Now that you know how many patients you are going to book and how many hours of immunization clinic you are planning for, it is time to prepare for the clinics.
Determine Roles within the Clinic
Having clear roles for each immunization clinic will help ensure a smooth day. This may feel like overkill for a smaller clinic, but these are the common roles to consider who would have these roles (and obviously each person can or will have more than one role):
Roles for Preparing your Immunization Clinic:
Within your office immunization clinic there are a few key roles to consider and likely these will be obvious:
- Immunization Clinic Lead – plans scope, estimates capacity, etc. (if you are reading this it is probably you).
- Pre-visit navigator / Visit scheduler – reaches out to orient patients and book them into the immunization clinic.
- Supply organizer – ensures all supplies are ready prior to each clinic from vaccine doses to PPE.
Roles for the Day of Clinic:
For each Immunization Clinic you run, you want to have clearly defined roles so everyone knows who is responsible for what. We suggest filling out a list and posting this in places where people will know who is doing what activities for the clinic. This is especially important if different people are working different Immunization Clinic shifts and roles may change.
Consider how to fill these roles within your broader team, including allied health, office assistants, other connected clinicians, and volunteers from your community. Recruiting people you might not think of for specific roles for the immunization clinic is a great way to build capacity (e.g. a dietitian can be a great person to do the pre-visit screening).
PHAC has a very robust roles list, which is suitable for larger, stand alone clinics. For more detail on scope of roles, please look here:
Ensure Sufficient Supplies Ordered
For each immunization clinic you run, you will need to ensure you have sufficient supplies. This includes: thermometer (for screening), PPE, cleaning supplies, forms, and immunization supplies (syringes, etc.). An example checklist is provided below:
PHAC has a more robust clinic supply list, included here for reference:
Determine Documentation Requirements
Confirm how everyone will be documenting for the immunization clinic and share this across the whole team. There are five areas for consideration:
- Patient Discussion on Immunization – Times contacted about the immunization clinic, their eligibility and desire to receive the vaccine (or not). This is prior to the immunization clinic day and important for follow up.
- Patient Consent – PHAC recommends written consent prior to the immunization. They have provided an example.
- Patient Surveys – If you plan to have a specific patient survey, these should be ready. The immunization clinic may want to capture information prior to the immunization (e.g. screening for allergies, etc) or post-immunization (e.g. feedback).
- Clinical Charting – determine who will chart and where. Elements of charting should be simplified and standardized for expediency but include process, brief history, review of systems, vaccine information (e.g type, lot #, location), etc. Consider an EMR template.
- Public Health Documentation – Public health in each province has additional documentation requirements to record who has received which doses of vaccine, etc.
Decide How You Will Document in Your EMR
There are several options for documenting in your office. We recommend using the immunization section of your EMR. For more information, we have outlined different approaches and provided more detail here.
Alberta’s Primary Care Immunization Documentation
See Alberta’s Immunization Policy
Confirm as a team your documentation practices and workflow. Direct entry into IDSM may minimize number of forms used in your clinic. Batching data entry may facilitate patient flow but require the use of more forms. Agree where the forms will be kept and how they will be completed and entered into provincial reporting systems recognizing the expected and required timelines.
Record of COVID-19 vaccination is expected to be completed at point of care and submitted through IDSM within 1 day (required to be submitted within 7 days). A patient immunization record and aftercare sheet is expected to be completed at point of care and provided to the patient before departure.
BC’s Primary Care Immunization Documentation
BC will have an online reporting for immunizations. Plus regular documentation requirements for the visit will be needed in your own EMR.
Manitoba’s Primary Care Immunization Documentation
All COVID-19 vaccine doses must be reported within two (2) business days of administration to the client/patient via:
- The Claims Processing System (CPS) for fee-for-service (FFS) physicians and, non-FFS physicians/nurse practitioners via shadow billing.
- NOTE: The PHIMS system will be used by pharmacists and other providers (as determined by Manitoba Health and Seniors Care).
- NOTE 2: for information on remuneration, contact your professional association.
All patient/client immunization records must include (at minimum) the client/patient personal health identification number (PHIN), the location of administration, provider, date of administration, vaccine product, lot number, reason for immunization and any additional regulatory requirements.
