American Red Cross Staffing Support Toolkit for Vaccination Sites
Engaging Volunteers and the Community to Support COVID-19 Vaccination Missions
*If you have any comments or suggestions for this guide, please email luke.beckman@redcross.org*
Overview:
Congratulations on getting vaccine supply and on getting a vaccination site operational! The purpose of this toolkit is to help you organize staffing. This is particularly helpful if you are engaging any kind of volunteers. This toolkit has been put together by the American Red Cross supporting local, state, business, and federal partners with vaccination missions.
User Experience:
This toolkit is designed for a group such as a county or healthcare team that needs to recruit, train and engage workers to run a vaccination site. This was built with the need for volunteers in mind, but all the included tools can work for paid staff not just volunteer staff.
See the Table of Contents below to find sections in this document that will be most helpful to you and your teams.
Table of Contents
Does It Make Sense to Staff Our Vaccination Site with Volunteers?
Key Considerations and Best Practices
Staffing Leadership Roles Necessary for Success
Will Volunteers Show Up and Will They Come Back for More Shifts?
Does It Make Sense to Staff Our Vaccination Site with Volunteers?
When it comes to staff for your vaccination site, having dedicated, full-time workers whom you train once, who come back to the site every day, is the easiest and simplest staffing option.
There may come a time (and you may be there already) where:
- Your paid staff are tired or need to return to day jobs
- You no longer have the funds to pay for that number of workers
- The community is eager to pitch in
- You need to grow your workforce beyond what you can accomplish with paid staff
If any of these are the case, you may want to consider using volunteers at your vaccination site.
You will likely ask: does it make sense to staff our vaccination site with volunteers?
This job tool will help you think through this question and come to a solid answer, and your answer may change over time. You don’t have to go from 0 to 100 overnight, but it is important to address several realities when it comes to recruiting, training, and engaging volunteers.
- “Volunteer” is a big category of workers; this basically means anyone who is volunteering their time and not obligated to be at a work location. Types of workers who are volunteers:
- Employees of your organization who want to volunteer their time (and either get comp time off from work or not)
- Affiliated volunteers (aka Red Cross volunteers who come to volunteer at your site)
- Unaffiliated/Spontaneous/Event Based/Community Volunteers (aka individuals in the community who want to volunteer on their own and are not associated with an organization)
- You may also consider workers such as AmeriCorps, FEMA Corps, and the National Guard as volunteers. While true at the philosophical level, in terms of ability to perform work, these groups should not be considered volunteers because each of the above team members comes as a dedicated Full Time Equivalent (FTE)/40 hour per week worker, whereas your traditional volunteer might only work 4 hours each week and that if they have a bad experience, they don’t have to come back to work.
- The biggest difference you will see between using dedicated contract staff and volunteers is that you have more turnover with volunteers and will likely have to explore shorter shifts for volunteers. We recommend exploring the idea of 4-6 hours shifts for volunteers.
- You need to think about a positive experience with a “Good Hello” and a “Good Goodbye” for your volunteers. If they enjoy the work, you will get a lot more out of them, they will want to come back, and they will tell all their friends and family. Each volunteer can be your best Community and Public Relations representative.
- You should plan to allow more volunteers (20% is a good planning assumption) for a shift than is required to account for last minute cancellations or no shows
- You should NOT need a whole different structure in place to manage your volunteers if you have a solid staffing team in place. You will need more people focused on scheduling, check-in and training if you are providing onsite training, since you may have new workers each day
- You need an easy online scheduling tool that volunteers can use to sign up for shifts. This will make life much easier for your team from an administrative point of view.
Key Considerations and Best Practices
Key Considerations:
- Will your site be a drive-through site or a pedestrian site (can be indoor or outdoor)?
- What will your operating schedule and shift schedule be?
- What languages will patients speak if not English? How can you communicate relevant information to these patients? Can you recruit staff who speak these languages, use translation apps or digital services to communicate, provide printed documents in these languages?
- Will you offer vaccination to volunteers? If so, do you want to require a commitment of a minimum number of shifts in order to get the vaccine?
- Will you accept out of state and expired medical licenses for volunteers in medical roles?
- Will you do criminal / sex offender / malpractice background checks for clinical and non-clinical staff, volunteers and paid?
- Will your vaccination site check the temperature of everyone, both staff and patients, as they come onsite?
- Will your vaccination site allow walk-in appointments or will it require that all patients receiving vaccinations make appointments in advance?
