the biggest things is making sure that your staff are comfortable doing a model like this because some staff will clearly communicate to me that they do not feel comfortable. Um, and in in my setting as a manager, I communicate sometimes a little bit too much to my staff because I do need to know do you feel comfortable? We also have Saturday Vaccine Clinic uh that runs during those hours too. So if somebody doesn't feel comfortable but they're on the schedule, I can swap um, you know, a nurse for who's working the floor versus who wants to work in the vaccine clinic. Um so um that is that is one of the most important things. Um making sure I think that the parents have a conversation with the kiddos that can understand that they're gonna get a vaccine because them just showing up to our clinic and seeing a needle uh reaching into the car could be a little bit scary. Um so the parents do such a great job with that. I've noticed that you know they do communicate with the patients prior to. Um, and obviously, PPE, our nurses wear PPE with every single patient. Um, and I am on site for all of these dates throughout the whole time just to make sure that if there is a patient that is screaming or crying or really just not prepared to get it that day, I will call it off and just make sure that, you know, both the patient is safe as well as my clinical staff because the last thing we need is, you know, for something to happen to the patient or this the staff. We don't we allow the parents to jump in and kind of you know help hold, but we don't rely on the parents because it's not their job. And they're also, you know, trying to maintain maybe a far car full of other children.

SPEAKER_00 10:19

So I've I've experienced it myself, and I love your point about, you know, kind of coaching the parents to prepare their children for this. Um my son, I believe, was three or four when we went through the drive-thru flu clinic the last time, and it was extremely efficient. But I had prepared him and told him what was going to happen, and there were no tears. He sat still. I wasn't having to hold him. I will say nurses have some very strategic holding uh processes in the car. I was very, very impressed with that when we were there. But I think it's so important to speak to the safety, but um I did want to go back to the efficiency because again, I think that is so important. And we were talking about with the efficiency, um, you know, having come from clinic operations previously, I know how important those time slots are in clinics. So I did want to talk about how do you all pair this? Because obviously you didn't vaccinate every single patient at your drive-thru flu clinic, although you knocked out a very large amount of those. But how do you handle that along with just your regular in in-house vaccinations for for appointments? And you mentioned your Saturday clinics, but in addition to that.

SPEAKER_01 11:29

Well, we, you know, the goal for this whole flu drive-thru was to improve accessibility for patients, for clinical staff, for providers, and especially keeping in mind that during six season, you could see many different other things besides the flu. Um, those those spots are gonna get taken up pretty quickly, as well as having just a well visit on the schedule for a patient to be seen by a provider. So we really wanted to knock out as many vaccines as we could, as well as just making it easy for the parent that they didn't have to take their kiddo out of a car seat, come up the stairs, and have to wait for a an injection. Um we do have nurse visit-only appointments that allow for for this to um take place if they didn't make it to the flu drive-thru. Um, but it really knocks out the need for the nurses to step away from their regular day to um, you know, administer the flu vaccine. But in addition, yes, we have the flu vaccine um nurse visit only option. We also pair it with the well visits, and we also had a flu clinic that we offer on but we did it last year. Uh, we don't know if we're gonna do it this year just because there wasn't a need for it on Wednesdays and Fridays. So we allow a certain amount of time for patients to come in and we call it the flu clinic. Um, they come into our Mount Juliet location and we have a nurse available for four hours throughout the day.

SPEAKER_00 12:58

That's amazing. Oh, we we alluded to staffing, and you were talking about staff who may be comfortable in this model, and yeah, there's always those who are, you know, able to work more efficiently or quickly, and again, just don't mind giving vaccinations. I've worked with some nurses that you know are always a little hesitant, especially with some of the littles. But yeah, and will you tell me a little bit about how you prepare your staffing model for an event like this?

