May 2021Spotlight feature

Decision-makers strategize at Vaccination Command Centre to keep the shots coming

Real-time, on-screen data is crucial in keeping vaccination campaign on track

So you’ve had your COVID-19 vaccination? Congratulations. Chances are, your visit was fast and easy: Register, get jabbed, wait briefly to be sure there’s no adverse reaction, and then leave—all in about half an hour.

What you may not be aware of is the multitude of strategic and logistical decisions that CIUSSS West-Central Montreal had to make to keep you moving smoothly.

In fact, the behind-the-scenes effort is so complex that some of the CIUSSS’s top decision-makers are now spending much of their day in a special Vaccination Command Centre. There, they examine real-time data on multiple screens and stay up to date about conditions that can change at a moment’s notice.

The overall goal is to be ready for the unexpected by responding with fast, informed decisions if the situation suddenly changes.

This hub of vaccination-related activity—located in CLSC Côte-des-Neiges—is an extension of the main Command Centre at the Jewish General Hospital.

Collectively, they’re known as C4, because they focus on “better Care through Communication, Collaboration and Creativity”.

Taken together, these facilities are key elements in a major initiative by the CIUSSS—with substantial financial support from the JGH Foundation—to harness the power of digital technology, in order to improve the delivery of health care and social services.

The many benefits of the C4 Command Centre

In addition to making vaccination a largely hassle-free procedure, the C4 Command Centre has been instrumental in streamlining bedflow—in other words, improving the process of getting certain patients admitted to the JGH and assigned to a bed with minimal delay.

Similarly, when patients are ready to be discharged from the hospital, C4 has been of key importance in enabling them to go home—or to be transferred to rehabilitation or long-term care—more quickly.

To do so, the CIUSSS has once again enlisted, Maisha Labs, a trusted partner that has contributed technical expertise to various projects over the past several years.

The Israeli‑based company, with offices in Tel Aviv and Montreal, helps organizations make more productive use of digital technology to handle the most demanding tasks.

Why is the vaccination campaign such a challenge to manage? Consider the following:

  • From one day to the next, CIUSSS West-Central Montreal is never sure how many doses of vaccine it will receive.
  • Sometimes a number of doses are taken away from the CIUSSS and allocated to a region elsewhere in the province where the need is significant.
  • Demand for the vaccine varies at the CIUSSS’s three public vaccination facilities and in the campaigns to vaccinate employees, vulnerable clients, patients at home, and residents of long-term care centres. As a result, decisions must be made every day on how many doses to designate for these purposes.
  • Most people get vaccinated by appointment, but some are seen on a walk‑in basis.
  • Some doses are administered to people who live outside the area served by CIUSSS West-Central Montreal.
  • Each of the vaccines (Pfizer, Moderna and AstraZeneca) has its own requirements for storage and use. Pfizer is the most finicky, needing to be refrigerated at -80 degrees Celsius and administered within five hours of being reconstituted.
  • Sufficient staff must be available, which means plans must be made in advance to recruit and train them. They must also be integrated into the CIUSSS’s workforce and scheduled appropriately at various locations.

And yet, despite these complications, you received your shot as if nothing were simpler.

In the Vaccination Command Centre, (from left) Lucie Tremblay, Sonia Boccardi and Joanne Côté examine the latest on screen vaccination data during a video conference with colleagues at various CIUSSS locations.

In the Vaccination Command Centre, (from left) Lucie Tremblay, Sonia Boccardi and Joanne Côté examine the latest on screen vaccination data during a video conference with colleagues at various CIUSSS locations.

With the support of the Vaccination Command Centre, the CIUSSS has managed to inoculate more than 100,000 people—at least one-third of the adult population—between December and May, says Lucie Tremblay, Director of Nursing and Director of Vaccination.

Not only can Ms. Tremblay and her colleagues refer to detailed data on numerous screens on their desks and on the walls behind them, they can view real-time video images of various locales within each of the vaccination sites.

“This gives us a clear sense of what’s going on at any moment,” Ms. Tremblay explains. “We can actually see if there’s overcrowding or if very few people are in line. Then, if necessary, we adjust our strategy and, later in the day, we can watch the results on‑screen.”

“Without the Command Centre, we would have constantly been playing phone tag or sending out emails,” says Joanne Côté, Director of Quality, Innovation, Evaluation, Performance and Clinical Ethics.

“The advantage is that we can function at a high level, because everybody is available on the spot,” Ms. Côté continues. “When a problem arises and when we’re all sitting in the same room, it’s much easier to get a clear understanding of the situation and make a prompt decision.”

The result is “not just greater efficiency, but greater agility”—the ability to change direction, if required by the circumstances.

Even if a crisis occurs and one or more of the key players is not present, most of them can arrive at the Command Centre within minutes, since their offices are at the JGH, just across Côte-Sainte-Catherine Road. The other members of the team are easily reachable by video conference.

The result, says Elliott Silverman, Director of Logistics and the Internet of Things, is “not just greater efficiency, but greater agility”—in other words, the ability to roll with the punches and change direction, if required by the circumstances.

This is how Amina Talib, Associate Director of Human Relations, can make such a timely contribution to decisions that involve what she describes as “the massive operation of staffing.”

She notes that in the first three weeks of the public vaccination program, the schedules of at least 1,000 employees had to be arranged, so that the vaccination sites would be properly staffed at all times.

“We’re solving problems in real time whenever we can,” adds Sonia Boccardi, Associate Director of the COVID-19 Vaccination Campaign. “For instance, if there’s a supply problem, Elliott is literally next to me and I can ask him about it.

“Of course, some situations need considerably more discussion and planning, but no matter what kind of problem we encounter, we can deal with it, because we’re together.”

This allows Lucie Tremblay to keep smiling, even when she’s up against a situation she describes as a volte-face—an “about-face” or an “abrupt reversal”.

“It’s my favourite expression whenever we get an unexpected phone call or an email from the authorities,” she says with a smile. “I walk into the Command Centre and announce, ‘We have a volte-face!’—and suddenly, everything changes.

“It means we have some tough decisions to make quickly. But I know we’re up to the task, because we’re able to work on it together in the Command Centre.”

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