When your immunization clinic is running, there are several activities that will happen. Some of these are not directly tied to individual patient flow and some are. We have outlined these below.

Patient Flow While Running Your Clinic

Below are the activities to follow for each patient as they move through a COVID-19 immunization clinic.

Check-in

As people arrive at the location, there should be a quick check-in to confirm that they are there for an immunization and are scheduled for that day. Other people (e.g. family members) should be invited to wait at a distance from the clinic. People who are not there for a scheduled immunization should be asked to return on a different day.

Check-in may happen outside.

Screen for Symptoms

As people arrive, they should be quickly screened for any COVID-19 symptoms, even before they are registered. Most practices do this already, here are the criteria to consider (from PHAC):

• Common COVID-19 symptoms (PHAC)

Registration

Registration for the immunization includes confirming identification and contact information. Also at this step, confirm that each patient has reviewed the pre-visit materials and / or had a virtual pre-visit (hand out if needed). Confirm consent for immunization (verbal or written as required by your jurisdiction).

Complete Surveys

Prior to receiving the immunization is a good time to complete any required documentation, including consent. If you have additional information you want to collect from patients internally, this would be a good time to do that with your own survey. Also consider how to support patients who are not able to complete the surveys on their own.

(Pre-Wait)

Ideally, your flow of patients is booked so that there is no pre-waiting needed (i.e. you have enough immunizers and everyone is coming on time), but if people cannot wait outside or there is some other unforeseen delay, patients may need a space to wait prior to receiving the immunization.

In your planning, you will have confirmed your capacity for waiting space while maintaining social distancing and whether patients will wait in a shared space or in an exam room.

All patients should, of course, wear masks throughout the clinic, use hand sanitizer, etc.

Immunize

At your designated immunization stations (e.g. exam rooms), take a brief history to:

• Confirm patient identification
• Review contraindications
• Ensure the patient has had a a pre-visit review (if applicable).

Then, with permission, follow the jurisdictional guidelines for immunization and the manufacturers instructions. Document the immunization.

Observe (Post-Immunization)

The current standards include a 15 minute observation period. Patients should be observed (with social distances, while still wearing masks). The clinic must ensure that people are not leaving early and operating a vehicle.

This would be an excellent opportunity to collect feedback, including a patient evaluation of the clinic, such as the one by PHAC:

• FORM: Client Immunization Evaluation Form (PHAC)

Give Follow up Reminder

Before each patient leaves, ensure that patients are aware of the follow up plan for their follow up immunization, if this is not their final dose.

Ideally the follow up plan should be specific (e.g. provide a visit date and time). Stressing to patients the importance of the follow up dose is critical to ensure better follow up for the second dose.

Provide Immunization Materials to Patient

Provide documentation to each patient outlining the immunization they received as per provincial recommendations.

Document Immunization

Documentation will likely need to be in two places:

• Your own record (electronic or otherwise)
• Provincial Immunization Record

Based on your planning step you will have decided when this happens, and it is good practice to document during the process in at least one system.