COVID-19 Mass Immunization Hockey Hub model goes on the road

The Grey Bruce Health Unit is sending a team to Peel Region, Saturday, June 12, to demonstrate the large scale operation of the Hockey Hub model as a mass immunization system.

Hockey Hub model

A group of clinical and non-clinic staff from Grey Bruce will attend the CAA Centre in Brampton’s mass immunization clinic to share the successful management change processes required  to administer vaccines to large numbers of clients using the Hockey Hub model.

The Hockey Hub model was designed by Grey Bruce’s Top Doctor, Dr. Ian Arra, and developed at the Grey Bruce Health Unit. It is yet another example of the health unit’s role as a Centre of Excellence in Rural Public Health. This locally developed model is a streamlined flow-through process, which is orchestrated to administer more vaccines with fewer clinical staff than traditional mass vaccination clinics. The rate of vaccines administered by one vaccinator is up to 90 vaccines per hour compared to 6 to12 vaccines per hour in a traditional clinic.

Prerequisites for the system are optimal collaboration of partners (Public Health, Municipality, Police, EMS, private sector), robust change management (clinical and non-clinical), and excellent communication.

The key to the system is increasing the number of clients receiving the vaccine and the efficiency of the process, while decreasing the risk of COVID-19 transmission by reducing the time the client spends within the clinic and the number of surfaces he/she interacts with. Once registered, the client remains in an individual pod for documentation, administering vaccine and recovery. The person administering the vaccine along with the clinic equipment move from pod to pod. The typical set-up in a standard rink would have 150 pods with one nurse assigned 30 pods each. A single vaccinator in the Hockey Hub can administer 90 vaccines per hour. When fully operational, the Brampton clinic could administer 6000-8000 doses a day.

The Hockey Hub was set up at the CAA Centre in Brampton through the support of Bruce Power, who were instrumental in establishing the current hubs in Grey Bruce at the Davidson Centre in Kincardine, the P&H Centre in Hanover and the Julie McArthur Centre in Owen Sound. The Hockey Hub model has been adopted and used in a number of public health agencies in Ontario, Manitoba, Alberta, and New Zealand.

The Hockey Hub model provides several efficiencies. Clinically trained personnel are focused on administering the vaccine while non-clinical staff take on the clerical and support roles. There is a reduced risk of injury/fainting as clients are immunized and recover in the same location instead of a recovery area (fainting is a well-known risk in immunization clinics). The one-touch surface means decreased surface cleaning to minimize the risk of transmission.

Some of the advantages of the system:

• Patient centred care
• Lower risk of fall related injury (Recover-in-place)
• Fast access for EMS
Less risk of transmission: narrower exposure time, less exposure surfaces, one-way flow,     better air circulation
• Efficiency:
• Diminished need for prioritization (saves resources)
• Physical resources (practically 100% reduction in clinic computers and tables, 50%             reduction in clinic chairs)
• Minimal need of clinical staff
• Decreased cleaning requirements for “touch surfaces”
Scalable: the model is scalable in that it can be expanded or contracted depending on         the amount of vaccine available, the size of the facility and the number of clients to be       vaccinated.
• Accessibility: arenas are ubiquitous, most Canadians live close to one

Chief Public Health Officer of Canada, Dr. Theresa Tam and other experts in the field of public health spoke highly of the Hockey Hub model as an example of progressive public health innovation. Experts in the lean process and industrial engendering find it to be “brilliant”.