SPEAKER_01 13:21

Yeah, so uh the staffing model is probably one of the most important because you want to make sure that you have enough staff, but not that you're overstaffed, because again, you're you know, it's it has to be a very uh strategic operational model. So for us, uh we have two to three medical receptionists just to be ready, prepared for the cars coming in. Um, and we have two lanes normally, and one receptionist per lane uh where they identify the insurance and the guarantor. And then we have a runner if needed for those yellow sheets. If there's a yellow sheet backed up, we have the medical receptionist runner to, you know, transfer those yellow sheets between the medical receptionist and then the clinical staff for the next step. Um, so then I have about two to three nurses who are documenting the vaccines. Um, we work very closely with IT to make sure that we have our hotspots available because again, this is outside of the clinic. Um so we have to make sure that we have connection to our database. Right, false. So, yeah, that is a very important thing. Um, because we do everything in real time. Um, so making sure that the hotspots set up, two to three nurses documenting, they just sit down the entire time and document these um flu vaccines given. And then we have about three to five nurses who are doing the injecting, um, including myself, when if we were to ever get backed up, and normally that doesn't happen, um, but I'm available too to inject. But three to five nurses, um, because we have again two lanes, and sometimes you may need two nurses per car to help out because sometimes you may get one patient, sometimes you'll get seven, you know. Uh, and we I think seven was our most that we've gotten in a car. Sometimes we've had families bring two cars for families. Oh wow.

SPEAKER_00 15:09

I was gonna say they must have had a 15-passenger van.

SPEAKER_01 15:12

It's so convenient.

SPEAKER_00 15:12

Why would you not?

SPEAKER_01 15:13

So it is convenient, it is convenient. It is really great. And then again, I'm always on as a site manager because um, God forbid, any adverse effect, any type of um um, you know, issue that's a very important thing. Yes, and thankfully we have not had to, you know, deal with that. But um, and I make it fun because, you know, when they're doing the hard stuff, I try to keep the parent busy um and ask the parent questions as well as asking, you know, maybe the second one who's about to get their flu vaccine a question about their sports. Sometimes they're in uniforms going somewhere else afterwards, so I'll try to keep them distracted. Um, so I just try to do that as well. And then yeah.

SPEAKER_00 15:52

That's very smart. And you alluded to the fact when you have to jump in because you got might get a little behind. Yeah. So tell me what are some things that sometimes can cause delays or make things slow down? And along those lines, let's also talk about how do you prepare for unexpected, you know, challenges like the weather and things along those lines. So if you kind of want to touch on both of those together.

SPEAKER_01 16:14

So, for one of the challenges that we may face is when um if somebody's not on the schedule and if they're not on the schedule, we know that we can add them fairly quickly. We just have a blank yellow sheet that we have them fill out and we get them on the schedule right away. And maybe another challenge that we face, and um this happens every year as well, is you have an unconsolable child that is just not ready for the vaccine and knowing when to say it's not a safe environment. So sometimes we spend a lot of time with someone who's visibly upset in the car, and we give it a lot of time until we make that executive decision, and that's when I jump in. But just maintaining patient safety is the most important. So if I need to call it off for that for that moment, we may just have them come into the clinic at a later date. Um, and then you face the weather, you face heat challenges, you also face the rain challenges, and we come up with a plan. We do have tents that we have our staff under, especially for the computer system. We have them uh covered, as well as our medical receptionists. You have to also prepare for things like wind. Um that was was learned through trial and error. Um, just making sure you have paper weights, as simple as you know, paper clips to keep everything together, um, baskets underneath your chairs just to make sure you have somewhere to put your papers that you had just documented on. Um and just being fully prepared uh office-wise, you know, whether it's extra pens, extra paper, extra bins, extra paper clips, extra weight holders, um, extra stickers for the patients that don't want um, you know, a sucker. So this is how we address some of the challenges and we make it work.

SPEAKER_00 18:08

Well, that's great. And you mentioned one of the most favorite things of all kiddos when they visit the doctor's office. We obviously have stickers, but also you mentioned suckers. But what other treats or um positive reinforcement items do you have for the kiddos that are coming through for the drop-through flu clinics? Because I know that you all have some great things. Yes.

