Faculty members at the University of Oklahoma Health Sciences campus in Oklahoma City recently published the scientific article they wanted for themselves four years ago: how to create a robust, efficient response to a global pandemic as a comprehensive academic health center.
When faced with an unusual medical condition or event, health care professionals typically turn to medical literature for evidence-based and peer-reviewed publications about how to address a situation. Because the last pandemic on par with COVID-19 occurred a century earlier, no such literature existed for a modern health system, so leaders from OU Health Sciences and its clinical partner, OU Health, created a successful pandemic response model that they ultimately felt was worth sharing with their peers. The result is “A Technology-Driven, Interprofessional Pandemic Response Strategy for a Comprehensive Academic Health Center,” published in the Associative Journal of Health Sciences.
“Our pandemic response was collaborative and interprofessional from the beginning. We utilized skills and expertise from people across campus to develop a screening and reporting tool, campus testing program, and immunization program. Everyone on campus rose to the challenge as a team, doing what no group could have done individually,” said Susan Conway, Pharm.D., a professor in the OU College of Pharmacy. Conway is an author of the study, along with Chad Douglas, M.D., Pharm.D., an assistant professor in the OU College of Medicine, and Eric Edwards, Pharm.D., who was a pharmacy student at the height of the pandemic.
OU Health Sciences is one of only a few academic health centers in the nation to have seven professional colleges located on the same campus, with a student population of approximately 2,600. The university’s clinical partner, OU Health, provides health care through three hospitals, 85 clinics, and diabetes and cancer centers. The combined employee population on the OU Health Sciences campus in Oklahoma City is approximately 12,000 people.
University and health system leaders began meeting in January 2020, even before COVID-19 had been detected in the United States, to devise a strategy for reducing the virus risk for everyone on campus. As guidance from the Centers for Disease Control and Prevention became available, it was operationalized to meet the needs of the campus.
One of the first efforts was the creation of an online screening and reporting tool to identify and manage people who had been exposed to the virus, experienced symptoms or tested positive. The university’s Information Technology Services devised a risk assessment algorithm that helped determine an employee or student’s next steps based on their answers to screening questions, as well as when they could return to campus following an exposure or positive test. The tool was continually updated as new information emerged from the CDC.
COVID-19 testing began in March 2020 for those identified as needing a test before they could return to campus. The testing site initially offered 40 testing appointments per day and eventually expanded to 100 daily slots. From March 1, 2020, to July 1, 2022, a total of 46,066 online screening forms were submitted. Of those, 13,618 tests were indicated based on the algorithm.
“The tool gave us real-time data about how many people were out and how many people were coming back to campus that day,” Douglas said. “We could see which areas of the hospital had more health care workers who were isolating or had tested positive. The tool also helped us to keep our students on track for graduation. Because the tool was kept up to date with CDC guidance, students could fill out the screening questions and we knew in real time how we needed to adjust to help them meet their graduation requirements. Having an automated tool was extremely beneficial.”
The next major task was devising a way to administer vaccines on a large scale. The OU College of Pharmacy, already experienced in large flu vaccine clinics, led the effort to vaccinate thousands of health care providers, students and staff. IT Services built a dashboard so that leaders could track how many vaccines had been given and how many people were registered, providing real-time numbers for daily planning. IT Services also built a “bridge” that automatically uploaded vaccination information to the Oklahoma State Immunization Registry, eliminating the need for manual input.
Staff from the Nuclear Pharmacy in the OU College of Pharmacy prepared the vaccines, which arrived freeze-dried in vials and required the addition of a diluent before being shaken and drawn into a dose. Supply was carefully tracked so that each vaccine clinic had sufficient doses, but not so much that could create waste.
After receiving their vaccines, people were required to wait 15 minutes in a monitoring area that was staffed by health care providers from many health disciplines across campus. Leaders also created an “urgent care” room at each clinic for people who appeared to have symptoms in response to the vaccine.
“As it turned out, very few people had true vaccine-related side effects, but there was so much emotion around COVID-19 and the vaccine that some people had psychosomatic reactions,” Conway said. “It was important to have a private space where a physician or other provider could assess a person and monitor their vital signs.”
Altogether, the immunization program administered 27,617 doses over approximately two years in numerous spaces across campus. That achievement would not have been possible without the volunteer efforts of health care providers, staff and students, whose educational journey faced sudden changes. Because students on clinical rotations could no longer go into most hospitals and clinics, they found new purpose in organizing vaccine clinics and administering vaccines.
Pharmacy and nursing students, already skilled at giving shots, performed thousands of vaccinations. Dentistry students, accustomed to giving shots in the mouth, were trained to give them in the arm, and medical students were prepared to administer vaccines as well. In some cases, formal vaccination rotations were created for students who were close to wrapping up their degrees.
“The students were part of the dynamic nature of the pandemic response and they had to adapt, which is a good lesson for practicing health care in general,” said Conway, Director of Experiential Education at the OU College of Pharmacy. “Because CDC guidelines evolved, our protocols were frequently revised, which showed students a model of continuous professional development. They were held accountable for keeping up with new guidelines.”
With OU’s pandemic response now part of scientific literature, other academic health centers may consider it a resource should another pandemic occur. The years-long effort was at times grueling, but it serves as a model of what an interprofessional team can do together.
“We utilized all the expertise at hand, from public health and infectious diseases to information technology and the wisdom of our leadership on campus, and it was a learning experience for students as well,” Douglas said. “If there is another such event in the future, we feel like we’ve created a framework that could be adapted by other campuses.”
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About the project
Portions of the pandemic strategy and technology created on the OU Health Science campus in Oklahoma City were also used on OU campuses in Norman and Tulsa, modified to meet their specific needs. The full publication in the Associative Journal of Health Sciences can be found at https://crimsonpublishers.com/ajhs/pdf/AJHS.000558.pdf.