6. Vaccines: A Shot of Hope and Chaos

Context

The first of our clients to receive doses of the Pfizer vaccine saw them arrive on December 16. We all knew the schedule was compressed as the FDA was moving on a quick timeline for emergency authorization, but we were surprised by how poorly the rollout was handled. Suddenly, it was, “Surprise, it’s here!” Everyone had assumed someone behind the scenes – in the government or elsewhere – was working on logistics to determine where the doses went after they left the factories. But that wasn’t really happening in an effective way. So, on December 16, they just showed up.

What was clear at every level was that healthcare workers should be the first to receive the vaccinations. That allowed many providers to create plans for an internal rollout. But beyond that was the issue of how to get doses in arms.

None of this was happening in a vacuum. The first doses arrived as…

  • We were seeing some of the highest number of COVID-19-related hospitalizations of the pandemic.
  • COVID-19 deaths were hitting new peaks.
  • Caregivers were struggling into the holidays and at the ends of their ropes.
  • The wake of a contentious election year where everything was politicalized wash over us — including the outcry from some complaining about the timing of Pfizer’s vaccine announcement the day after election.
  • The social justice movement continued and concerns about health equity swirled. (Soon, this would be joined by skepticism of vaccines among minority populations and issues with equitable distribution.)

In the middle of all of this, hospitals found out they were on their own to figure out the vaccination administration process, with no clear guidance from federal or state agencies.

To be clear, providers had their own missteps. Once hospitals and doctors’ offices realized that there wasn’t a lot of cohesive information out there, it would have been a good time to produce patient information explaining what was happening, what wasn’t and what wasn’t known. Even simple things like automatic messages on phone systems could have helped alleviate some of the strain.

More significantly, hospitals that appeared to (or did) play favorites with doses didn’t help their image. Health systems that sent letters to their donors should have known better. It’s one thing to just start calling people if you had leftover doses at the end of the day. That happened a lot. But prioritizing donors, board members and families wasn’t a great look where it happened.

In the end, though, the public recognizes that so much of this was thrown on providers, and they’re giving healthcare organizations a lot of grace. Our most recent survey shows that people put the blame at the feet of state and federal government far more than hospitals. That’s good for providers, but it shouldn’t be taken as a free pass. Now is time to evaluate where missteps were made by hospitals, where the buck got passed to hospitals and to figure out how to thread the needle better next time (yeah, next time).

Lessons learned

Ask more questions

In the absence of clear answers, hospitals could have probed more to understand earlier they’d be going it largely alone – and prepare for that. Where there were answers, those could have been better incorporated into planning. Asking questions also makes it easier to pass along important messages to the public, even if they are “We don’t know” or “That information hasn’t been made available to us yet.”

Develop personalized messages

Vaccine skepticism is real and challenging. We’ve seen that providers who were able to work with their communities to understand those concerns are having a smoother ride in vaccine administration. Particularly in communities of color, listening, working with community leaders and creating very specific messages delivered by thoughtful, trusted messengers, is all necessary to build trust and serve patients effectively.

Streamline the hell out of things

We saw examples of hospitals doing an outstanding job getting vaccines in the arms of their employees. It was done through a combination of communications and operational finesse. This goes to the idea of controlling what we can control. If hospitals could only do so much to get the public vaccinated, they could have focused more on their own teams and pushed to get beyond the 50 to 60 percent vaccination rate so many providers achieved over the first couple of months. And those that achieved 80 percent or 90 percent employee vaccination rates did it by making things easy. The logistics were simplified for scheduling appointments and knowing where to go and when. When hospitals had the process down, people who wanted a shot responded and showed up.

Remember people are watching

Everybody’s watching this. The media is hyper-focused on the vaccine rollout because people are focused on it. Some missteps came from providers trying to do the best they could in tough circumstances. Others were avoidable and foolish: It’s a mistake to prioritize a healthy, wealthy donor over your environmental services staff regardless of who is or isn’t watching you. The accountability coming from heavy scrutiny simply puts providers under more fire for something that shouldn’t have happened under any circumstances.

Plan for the unknowns

What is the process for unexpected changes? For example, if you get extra doses – or fewer doses than promised. The vaccine rollout has showcased the value of scenario planning. It helps operationally and optically. If you do get called out on something that you did, you’ll be able to say, ‘Yeah, we were all trying to figure things out. Here’s what we’re doing going forward.”

Answer questions – even if they don’t help you

Be the source of truth. I was in a doctor’s office recently and heard the woman at the front desk hang up the phone and say, exasperated, “There goes call number 400 on the vaccine.” If you’re getting 400 calls a day – about anything – it’s probably worth giving your team the resources to respond. Even if that means you’ll be providing information that helps a competitor. Even if you’re sending people to Walgreens. Even if the answer is, “Check the CDC website.” Our Jarrard Inc. surveys over the past year consistently show that the public wants to hear from healthcare providers about healthcare issues. Not the government. Not their neighbor. Be ready to provide that information. Bonus: it’ll help alleviate the stress on your employees.

Bonus: Upgrade your GR program

Stay tight with your governor. Stay tight with your health department. There’s never been a time when it’s more important to be in lock step with public officials, as irritating as those relationships can be. I know of two provider organization that were getting vaccines to donors. Both came under fire for it. In one case the governor said, “I just told them to get vaccines in arms, and that’s what they were doing. They were following my guidance.” The other governor said, basically, “What were they thinking!? I can’t believe they did that.” The lesson should be obvious.

About the Author /

kfox@jarrardinc.com

As a partner and leader of Jarrard Inc.’s Regional Health System Practice, Kim Fox brings to our clients an in-depth understanding of multihospital systems and the evolving healthcare marketplace. Fox has spent her entire career – which includes more than two decades of in-hospital experience – helping healthcare providers use the power of communications and engagement to accomplish their most important strategic goals.