SPEAKER_01 18:30

And uh last year we trialed this. Uh, we had an ice cream truck last year, and we also had a snow cone truck. Both were so successful. Um, we actually sold out of the ice cream in the ice cream truck. Um, and they had to leave, they had to leave a little bit earlier than expected, but it was so great. Um, and the kiddos loved it. Um, we did get consent from the parents to take pictures of some of the kiddos uh who were enjoying the ice cream. But and this year we have an Italian ice truck that comes with all the toppings and including floats and whipped cream and ice cream and all the fun stuff. So we're doing it again this year, and I think it's gonna be a huge success.

SPEAKER_00 19:15

That's really exciting. Yes, if you think about flu season, it's kind of weird to think about, but it's still warm when you start giving these flu vaccinations. Yeah. So it's great to have a treat for the kids. And I was talking about for my son in particular, but even my daughter who's now two, I do typically have to have a little bit of bribery before we um, you know, get to the location. So I think this is very, very, very well thought out.

SPEAKER_01 19:39

It's healthy bribery, even for my staff. Um, I come from a very big Italian family, and the way I show love is with food. So I cook for them and I bring them water, I bring them coffee and bagels in the morning, I bring them pizza in the afternoon. So I feed them uh because it makes them want to work a little bit harder. And it is hot outside too. I mean, we work long hours, so just to reward them because I think that's one of the most important things, too, is just to show the appreciation to the families and our staff as well.

SPEAKER_00 20:10

I love that you have to take care of them. I've always said my giving love language is absolutely food. So I've always uh used that um and love to partake myself. So I think that's very well thought out. So one thing from a logistical standpoint, being outside of the clinic, you know, I've been involved in this from the operation side, but not the nurse and vaccine storage side. So tell me a little bit about how you, you know, keep the vaccines out at an event like this and how do you prepare for the storage of those?

SPEAKER_01 20:39

Um, you spoke a little bit to the observation, but maybe even more about the observation of um so we were also talking about that during these months, it could be hot. So we have to make sure that the vaccines maintain um proper temperature throughout the entire time of us giving the vaccines. Um, and we run this clinic from 8 a.m. to 1 p.m. So making sure that uh we maintain cold chain temperatures that are safe for handling, as well as having digital data loggers on top of those coolers that we have outside. A big part of my job is being a runner as a manager. I have to keep observation on the vaccines and not having too much on hand at any given time. So I do run upstairs, grab those vaccines from the refrigerator, and bringing them back downstairs into the coolers. And another big part of that piece is documentation and those crates that we do have underneath the table, that they are HIPAA compliant, that they are not just papers that anybody can touch that our clinical staff has a handle on once they put those lot numbers on there. I do grab those papers and I securely hold them and file them away as needed. So HIPAA compliance is a very Big part of that, as well as maintaining proper documentation.

SPEAKER_00 22:04

That's excellent. And you all are documenting real time into the EMR too, as you mentioned. So that's great. So this is just a good backup to help with the flow. That's wonderful. I think that's so smart. And it just helps give everybody an idea of how they can bring the clinic life out into a parking lot or outside to make this so much more effective.

SPEAKER_01 22:24

Yes, for sure. And it's it's creative and fun.

SPEAKER_00 22:27

The one thing I wanted to go back and touch on actually begins before people even show up for the flu clinic. So how do you notify people that you're doing this and how do you get them to register to come? Just tell me a little bit about that.