- What will your vaccination site do with excess vaccine supply at the end of the day?
- Will your vaccination site hold some vaccine supply for second dosages and booster shots, or will your site make all vaccine supply available immediately?
Best Practices:
Best Practices from North Dakota and Baltimore, MD
Recording of Presentation: https://www.youtube.com/watch?v=wGHZsdKz6PU&feature=youtu.be
Slides from Presentation: https://files.constantcontact.com/e67f91cd701/a3e216e0-775c-48ea-82ec-b4737f11f78f.pdf
Site Layout:
For both walk-through and drive-thru sites, the space should be allocated into separate areas for these purposes:
- reception: sign-in / screening site for signs of COVID symptoms, e.g., temperature check
- primary vaccination area
- exception vaccination area: 1-2 vaccination stations near the reception but separate from the primary Ko vaccination area for persons with disabilities or history of allergies, people showing signs of COVID symptoms, people with support animals, etc.
- observation / rest area for patients to sit for 15-30 mins after injection to be monitored for adverse reactions
- private area for people with adverse reactions to the vaccine, near an exit for EMT access
- enclosed area for vaccine preparation, ideally near loading dock or door in the rear where vaccine will be delivered – out of sight of primary vaccination traffic
General Recommendations:
- Obtain a backup power supply for your vaccination site, especially if you’re in-season for disasters in your location, e.g., hurricanes, floods, fires, etc.
- Make sure your vaccination site is accessible to people with disabilities, especially people in wheelchairs or with difficulty walking. Your patients are likely to have mobility challenges.
- Get technology donated – you will need wi-fi access and devices for sign-in / verification of patient appointments
- If your vaccination site is staffed by people who are both paid and unpaid (volunteer) for their time, treat them all as similarly as possible, across screening/verification, training, scheduling, management/supervision, and evaluation.
- Hiring EMT and security services is often the fastest, most stable way to make sure these critical needs are met in case of emergency
- Make a plan in case individuals or groups come to your site to protest the vaccine or attempt to disrupt your operation. The plan should include how to de-escalate agitated individuals, appropriate locations for protestors to demonstrate, patient safety, which staff should manage the situation, evacuation training for all staff, and what the criteria is for escalation to law enforcement.
Diversity, Equity, and Inclusion:
- When making executive decisions, choose options that will optimize vaccine delivery for the highest risk populations: the elderly, people with underlying health conditions, frontline workers, and people of color.
- If possible, choose a site location convenient to populations in greatest need for vaccination.
- Set hours of operation outside regular business hours, e.g., evenings and weekends, to maximize both availability of the vaccine to patients and volunteer recruitment.
- Recruit your staff, especially greeters and wayfinders, so that they reflect the population being vaccinated as much as possible, e.g., in ethnicity and languages spoken.
Staff retention and management:
- Manage team members’ certifications, training, and scheduling in one tool / software for both paid and volunteer staff so that you have a unified view of all personnel and can easily identify gaps to fill
- Establish a stand-up meeting for all staff at the start of every shift so that everyone has consistent training and latest updates
- The staff supervisor should be onsite as much as possible – your site may run into significant communication and management issues if that role is remote-only.
- Shifts that are 4-6 hours long are ideal; shorter ones create a lot of administrative work in managing shift changes, and longer ones are less appealing to prospective staff, especially volunteers, and increase expectations that the site will provide food, include longer break times to eat, etc.
- People giving the vaccination shots should not have the ability to register new patients for vaccination; only the reception / sign-in staff should have access to that system so that people who do not meet the qualifying criteria cannot get unauthorized vaccinations
Staffing Leadership Roles Necessary for Success
Getting your staffing leadership team in place is a critical first step. Many organizations skip this step and just start looking for workers. While this might work for the first 48 hours to meet an immediate need, problems quickly arise and morale drops rapidly when a staffing team is not in place.
Critical leadership roles to fill immediately:
(depending on the size of your operation, you may have one person filling multiple roles):
- Staffing lead who reports to the person in charge of your site
- This person is responsible for ensuring you have enough of the right kinds of people at your vaccination site. At a minimum, they should know and be able to share your daily and weekly staffing requirements and gaps. This person should be able to report on paid and volunteer staff.
- Scheduler
- This is a person who oversees setting shift blocks, getting people scheduled into shifts, and answering questions from prospective workers. This person may coordinate schedules for paid and volunteer staff.