Record doses administered to persons without a PHIN via the appropriate inputting inform available at:
New Brunswick’s Primary Care Immunization Documentation
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Newfoundland’s Primary Care Immunization Documentation
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Nova Scotia’s Primary Care Immunization Documentation
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Ontario’s Primary Care Immunization Documentation
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
PEI’s Primary Care Immunization Documentation
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Quebec’s Primary Care Immunization Documentation
Nous n’avons pas reçu de contenu provincial spécifique pour ici, veuillez vous référer aux documents nationaux ou à votre site CDC provincial.
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Saskatchewan’s Primary Care Immunization Documentation
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Error: we are not able to resolve your region and cannot show you provincial content at this time.
Alberta
Alberta’s Primary Care Immunization Documentation
See Alberta’s Immunization Policy
Confirm as a team your documentation practices and workflow. Direct entry into IDSM may minimize number of forms used in your clinic. Batching data entry may facilitate patient flow but require the use of more forms. Agree where the forms will be kept and how they will be completed and entered into provincial reporting systems recognizing the expected and required timelines.
Record of COVID-19 vaccination is expected to be completed at point of care and submitted through IDSM within 1 day (required to be submitted within 7 days). A patient immunization record and aftercare sheet is expected to be completed at point of care and provided to the patient before departure.
BC
BC’s Primary Care Immunization Documentation
BC will have an online reporting for immunizations. Plus regular documentation requirements for the visit will be needed in your own EMR.
Manitoba
Manitoba’s Primary Care Immunization Documentation
All COVID-19 vaccine doses must be reported within two (2) business days of administration to the client/patient via:
- The Claims Processing System (CPS) for fee-for-service (FFS) physicians and, non-FFS physicians/nurse practitioners via shadow billing.
- NOTE: The PHIMS system will be used by pharmacists and other providers (as determined by Manitoba Health and Seniors Care).
- NOTE 2: for information on remuneration, contact your professional association.
All patient/client immunization records must include (at minimum) the client/patient personal health identification number (PHIN), the location of administration, provider, date of administration, vaccine product, lot number, reason for immunization and any additional regulatory requirements.
Record doses administered to persons without a PHIN via the appropriate inputting inform available at:
New Brunswick
New Brunswick’s Primary Care Immunization Documentation
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Newfoundland
Newfoundland’s Primary Care Immunization Documentation
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Nova Scotia
Nova Scotia’s Primary Care Immunization Documentation
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Ontario
Ontario’s Primary Care Immunization Documentation
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
PEI
PEI’s Primary Care Immunization Documentation
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Quebec
Quebec’s Primary Care Immunization Documentation
Nous n’avons pas reçu de contenu provincial spécifique pour ici, veuillez vous référer aux documents nationaux ou à votre site CDC provincial.
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Saskatchewan
Saskatchewan’s Primary Care Immunization Documentation
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Confirm as a team what should be documented, where and how it will be stored (paper, within your electronic record, in provincial information system).
Confirm Consent Requirements
Download consent forms for emailing and printing if required.
Alberta’s Consent Requirements
Informed consent for administration of the COVID-19 vaccine is required for each patient. Consider using the AHS Fit to Immunize Tool for COVID-19 Vaccine as a conversation guide to inform the consent process.
Consider using the COVID-19 Vaccination Consent Form in situations where substitute decision makers are involved.
BC’s Consent Requirements
Verbal consent is required.
Manitoba’s Consent Requirements
Resources, Consent Forms, and Product Monographs can be found here:
New Brunswick’s Consent Requirements
Complex medical conditions:
- Review the list of complex medical conditions. At the time of your appointment you must present this signed declaration.
Newfoundland’s Consent Requirements
Nova Scotia’s Consent Requirements
Ontario’s Consent Requirements
PEI’s Consent Requirements
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Quebec’s Consent Requirements
Nous n’avons pas reçu de contenu provincial spécifique pour ici, veuillez vous référer aux documents nationaux ou à votre site CDC provincial.
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Saskatchewan’s Consent Requirements
Consent Requirements
Error: we are not able to resolve your region and cannot show you provincial content at this time.
Alberta
Alberta’s Consent Requirements
Informed consent for administration of the COVID-19 vaccine is required for each patient. Consider using the AHS Fit to Immunize Tool for COVID-19 Vaccine as a conversation guide to inform the consent process.
Consider using the COVID-19 Vaccination Consent Form in situations where substitute decision makers are involved.
BC
Verbal consent is required.