SPEAKER_01 22:40

Yeah, um, over the months leading into flu season, um, we uh contact our HR department, our and and they basically uh send messages out via text message or send emails out. We do a really great job with posting beautiful flyers throughout the clinic just to let the parents know who's in for a well visit. Let's just say that, hey, we're also running the flu drive-thru on these dates. Um, we also have social media. Uh, you have to do everything through social media nowadays. I feel like that is the biggest outreach that we have on our platform. We have a Facebook page and we also have a new Instagram page that we uh opened up about two weeks ago. So yeah. That's exciting. And so we we do a really good job with um with social media. Um I manage the Facebook page as well as one of my other clinical staff members, and um every week we just you know advise them to go ahead and make their appointments because again, this is appointment-based, it's not um walk-in based. Again, you're gonna have those walk-ins, but we we really do encourage the appointment process to take place. And do they cla call the office? Yes, they call the office and schedule their appointments, and they could also um reach out to our our medical receptionist if they have any questions, uh, or our triage nurses if they have any questions for legibility. Um, because some some new patients that do receive it need a two-dose um vaccine um if it's their first vaccine. So just answering those questions and being available is important.

SPEAKER_00 24:21

That's wonderful. Well, as we wrap up this conversation, I could talk about this topic for hours on end. It is something I'm extremely passionate about. But um, I wanted to just ask you again, you know, if there is a clinic that is wanting to get started this coming fall, what are some things that you said you would suggest that they, once they're listening to us on the podcast, what where should they start? What's the first thing they should do?

SPEAKER_01 24:44

Yeah, I again I think knowing why they're doing it, if there is a need for it, um, staffing is very important, making sure you have enough staff and as well as forecasting your vaccines, because I think with this model, you you do look at how many vaccines you do give for the vaccine drive-thru, but you also have to have that stash on the back end for the patients that are coming into the clinic as well. Um, so just knowing your forecasting for vaccine doses, I think is really important. Um, I also say reach out to your community for outreach to see if there's somebody that you can partner with um to get the word out. Um, just communicating to anybody who um would be willing to work with you is really important, I think, and make it fun. I think just making it a fun process, and if it's a small flu vaccine drive-thru to start, that's how we started. Um, and we grew over the years. And last year was the most vaccines that we've ever given, and um, within two days, especially. Um, and we just expect it to increase every year. But as long as we're, you know, working throughout the years and learning from our mistakes and learning to see what could be better um done the year after, that's how we we do. But I just say get out in the community and get the word out is the most important.

SPEAKER_00 26:10

So I love that. I just I do want to remind our members. So for those that are members of the foundation, we do have people on our staff that are previous practice administrators, and obviously we have access to Lucinda as well. But if this is something you're wanting to incorporate in your clinic, we would love for you to reach out to us. We would be happy to consult you on this. Um, it's all free of charge, it's part of your membership. And, you know, the pediatric community is, I mean, it's a family, you know, we are all here to serve the patients. And so, you know, Lucinda's, we've already talked about her sending me some pictures and graphics of how they make this happen that she's willing to share, you know, and I think that's so important that we all collaborate just to make sure the children are best taken care of. So before we wrap up, I just had one last question. What is just the one key takeaway that you would want listeners to remember about what we've discussed today?

SPEAKER_01 27:03

I think I know it's not a traditional model to have a nurse come into a car and administer a flu vaccine. Um, but just know that it is a safe model. It is an effective model. And once the parents do it once, they want to do it over and over and over again. Um, to the point that every year we get parents asking, can you give me my flu vaccine? Um, so giving it a chance. And it's not a traditional model, but it's a great model and very effective.

SPEAKER_00 27:36

Well, Lucinda, this has been one, so much fun, but two, so informative. What you all are doing is amazing. Thank you. I think the impact to your patients and the families and their overall health and protection through six season is just wonderful. I'm grateful for your time. I know it's very difficult to step away from the clinic, but we value your all's partnership and and participation in what we do. And just thank you for sharing your knowledge and experience that you've had. This has been great. I seriously could talk about it forever. So again, um, thank you for joining us for today's episode of Practice Management Minute. We hope you'll join us again. Thank you. Thank you for joining Cumberland Conversations. We're proud to support the people who care for Tennessee's children. Don't forget to subscribe so you never miss an episode and stay connected with CPF for more tools, trainings, and community updates. Until next time, take care.