- On-Site Staffing Coordinator
- This person should oversee day-to-day onsite staff check-in, questions, and issues. They need to make sure staff are trained appropriately. This person is not the staff member’s direct supervisor. This is a general staffing role. This person should be available for paid and volunteer staff.
Full List of Staff Positions
Patient-facing positions:
- Greeter/Wayfinder (including drive-through sites)
- Registrar*
- Vaccinator**
- Vaccine Observer**
Cross-site positions:
- Vaccine Prepper*
- Space Sanitizer
- Medical Supply Clerk/Runner
- Security
- On-Site Staff Coordinator
- Site Supervisor
- EMS Clinical Support **
* Requires special training
**Requires licenses or certifications
Staff Position Descriptions:
Greeter/Wayfinder
Role summary: To welcome patients, provide information and direction, check that masks are being worn, and determine if patients need extra support (for interpretation or other access needs)
Required competencies:
- Demonstrate ability to identify COVID symptoms in incoming patients
- Communicates easily with strangers, e.g., mask requirements, directions, etc.
- Confirm understanding and demonstrate ability to de-escalate and provide customer service strategies for long wait times
- Shows judgment and comfort with calling on teammates when required for translation, security, or supervision
If temperature checks are required upon entry:
- Demonstrate ability to use a digital thermometer
- Confirm understanding of what to do if temperature exceeds local threshhold
Position training considerations:
- Greeters reflect the community they are serving and have patient-facing skills while wayfinders may have less experience and focus on directions
- Wayfinders and greeters may both be needed at some sites (e.g. large sites or drive-through)
- Language skills of greeters or availability of translators
- Ensure greeters/wayfinders develop the abilities to communicate with waiting patients, assist with mask compliance, manage expectations, de-escalate agitated patients
- If greeters are responsible for screening questions rather than registrars, train them to hand out and explain screening forms and answer questions
- Train greeters/wayfinders to identify and accommodate patients with disabilities or language needs
Supply List:
Before shift, review this supply list and ensure that enough of each supply is available for the shift. If additional supplies are needed, obtain them from the Medical Supply Clerk. If you are running low during your shift, escalate to the Medical Supply Clerk and your Supervisor.
Items:
- List of COVID-19 symptoms to identify and steer at-risk patients into separate vaccination area
- Masks
- Patient screening questions
Optional items:
- Hand sanitizer
- Pens
- Clipboards
Registrar:
Role summary: To confirm that the patient has an appointment (confirmed or scheduled on-site) and has completed screening questions; document vaccine details in the patient record
Required Competencies:
- Experience or willingness to learn patient registration and appointment data management IT system
- Sensitivity to patient privacy
Responsibilities:
- Confirm identity of patients
- Create (walk-in) or confirm appointment (if scheduled) and schedule a second vaccine appointment (if needed)
- Maintain vaccination appointment/completion records of patients in an organized manner
Position training considerations:
- Use of specific data systems at the site for patient registration and tracking
- Ability to work with patients who may need ADA or other accommodations, e.g., ASL
- Position may require HIPAA training
Vaccinator:
Role summary: To prepare and administer vaccine to patient and document vaccine delivered on patient records/card
Required Competencies:
- Appropriate licensure to administer vaccines per state regulations
- HIPAA training
- Understanding of safe disposal procedures for medical supplies
- Clear communication skills, both with patients and medical supply runners
Responsibilities:
- Review patient’s questionnaire and risk for allergies (medications and foods)
- Communicate with patients about health risks, side effects, allergic reactions, vaccination process, and required wait time
- Deliver vaccine doses and monitor for immediate reactions
- Direct patients to observation area summon EMS Clinical Support if immediate reaction
- Update patient records accurately
Position training considerations:
- Location of a gurney/triage area for those requiring immediate medical attention
- Role may require vaccinators to work with patients who may need ADA accommodations or language assistance (e.g. ASL)
- Train vaccinators on how to restock themselves or communicate with medical supply clerk if supply levels are below requirements; protocol may differ by site
Supply List:
- Gloves
- Eye shields
- 21-25 gauge – 1 and 1 ½ inch needles
- Alcohol Swabs/Prep pads
- 2X2 Sterile Gauze
- Band-Aids
- SHARPS Container
- Hand Sanitizer /Sani Wipes
- Different Colored Trays for Moderna and Pfizer vaccinations once prepped (if multiple brands)
- Color Cards for ADA and 30-minute observation
- Ball Point Pens
- Fine Point Sharpie
- File Trays
