Extreme Makeover

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Extreme Makeover

• Vaccine Ordering and Delivery Optimization

Brandon Rector MSW Customer Service Supervisor NC
Immunization Branch Helen T. Kuykendall Public
Health Analyst, Immunization Services
Division Vaccine Supply and Assurance
Branch Immunization Services Division, NCIRD, CDC
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Course Outline

• Provider Survey Results
• What happens when you order vaccine?
• Minimizing Lost Vaccine
• How to Receive Vaccine
• Allocated Vaccines (Hib, Pentacel, influenza
  vaccine, hepatitis B vaccine)
• Common Causes for Delay
• Tips Tricks for Optimizing Your Order

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What Do You Think?

• I would like to see decreased time between
  ordering and delivery.
• Please increase the timeliness once an order is
  placed.
• When we use McKesson as a wholesaler, we get the
  vaccine next day. Why does it take two weeks for
  state orders to arrive?
• Returning boxes is impossible. Boxes are bulky
  and are often not picked up for weeks.

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What Do You Think?

• Supply must meet demand. We have had shortage
  after shortage despite ordering vaccines. The
  interruptions in the chain from company to state
  to office to patient must cease. It is a
  nightmare to keep track.
• Vaccine shipments were delayed in the fall and
  orders were received in individual shipments
  rather than collectively. Is the state being
  charged for each shipment?
• We have concerns with errors in the lot numbers
  of vaccines that we have received.

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The Ordering Process
Orders come to Raleigh
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Orders submitted to CDC for approval
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CDC sends orders to McKesson Specialty
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McKesson Specialty sends vaccine to provider/data
to Raleigh
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McKesson Distribution Process
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North Carolina Monthly Volume - Doses
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Ways you can minimize vaccine loss

• Open and inspect all vaccine shipments
  immediately
• ColdMark Freeze Indicator
• Warm Mark
• Call 877-TEMP123 (877-836-7123) or your State
  program office if you have questions about
  vaccine viability within 2 hours of receipt

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Ways you can minimize vaccine loss

• Office Closure
• Ideally do not place orders that will arrive when
  your office is closed
• Communicate any planned office closures with the
  State program
• Do NOT work directly with the carrier
• Order Refusal
• Do NOT refuse vaccine shipments
• Even if you think you cancelled an order
• Contact your state program

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Receiving Vaccine

• Does everyone in your office know who to contact
  when vaccine arrives?
• Open and inspect all vaccine packages
  immediately.
• What does inspect mean?
• Put vaccine into refrigerator/freezer
• Accept your Inbound Transfer in NCIR.

QUILT
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QUILT

• Quantity
• Integrity
• Lot/Expiry
• Temperature

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Allocated Products

• PedvaxHIB
• ActHIB
• Pentacel
• Fluzone
• FluMist
• Fluvirin
• Recombivax-HB
• Engerix-HB
• H1N1?

• Limited Supply
• Production Shortages
• Outbreaks
• Pandemics

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How Do You Allocate Vaccine to 1300 Hungry
Providers?

• Order-Driven Process
• Most vaccines are allocated monthly
• Provider orders are shipped weekly

Why is it so difficult to predict the amount of
vaccine needed from week to week?
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What Is Holding Up That Vaccine?

• Providers
• NC Immunization Branch
• CDC
• McKesson

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Beyond Your Control

• Data entry errors
• Allocation management
• Change of contracts (3X/year)
• Holidays
• Handling errors

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Winning Strategiesfor Providers

• Are ordering the suggested amount?
• How often are you ordering?
• What day are you ordering?
• What are your hours?

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Course Outline

• Provider Survey Results
• What happens when you order vaccine?
• Minimizing Lost Vaccine
• How to Receive Vaccine
• Allocated Vaccines (Hib, Pentacel, influenza
  vaccine, hepatitis B vaccine)
• Common Causes for Delay
• Tips Tricks for Optimizing Your Order

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Thank you! Brandon Rectorbrandon.rector_at_ncmail.n
et 919-707-5553NC Immunization Help
Deskncirhelp_at_ncmail.net 1-877-873-6247