Kanban Practices in use at a Covid Vaccination Hub

I went and got my first shot of the vaccine this past weekend. For those of you reading from countries outside Australia, we’ve been fairly slow on the uptake of vaccination not because of lack of demand but because our government didn’t order sufficient supply – so it’s a little slow going. But the purpose of this post isn’t about upstream / downstream kanban and the supply / demand – rather it is about what I observed in terms of how they managed flow out our local Covid vaccination hub and I was rather impressed.

For those who are not local to Australia, or even Melbourne Australia, the vaccination hubs have been set up at various communities within each city to help distribute the vaccines for Covid. The main vaccine in use is Pfizer, thus it needs to be kept at -70 degrees which requires specialist cooling equipment, thus it’s not so practical to have these more distributed. Thus they are designed with greater demand per hub in mind and are on a moderate scale.

There were several points in the workflow / system of work that I noticed:

  • Initial site check in using a QR code & hand sanitisation – this is normal now in practically every establishment (restaurants, shops etc) as the government uses it to trace the spread of the disease.
  • Main tent – here they double check that we’ve checked in properly and we enter a queue. During the queuing, we’re asked to read a number of documents to make sure we understand what we’re getting.
  • Secondary check in:
    • Outside – this is the main queue with a secondary sanitation station
    • Inside – there is a small queue here and then there was a identity check station
  • Vaccination cubicles (with a small queue beforehand)
  • Post vax waiting area

The following were some of the things that I noticed in this system:

  • The system was clear with it’s policies
  • There were specialists trained in each station, plus there were flow managers there to manage flow and queue sizes.
  • There were different classes of service
  • There were different work item types

I’ll talk about each in more detail

Policies

At each station it was fairly clear what we needed to do, and if not there were people there to make sure we did the right things at each point. This was most clear with the check in stations, where there were plenty of QR codes and signs – plus we are now used to this policy more generally. In the inside spaces in particular, there were floor markings noting the distance to stand from one another.

Additionally, each team member was wearing a badge to describe the kinds of work they were doing. This made it easy to identify who was qualified to do each task.

When we had our shot, the nurse gave us a little sticker with a time that we can exit – very clear and explicit. This allows them to monitor to see if there’s been any side effects. There was a large digital clock projecting in the waiting area which made it really clear when you could leave. On exit, the check out attendant took the vaccine type sticker and the exit time sticker and kept it for their records.

Although I would have like to take pictures to share with you on this blog, there were clear policies posted around the area requesting that we not take pictures.

Managing Flow

I noticed this particularly once inside in the secondary check in. There were very small queues before each of the pairs of check in attendants. Plus there were a one or two flow managers. What I noticed at one point was that the flow managers actually stopped people checking in, thus people stopped coming inside into the small queues. The outside queue (single queue) started to grow at this point. It became evident to me that the main bottleneck in the flow was the vaccination cubicles. Thus it made a lot of sense to make sure there were flow managers before the bottleneck to make sure the system doesn’t get overwhelmed. Once the health workers giving the vaccines caught up, the flow managers then allowed us to check in – but they still kept a watchful eye of what was going on downstream.

Also, having us read information whilst we were queuing made the overall flow occur more quickly – this was well thought out as it reduced the overall lead time to get the vaccine process completed.

Different classes of service

I noticed this when one person was on crutches – in the outside tent they let her straight through to secondary check in, I took a little longer to get through. Then when she got to the station just before entering the building, I heard the attendant there usher her forward and call out ahead “Priority!”. She went to a queue that didn’t have anyone in it so she could get checked in right away. This was a very simple example of a different class of service – note that the policies and workflow changed to allow this person through more rapidly so as not to cause any hardship.

Different work item types

I also noticed that there were different work item types here. The attendant at the door to the building who was checking priority was also starting to filter for work item types as well. She called out “Is there anyone here for AstraZeneca?” (this is another vaccine we have available, but is used less). I didn’t see anyone come through at the time with that, but there may have been different rules for how that flowed through the system. I did notice that when we checked in we got a blue sticky dot that we put on our clothing to identify the type of vaccine. I noticed on the check in desks that they also had orange dots – I’m guessing this was for the AstraZeneca. No doubt there would have been a subtly different process (perhaps specialist cubicles) for that type of vaccine.

Conclusion

I was most impressed with the system of work that was put in place for the covid vaccination hubs locally. Seeing many of the practices we teach about Kanban come into play allowing them to provide an efficient, safe and “fit for purpose” service based on the resources they had. I’m booked in for my second dose and I’m wondering if I’ll see some of the other Kanban practices come into play around improvement and see if they’ve made it even better. Kanban is being used around you in ways you might not be aware. If you want to learn how you can build it into the way you work, check out our Kanban System Design course.

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