- Laptop & Charger or Computer Workstation on Wheels
- Stickers for 15 and 30 minute wait times in different colors
- First Aid Kit
- Non-medical waste basket
Ensure each Vaccination Table has adequate space for the necessary supplies
Vaccine Observer
Role summary: To directly observe for 15-30 minutes vaccinated patients; actively assess and consult on allergic reactions and other clinical problems that arise; and document adverse events in compliance with protocols and reporting requirements
Required Licensures (confirm your state’s regulations):
RN, NP, CNM, CNS, CRNA PA, MD, DO, Naturopathic Doctor, Dentist, and Pharmacists
Required Competencies
- Attentiveness to detail
- Comforting bedside manner
- Responds quickly and effectively to crisis
Responsibilities:
- Assess allergy risks and respond accordingly
- Conduct clinical consults for patients who may become ill while at the site
- Observe and assist patients who require ADA accommodations or may not speak English as a first language
- Complete any required documentation per protocol and in compliance with state and federal requirements
- Respond to adverse events, administer necessary emergency care onsite, and alert EMS Clinical Support
- Report adverse events
Position training considerations:
- Must have familiarity with adverse events and emergency situations
- Knowledge of emergency protocols for administering care, escalating to EMS, and reporting any adverse events
Vaccine Prepper
Role summary: To support the Vaccinator in the preparation and labeling of syringes, avoiding vaccine wastage, and ensuring end of day Clinic Checklists/Vaccine Usage and Forms are completed
Space Sanitizer
Role summary: To ensure that high touch areas are kept clean, spills are managed, and biohazard waste disposal is completed
Medical Supply Clerk/Runner
Role summary: Ensure the supplied needed for the shift are available throughout the day, and inventory is maintained
Security
Role summary: To provide security for patients, volunteers and other staff throughout the day across the site
Site Supervisor
Role summary: Provide oversight to overall site operations and function as the decision maker for the site
On-site Staff Coordinator
Role summary: Work with volunteers and all other paid workers on site for each shift; conduct daily huddles and coordinate with Volunteer Scheduler and Site Supervisor for shift preparation
EMS Clinical Support
Role summary: To address any emergencies that come up at the site, for vaccine and non-vaccine related adverse events and to provide medical support as needed for non-emergencies
Scheduling/Staffing Tool—
Requirements: https://youtu.be/cqvn4HnGC9k
Tool Recommendation: https://youtu.be/M2IwV_0v-Nc
For your site to run smoothly, you need a good way to schedule your workers. If you have the same workers everyday, and if these workers are hired by a staffing agency or a subcontractor, you may just want to check in with that partner daily to ensure the next day’s staffing levels are appropriate.
If you are using multiple agencies, have new workers on a regular basis, and/or are using volunteers, you may need a robust scheduling tool. Our team conducted a multi-week deep dive into understanding the many potential staffing requirements of a vaccination site. We recorded a video highlighting those requirements. Here is the link to the video: https://youtu.be/cqvn4HnGC9k
The tool we found that meets the greatest number of vaccination site requirements is called Timecounts.org. Here is an overview video of Timecounts→ https://youtu.be/M2IwV_0v-Nc
Here is the direct link to Timecounts- http://timecounts.org/vaccinationsite
Timecounts Help Videos- https://help.timecounts.org/en/collections/2806460-new-vaccination-site-tutorials
Will Volunteers Show Up and Will They Come Back for More Shifts?
Most volunteers show up for scheduled shifts. It is good practice to assume a 20% last-minute shift cancellation/no show rate. Whatever number of folks you require onsite, allow 20% more registrations to cover that possibility. If you have weak staffing support (both pre-shift and onsite) at your vaccination site, then this number is likely to be higher.
In general, if you have strong staffing support with clear communication in place, your volunteers will be excited to come back and tell their friends and family about the experience. Your workers can be your best recruiters.
Here are some strategies to increase worker retention and morale. These are strategies that work well for any type of worker- paid or volunteer.
- Have a start- and end-of-shift meeting with the team to introduce new team members, talk about what went well, and acknowledge outstanding work. This builds a sense of team and community
- Have swag or small gifts for workers who complete a certain number of shifts or work a certain number of hours.
- Send personalized thank you emails or texts to thank workers after their shifts
- Send personalized emails or texts to remind workers about their upcoming shifts.
- Post a central number that any of your workforce can contact if they have questions, issues or problems. This way, nobody feels isolated or alone.
