The Grey Bruce Health Unit has developed the Hockey Hub, a made-in-Canada solution for mass COVID-19 immunization clinics. Although there are not the quantities of vaccine in Grey Bruce to implement the Hockey Hub model, at this time, the model can be implemented when large quantities of vaccine become available.
The Hockey Hub uses local hockey arenas to deliver thousands of COVID-19 vaccines per day in local communities, based on a standard size hockey rink – ubiquitous throughout Ontario and Canada. The plan is scalable in that it can be expanded or contracted depending on the amount of vaccine available and the number of clients to be vaccinated.
“Almost everyone in Canada is near a hockey arena. That makes the Hockey Hub an ideal solution for large scale immunization, not just locally but across Canada,” says Grey Bruce Medical Officer of Health, Dr. Ian Arra. “Through mobilizing community partners, I have the utmost confidence the Hubs will be activated to utilize vaccines promptly no matter how large the shipments we receive. I trust the plan and the action will impress.”
The Hockey Hub (presentation attached) was presented on Saturday to General (ret’d) Rick Hillier, former Chief of Defence Staff for the Canadian Forces and chair of the province’s Ministers’ COVID-19 Vaccine Distribution Task Force.
“A professional and well designed plan. Caring and considerate for all Ontarians,” said General Hillier. “A great example for rural and small urban areas across Ontario to consider – very much Hockeyville Canada!“
The Hockey Hub, set up in a standard hockey arena, can administer 4500 vaccines in a 10-hour shift of five nurses (or whoever is administering the vaccine). Traditional large volume clinics administer about 1,000 vaccines a day, employing 20 nurses. Conventional smaller vaccine clinics administer 400 vaccines a day, in a shift of eight nurses.
The efficiency of the Hockey Hub model is based on utilizing a non-clinical staff for any task that is non-clinical, preserving the clinical capacity to support the healthcare system.
Process flow times have been calculated to the half minute. In the Hockey Hub, a vaccinator can administer 90 vaccines per hour. In a typical vaccine clinic, a vaccinator can administer 14 vaccines per hour.
The difference in the Hockey Hub model is the streamlined flow-through process. Once registered, the client remains in an individual pod for documentation, administering vaccine and recovery. The person administering the vaccine moves from pod to pod. The typical set-up in a standard rink would have 150 pods with one nurse assigned 30 pods each.
Activating all three Hockey Hubs in Grey and Bruce, given sufficient supply of vaccine, it would take about 21 days to vaccinate 140,000 people or 75 percent of Grey Bruce’s population. Conventional vaccine clinics would take considerably longer, months rather than days.
The Hockey Hub provides several efficiencies. Clinically trained personnel are focused on administering the vaccine requiring only 5 clinically trained personnel to administer 450 vaccines per hour. Other non-clinical staff take on the clerical and support roles. There is a reduced risk of injury/fainting as clients are immunized and recover in the same location instead of risking fainting while walking to a recovery area (fainting is a well-known risk in immunization clinics). The one-touch surface means decreased surface cleaning to minimize the risk of transmission.
The model is cost-effective as the Hockey Hub costs about $6,000 per thousand vaccines or about $1.7 million total for 140,000 population. Large volume clinics cost $26,000 per thousand or $7.2 million for 140,000 population.
For example, Bruce Power (the largest nuclear generation facility in Canada) has provided resources and logistics for three recovery centres (field hospitals) in three locations. These sites are currently being converted to mass immunization hubs including adding an ultra-low temperature vaccine freezer and accessories. Lower-tier municipalities have provided the arenas, and Grey and Bruce Counties have funded and supported part of the project. Chapman’s has donated two ultra-low temperature vaccine freezers.
The Hub model capitalizes on the optimal readiness and collaboration among the Grey Bruce Health Unit, Grey and Bruce municipalities, police services in Grey Bruce, and community partners.