Manitoba
Manitoba’s Consent Requirements
Resources, Consent Forms, and Product Monographs can be found here:
New Brunswick
Complex medical conditions:
- Review the list of complex medical conditions. At the time of your appointment you must present this signed declaration.
Newfoundland
Nova Scotia
Ontario
Ontario’s Consent Requirements
PEI
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Quebec
Nous n’avons pas reçu de contenu provincial spécifique pour ici, veuillez vous référer aux documents nationaux ou à votre site CDC provincial.
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Saskatchewan
2nd Dose Follow-up Plan
The second dose is key to the success rates of our current vaccines and this is often where people do not follow up. So, before you run your clinic, know what your multi-pronged approach will be to encouraging and following up for that second immunization.
Strategies to Ensure Second Dose Follow Up
Have Adequate Signs
The COVID-19 immunization is both exciting and anxiety provoking for some. Clear education and clear directions, including signs throughout the clinic, will help keep people calm and understanding the processes. These are particularly important if you are changing the normal flow of patients through the clinic.
Signs should mark: entrances, mask wearing, sanitizing practices, patient flow, waiting area, and exit. We have provided simple, generic signs as letter-sized PDFs that you can download and then print:
Childcare
Consider how to offer safe childcare when needed for patients to ensure that people with kids can come to get vaccinations and they have no childcare options. Some families do not want their children observing the immunization. A safe and socially distanced space is recommended that can clearly be observed by both staff and the parent or guardian. You should confirm this in the pre-visit check.
Washrooms
Assume and plan that at least one patient will need to use the washroom during the observation time. These should be clearly marked for patient flow. If the washroom absolutely must be used during the observation period, the patient should notify the observer.
Staff Training
In preparation for running your clinic, consider any additional training that might be helpful:
- Vaccination training – some staff (e.g. LPNs) can receive extra training to give vaccines in some jurisdictions. This may increase capacity.
- CPR training – there should be at least one person with up to date CPR training.
- Anaphylaxis management – ensure that there is a clear protocol for anaphylaxis.
Alberta’s Training Opportunities
A checklist of resource and educational materials have been developed to support clinic teams. It is recommended that clinic team members review educational materials related to key process steps that they will be supporting. Clinics may wish to maintain a record of team member engagement with the educational materials.
Recommended and supplemental educational/resource material for clinics new to offering immunization.
BC’s Training Opportunities
BCCDC has developed:
- COVID-19 Immunization Competency Course for Nurses (RNs, RPNs, LPNs) that is now live on the LearningHub. This course is 2 hours in length,
- Nurses are also recommended to complete the Anaphylaxis Initial Emergency Treatment by Nurses (Adults and Pediatric) course on Learning Hub (45 minutes). Please note that the anaphylaxis course is required for LPNs as per the BC College of Nurses and Midwives (BCCNM).
These are accessible in the Learning Hub and you must be logged in to access them.
Training materials and course content required for the extension of engagement of authorized health professionals in the immunization effort are listed in the Public Health Order (March 24th 2021)
Manitoba’s Training Opportunities
Vaccination training – vaccines are in the scope of all nurses in Manitoba. Your clinic assistants can receive training to give vaccines for a limited time through Red River College. This may increase your clinics capacity. https://www.rrc.ca/part-time/programs/health-education/covid-vaccine-administration/
New Brunswick’s Training Opportunities
Memo on Immunizer Education and Information (for physicians and pharmacists)
Newfoundland’s Training Opportunities
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Nova Scotia’s Training Opportunities
Skills checklist for Vaccine Administration (with links to training opportunities)
Ontario’s Training Opportunities
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
PEI’s Training Opportunities
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Quebec’s Training Opportunities
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Saskatchewan’s Training Opportunities
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Provincial Immunization Training Opportunities
Error: we are not able to resolve your region and cannot show you provincial content at this time.
Alberta
Alberta’s Training Opportunities
A checklist of resource and educational materials have been developed to support clinic teams. It is recommended that clinic team members review educational materials related to key process steps that they will be supporting. Clinics may wish to maintain a record of team member engagement with the educational materials.
Recommended and supplemental educational/resource material for clinics new to offering immunization.
