Roadblocks and successes in preparing COVID-19 vaccination clinics: Perspectives from pharmacy residents.

PURPOSE: To outline logistics challenges, barriers, and successes in the development of separate programs for mass COVID-19 vaccine distribution and administration to healthcare employees and community members. SUMMARY: In the face of the global coronavirus disease 2019 (COVID-19) pandemic, COVID-19 vaccine development and distribution became a worldwide priority. AdventHealth Orlando was selected as the central hub for vaccination efforts for central Florida. There was a need to quickly evaluate literature, patient safety, and institutional resources and logistics to coordinate the development of employee and community vaccination clinics. These efforts were driven by postgraduate year 2 residents in health-system pharmacy administration and leadership, medication-use safety and policy, and informatics. Clinic development focused on 4 key areas: vaccine quality control, secure inventory movement, safe preparation and administration, and consolidation of inventory. Healthcare worker vaccinations were administered on the health system's main campus, and community vaccination events were carried out at temporary clinic facilities set up in the parking lot of Orlando International Airport. CONCLUSION: In a mass COVID-19 vaccination initiative directed by the pharmacy enterprise leadership of a large Florida health system, postgraduate year 2 pharmacy residents played a key role in developing and implementing vaccination clinics targeting healthcare worker and community populations. During multiple vaccination events, a total of more than 50,000 COVID-19 vaccine doses were administered, with minimal to no vaccine wastage.

Regionalized Health System Review of Automated Dispensing Cabinet Overrides.

Automated dispensing cabinet (ADC) overrides are used to access emergent or urgent medications when time delay from computerized provider order entry may result in patient harm. [1] Although necessary, ADC overrides bypass the safety features of order entry and verification which increase the risk of an error occurring and potential patient harm. To protect patient safety, national organizations such as The Joint Commission and Institute for Safe Medication Practices have called for hospitals to review overriding trends and available medications on override. AdventHealth Central Florida Division - South (CFD-S) met the recommendations to track overrides but there was limited understanding of the data. A quality improvement project was necessary to investigate the division's risk of error and identify interventions to proactively limit patient risk. The initial task of the quality improvement project was to create a standardized ADC override report that could be shared with pharmacy and nursing leaders within AdventHealth CFD-S monthly. As the project progressed, multiple interventions were identified such as standardizing the information reflected in the report, improving education about ADC overrides across multi-disciplinary departments, and critically reviewing the data to identify needed changes within the division. The efforts to share the ADC override metrics across all levels has improved understanding of ADC override goals and intentions of monitoring ADC overrides. This has paved the path to improving ADC override unit culture and identify gaps within the system that allows overrides to occur.