Incorporating health systems engineering into COVID-19 vaccine planning and administration

The COVID-19 pandemic has created unique logistical challenges for vaccine transportation, inventory management, allocation and distribution at multiple levels — the federal government, states and healthcare institutions. Unpredictable weekly vaccine allocation from state health departments, changing population priorities, stringent vaccine requirements for ultracold storage, transportation, reconstitution and 2-dose administration intervals have presented challenges never seen before in the history of mass vaccination programmes, including those at Mayo Clinic. To meet the challenges, an efficient system of allocation and administration for COVID-19 vaccines was developed through collaboration with process engineering. To understand the challenges, ten health systems engineers from the Department of Management Engineering & Consulting at Mayo Clinic facilitated the institution-wide COVID-19 vaccine project, collaborating closely with diverse multidisciplinary teams that included physicians, nurses, pharmacists, administrative services, information technology, human resources, scheduling operations and public affairs. The internal consultants designed tools and solutions based on systems and process engineering methodologies to solve a myriad of complex problems, including identifying priority populations, using resources efficiently and minimising vaccine waste. Tools designed included a vaccine resource playbook; dynamic staffing models based on vaccine allocation, storage, inventory and distribution processes using a hub-andspoke model; workflows and staffing models for face-to-face and drive-through vaccine administration sites; and end-of-day workflows to reduce vaccine waste. Through the collaboration, modelling and engineering, multiple sites across Mayo Clinic have implemented successful COVID-19 vaccination programmes that are efficient in resource utilisation and have minimal waste. In this paper, we share what we have learned to help other healthcare organisations prepare for future mass vaccination scenarios.