BC
BCCDC has developed:
- COVID-19 Immunization Competency Course for Nurses (RNs, RPNs, LPNs) that is now live on the LearningHub. This course is 2 hours in length,
- Nurses are also recommended to complete the Anaphylaxis Initial Emergency Treatment by Nurses (Adults and Pediatric) course on Learning Hub (45 minutes). Please note that the anaphylaxis course is required for LPNs as per the BC College of Nurses and Midwives (BCCNM).
These are accessible in the Learning Hub and you must be logged in to access them.
Training materials and course content required for the extension of engagement of authorized health professionals in the immunization effort are listed in the Public Health Order (March 24th 2021)
Manitoba
Vaccination training – vaccines are in the scope of all nurses in Manitoba. Your clinic assistants can receive training to give vaccines for a limited time through Red River College. This may increase your clinics capacity. https://www.rrc.ca/part-time/programs/health-education/covid-vaccine-administration/
New Brunswick
Memo on Immunizer Education and Information (for physicians and pharmacists)
Newfoundland
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Nova Scotia
Skills checklist for Vaccine Administration (with links to training opportunities)
Ontario
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
PEI
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Quebec
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Saskatchewan
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Who Can Administer COVID-19 Vaccines
Across Provinces have been defining who can administer COVID-19 Vaccines and/or engage in other Immunization activities including: initial patient assessment; preparation of vaccines, adminstering an injection, and post immunization monitoring.
Alberta’s Vaccine Administration
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
BC’s Vaccine Administration
BC has extended the list of health professionals who can normally provide immunizations under their health profession regulations (e.g. Medical Practitioners, Registered Nurses (RNs), Registered Psychiatric Nurses (RPNs), Licensed Practical Nurses (LPNs), Pharmacists and Naturopathic Physicians). The Public Health Order (March 24th 2021) includes a detailed breakdown of Immunization Activity, Limitations and Mandatory Training
Authorization, with varying supervision requirements, has been extended to include: Dentists, Midwives, Retired Medical Practitioners, RNs, RPNs, LPN’s and Midwives, Employed Student Nurses and Students enrolled in Registered Nursing or Midwifery Programs, Dental Hygeneists, Podiatrists.
Authorization with varying supervision requirements and some exclusion of specific services has been extended to include International Medical Graduates, Anaesthesia Assistants, Medical Laboratory Technologists/Assistants, Pharmacy Technician and Dental Therapists.
Manitoba’s Vaccine Administration
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
New Brunswick’s Vaccine Administration
Please refer to the new guidelines for Immunization in Community Pharmacies
Newfoundland’s Vaccine Administration
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Nova Scotia’s Vaccine Administration
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Ontario’s Vaccine Administration
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
PEI’s Vaccine Administration
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Quebec’s Vaccine Administration
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Saskatchewan’s Vaccine Administration
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Provincial Vaccine Administration
Error: we are not able to resolve your region and cannot show you provincial content at this time.
Alberta
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
BC
BC has extended the list of health professionals who can normally provide immunizations under their health profession regulations (e.g. Medical Practitioners, Registered Nurses (RNs), Registered Psychiatric Nurses (RPNs), Licensed Practical Nurses (LPNs), Pharmacists and Naturopathic Physicians). The Public Health Order (March 24th 2021) includes a detailed breakdown of Immunization Activity, Limitations and Mandatory Training
Authorization, with varying supervision requirements, has been extended to include: Dentists, Midwives, Retired Medical Practitioners, RNs, RPNs, LPN’s and Midwives, Employed Student Nurses and Students enrolled in Registered Nursing or Midwifery Programs, Dental Hygeneists, Podiatrists.
Authorization with varying supervision requirements and some exclusion of specific services has been extended to include International Medical Graduates, Anaesthesia Assistants, Medical Laboratory Technologists/Assistants, Pharmacy Technician and Dental Therapists.
Manitoba
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
New Brunswick
Please refer to the new guidelines for Immunization in Community Pharmacies
Newfoundland
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Nova Scotia
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Ontario
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
PEI
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Quebec
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Saskatchewan
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Create a What to Expect Sheet for Patients
Technically part of the next step, but having information for your patients on what to expect as part of the immunization clinic, before and after, is really important for a smooth running day. Make sure you have an orientation sheet ready to put on your website, put in your waiting room, and to send out to patients before the clinic.
Develop Your Clinic Checklists
Lastly, we recommend a set of Immunization Clinic checklists that summarizes the pieces above that can be quickly reviewed before the start of your clinic. We have provided word template you can use or adapt below: