Download as PDF: Guideline for COVID-19 Screening Clinics (Drive-
Through, Pop-up and Mobile Vans) 

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Overview

About this document

To meet the NSW aim of ≥ 8,000 COVID-19 tests per day, Local Health Districts (LHDs) should strive to maintain a daily testing rate of ≥ 100 people per 100,000 population.

Pop-Up, Drive-Through and Mobile Van COVID-19 Screening Clinics can be rapidly established to promote testing within the community and increase local testing capacity. This document provides guidance on how to establish Pop-Up, Drive-Through, or Mobile Van COVID-19 Screening Clinic safely and efficiently during the COVID-19 response and also related pathology services.

These guidelines recognise that individual facilities and LHDs will need to tailor their response to local patterns of disease and available resources.

Definitions

NSW Health acknowledges that due to rapid inception, there has not been an approved naming convention for COVID-19 related clinics. For the purposes of this document, the following definitions apply:

  • COVID-19 Assessment Clinics refer to clinics which provide comprehensive clinical assessments and COVID-19 collection/swab to patients that meet the COVID-19 screening criteria, with the aim of diverting mild to moderate cases of respiratory illness from the Emergency Department (ED).
  • COVID-19 Screening Clinics refer to clinics which provide COVID-19 collection/swab to patients that meet the COVID-19 screening criteria, with the aim of providing the community with fast and easy access.

Objectives

The objectives of establishing a Drive-Through, Pop-Up or Mobile Van COVID-19 Screening Clinic include:

  • To promote early detection of community-acquired COVID-19 cases by maintaining a daily testing rate of ≥ 100 people per 100,000 population;
  • To support and encourage the NSW population to get tested by providing fast and convenient collection/swabbing options;
  • To assist with deployment of resources to areas of concern; and
  • To provide culturally appropriate options for vulnerable populations within the NSW community.

COVID-19 screening clinic considerations

Demand

Goal: The NSW community has sufficient access to COVID-19 testing.

Establishing a Drive-Through, Pop-Up or Mobile Van COVID-19 Screening Clinic can provide increased collection/swabbing capacity to areas of need, and promote access in areas with low testing rates.

Key questions to consider when assessing the need for a COVID-19 screening clinic

The key questions below provide guidance as to whether a new COVID-19 Screening Clinic may be required. If you answer ‘yes’ to any of the below questions, the establishment of a Drive-Through, Pop-Up or Mobile Van COVID-19 Screening Clinic should be considered.

Location

Goal: Drive-through, pop-up or mobile van COVID-19 screening clinics are located on a safe and easily accessible site.

The officer responsible will need to determine the suitability ​of the proposed COVID-19 Screening Clinic location to ensure the site is both safe and easily accessible.

If it is determined that a location may be suitable for a Pop-Up, Drive-Through and Mobile Van COVID-19 Screening Clinic, a clinic checklist should be completed to ensure other relevant factors have been considered prior to set-up. An example checklist has been provided in Appendix 1​.

Conditions at the selected site may also change and it is important that the site is checked daily for new hazards. The chosen site should be monitored and checked daily for any environmental changes.

If you have further questions about the suitability of a location, please contact the SHEOC Operations team via email at MOH-JasminCovid19Ops@health.nsw.gov.au​.

Key questions to consider for location

The key questions below should be considered when determining the suitability of the site. If you answer ‘no’ to any of the below questions, alternate arrangements should be considered e.g. consider portable toilet hire if restrooms are not provided.

  • Is there space for at least one lockable station/demountable?
  • s there access to security onsite whilst in operation, and security for night patrol?
  • Is there space to hold at least four cars in queue including parking bays, with separate entry and exit points for vehicles?
  • Is there access to utilities including power and water?
  • s the site mobility friendly?
  • Is the site well-lit? Consider security of any equipment/structures that are left unattended after-hours.
  • Are there staff amenities within close proximity including a kitchen, toilet and parking?
  • Does the site offer weather protection e.g. ability to erect awning or marquee for sun, wind and rain during testing?

Resources

Appendix 1: Example – NSLHD Testing Clinic Checklist​​​​​


Traffic management

Goal: Traffic is safely and effectively managed when entering, whilst on site and when exiting the clinic. Mobile and Pop-Up clinics minimise the impact on other road users and the wider community.

The health and safety of staff and patients in the COVID-19 Screening Clinic is of vital importance. Traffic management is site specific and needs individual attention to determine the best layout including flow, entry points, exit points and overflow areas. Clinics on road related areas, including private property car parks, remain subject to RTA road rules and traffic should be managed accordingly.

The officer responsible should ensure local Standard Operating Practices (SOPs) have been developed for each site. These will depend on the anticipated demand, size and location of the site and should be developed in consultation with the Local Council, NSW Police and NSW Roads and Traffic Management.

If the projected throughput of cars is expected to be high, consideration should also be given to employing a traffic controller. Please note the holder of this role must have completed the TAFE Traffic Controllers course to comply with legislation. A Site Supervisor may also be needed depending on site assessment.

If you require additional support or advice regarding traffic management and flow, please contact the SHEOC Operations team via email at MOH-JasminCovid19Ops@health.nsw.gov.au.​​​​​

Key questions to consider for traffic management

The key questions below should be considered when developing a traffic management plan. If you answer ‘no’ to any of the below questions, ensure appropriate strategies are implemented so these are addressed.

  • Can the staff member performing the testing always approach from the drivers' side to ensure staff safety?
  • Is there a designated path for pedestrians so they can avoid walking between any vehicles that are queued? A physical barrier (preferred) or witches' hats should be employed to provide clear pedestrian walkways.
  • Do staff have a clear line of sight of approaching or queuing traffic?
  • Do staff have sufficient space so that, in the event that a driver loses control o​f their vehicle, the staff member has an identified escape route?​

Resources

  • Appendix 2: Example – Route Maps for Drive-Through COVID-19 Screening Clinics


Governance

Goal: COVID-19 Screening Clinics are run safely and efficiently

The officer responsible will need to ensure clinic governance is established and communicated.

Medical emergencies

For any patient that deteriorates, local emergency protocols should be activated and 000 should be called. For clinics located on hospital sites, patients who are safe to transfer to ED by wheelchair should be done promptly with an escort and porter. Ambulance staff must be informed that the patient requires droplet/contact precautions for transport. If an aerosol producing procedure needs to be performed suctioning airborne and contact precautions must be used.

Communication with SHEOC operations team

The SHEOC Operations Team is the central coordination point for NSW Health COVID-19 clinics. To ensure oversight of clinics across NSW and effective management of supplies, consumables and logistics, communicate the establishment, variation or closure of any clinics to the SHEOC Operations team via email at MOH-JasminCovid19Ops@health.nsw.gov.au. Once notified, these changes will be made to the public NSW Health COVID-19 Clinics webpage.

Request by a LHD/SHN/NSWHP from the NSW Health Chief Health Officer to open a clinic

On the occasion of a positive COVID-19 patient being identified, an LHD/SHN may be requested to establish a time limited clinic within 24 hours to support existing COVID-19 services. In these instances the Chief Health Officer (CHO) will contact the Chief Executive of the LHD/SHN/NSWHP with a request for a service to be established.

If the LHD/SHN/NSWHP requires support to provide this service within the timeframe indicated by the CHO, the LHD/SHN/NSWHP is to contact the SHEOC via MOH-JasminCovid19Ops@health.nsw.gov.au. NSW Health has engaged St John’s Ambulance NSW to provide adjunct staffing and equipment to facilitate rapid clinic set up by LHD/SHNs. The request form is included in Appendix 3​.

Key questions to consider for clinical governance

The Key Questions below should be considered when developing or enacting governance processes for COVID-19 Screening Clinics. If you answer ‘no’ to any of the below questions, governance processes should be reviewed.

  • Has the location of the proposed clinic been communicated +/- approved by all relevant parties? (SHEOC Operations team, NSW Health Pathology, local PHN​, local Aboriginal Medical Health Service​, local NSW Council​, NSW Police, NSW Roads and Traffic Management).
  • Have all relevant governance documents been confirmed, documented and communicated? (Consider Escalation Pathways, Emergency Management, Supply and resupply of disposables etc.)​

NSW Health Pathology

NSW Health Pathology will provide testing services to NSW Health clinics unless otherwise arranged.

NSW Health Pathology is to be contacted prior to the establishment of a clinic to discuss and confirm service provision. This is to ensure swab supply and laboratory capacity can be managed by NSW Health Pathology.

The following information should be provided prior to clinic set up to
NSWPATH-LIAISONOFFICER-COVID19@health.nsw.gov.au:

  • Estimated start date
  • Estimated period of time clinic will operate (for example 7 days or 1 month).
  • Proposed location of clinic
  • Hours and days of operation
  • Daily capacity of clinic
  • Time the samples will be delivered and to which NSWHP Laboratory (for example midday and 3pm)
  • Clinic lead and contact number
  • Who is supplying the swabs​

Resources

Appendix 3: Request for St John’s Ambulance Australia (NSW) COVID-19 support service.

Staffing

Goal: For all staff to be orientated to site and perform their duties safely and within scope of practice.

The officer responsible will need to determine that all staff working in the Drive-Through, Pop-Up or Mobile Van are oriented to the site prior to commencing, and that the skill mix is adequate to ensure effective clinic operation.

Key questions to consider for staffing

The key questions below should be considered for safe and effective management of clinic staff. If you answer ‘no’ to any of the below questions, staff management processes should be reviewed.

  • Is there an agreed orientation process for all staff on site?
  • Is their sufficient staff mix to allow staff breaks as per their award?
  • Have all staff been trained in the correct use of Personal Protective Equipment (PPE)?

Resources


Vulnerable populations

Goal: Provide COVID-19 testing in a culturally safe manner in a range of formats.

COVID-19 testing is a core strategy in limiting the spread of COVID-19 in the NSW population. It is vital that all parts of the population have the opportunity to access testing when appropriate. With regards to COVID-19 testing, vulnerable populations may include paediatrics, Aboriginal and Torres Strait Islander communities, people from ‘culturally and linguistically diverse' (CALD) backgrounds and those who may have mobility issues or other special needs.

While children appear to be less commonly and less severely affected by COVID-19 than adults, it is important that children that are unwell (particularly with a fever) are assessed for other potentially serious illnesses.

Key questions to consider when developing a COVID-19 testing service for vulnerable populations

The key questions below should be considered to support COVID-19 testing for vulnerable populations. If you answer ‘no’ to any of the below questions, ensure appropriate strategies are implemented so these are addressed.

  • If a COVID-19 Screening Clinic offers testing for paediatrics:
    • Has SHEOC Operations been notified (to ensure details are documented on the public NSW Health COVID-19 Clinics webpage)?
    • ​Have staff with appropriate paediatrics experience been rostered?
  • Have you included the Aboriginal Chronic Care Team in your COVID-19 testing plan?
  • Is there an opportunity for members of the Aboriginal health workforce to be trained to perform swabs?
  • Do local CALD communities have access to COVID-19 testing information?
  • Are testing sites in the area mobility friendly?
  • Have opportunities to promote COVID-19 testing within existing health activities for vulnerable populations been considered and implemented?
  • Has the local community been consulted? (E.g. how would they like to access testing?)

Resources


Signage and communications

Goal: The clinic has clear signage indicating the clinic location and instructions for clinic users whilst on site. Patient education and follow up information is given to each testing recipient.

The officer responsible will need to ensure planning of appropriate signage to indicate the location of the clinic, flow of vehicle and pedestrian traffic, and any other relevant information. Depending on the needs of the local community, signage in alternate languages should also be considered. Signage should be weatherproof and secured to objects with consideration of WH&S principals.

Prior to the set-up of a Drive-Through, Pop-Up or Mobile Van, communication should be provided to the local community with an identified contact for any enquiries. A sample letter of notification to community (which should include clinic duration, days and time) has been provided in Appendix 9​.

If further assistance is required in regards to communication strategies or resources, please contact the SHEOC Operations team: MOH-JasminCovid19Ops@health.nsw.gov.au

Key questions to consider for signage and communications

The key questions below should be considered when developing and publishing communication or signage. If you answer ‘no’ to any of the below questions, ensure appropriate strategies are implemented so these are addressed.

  • Has the location and hours of the clinic been communicated to the local community?
  • Is the patient provided with clear instructions as to the Drive-Through, Pop-Up or Mobile Van clinic process?
  • Have information leaflets for patients been developed, considering CALD communities?
  • Has appropriate signage been set up upon entry to the clinic? For example:
    • Drivers should be instructed to come to a complete stop at the designating testing site, turn engine off and place vehicle in park/apply handbrake
    • Patients should be informed that they must remain in their vehicle unless otherwise directed by the Drive-Through Team

Resources


Equipment, consumable and waster management

Goal: Clinics and clinic staff have adequate access to identified resources and resupply pathways and are aware of escalation pathways.

The officer responsible will need to determine the anticipated demand for stock and the logistics for safe storage and re-supply. Staff working on site should be familiar with the location of stock and stock ordering procedures.

Waste management on site should align with Clinical Excellence Commission (CEC) Infection Prevention and Control Guidelines for the Management of COVID-19 in Healthcare Settings​. Clinical waste should be disposed of in clinical waste streams, all non-clinical waste should be disposed into the general waste stream, and PPE is considered general waste unless contaminated with bulk blood and or body substances.

Key Questions to consider for equipment and Waste management

The key questions below should be considered when developing plans for equipment and waste management. If you answer ‘no’ to any of the below questions, ensure appropriate strategies are implemented so these are addressed.

  • Have supply chains for stock been established and communicated to staff, including escalation pathways for stock shortages?
  • Is there an agreed process for removing waste safety from the site?

Resources

Clinical operations

Goal: Patient registration processes, screening criteria and testing protocols for COVID-19 Screening Clinics are clear and effective.

The officer responsible will need to ensure staff are familiar with agreed clinic processes including the patient registration process, screening criteria and testing protocol.

Information should be available to patients that use the clinic to inform them of their privacy and how patient information will be used. It is also recommended that where possible the patient’s GPs contact details are collected to ensure continuality of care. Patient registration processes, screening criteria and testing protocols for COVID-19 Screening Clinics are clear and effective.

The officer responsible will need to ensure staff are familiar with agreed clinic processes including the patient registration process, screening criteria and testing protocol.
Information should be available to patients that use the clinic to inform them of their privacy and how patient information will be used. It is also recommended that where possible the patient’s GPs contact details are collected to ensure continuality of care.

Key Questions to consider for clinic operations

The key questions below should be considered when documenting and communicating the operational processes of the clinic. If you answer ‘no’ to any of the below questions, ensure appropriate strategies are implemented so these are addressed.

  • Have patient flow pathways been clearly mapped out and communicated to staff?
  • Have patient registration processes been clearly documented and communicated to staff, ensuring sufficient details are captured to ensure follow up of patient results?
  • Is the clinic screening criteria regularly updated per NSW Health advice?
  • Do testing protocols provide staff with clear, up-to-date information?
  • Have considerations been made as to how clinic operations should change during periods of surge activity? Have these processes been agreed and documented?
  • Are new staff provided with clinic processes and protocols during orientation?

Resources

Follow up post-swab

Goal: All patients are informed of isolation requirements post-swab, and how and when they can access their result.

All patients undergoing COVID-19 testing need to self-isolate while they wait for their COVID-19 test result; this may take up to 72 hours.

Positive results

All positive COVID-19 results will be managed by the NSW Public Health Unit (PHU). Patients who test positive are given priority and their results are reported immediately to the referring doctor and PHU in line with high-risk results procedures.

Negative results

NSW Health Pathology have developed an SMS system to deliver negative results to patients. Utilisation of the SMS system should be promoted to reduce the time taken to receive results. Please note the SMS registration number may change depending on the location of the clinic.

Patients who test negative do not need to continue isolation unless they have been advised otherwise due recent overseas travel or being identified as a Close Contact of a COVID-19 case.

Expedited test results

For LHD-run clinics, decisions regarding testing prioritisation are made by the NSW Ministry of Health in response to clinical and public health imperatives, including early detection in vulnerable communities such as aged care facilities, remote Aboriginal communities and where testing is required to maintain essential services.

Details of how to expedite testing within these remits are available on the NSW Health Pathology webpage​.​

Key Questions to consider for COVID-19 testing follow up

The key questions below should be considered for patients post-swab. If you answer ‘no’ to any of the below questions, ensure appropriate strategies are implemented so these are addressed.

  • Is the NSW Health Home Isolation Fact Sheet provided to all patients post-swap?
  • Have information leaflets been developed for local CALD communities?
  • Are patients provided with a contact number for queries post-swab?

Resources

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Appendices

Appendix 1: Example - NSLHD Testing Clinic Checklist


Checklist for new testing clinics

Executive Lead Name, Position

Item 

Owner
(Initials)

Completed
(tick / cross)

Date
Coordination of clinic location

Public Health Unit (PHU) to provide data on screening numbers in Local Government Areas (LGA's)​

     
Executive Team to provide input regarding clinic location      

CE/Executive Team Member to contact LGA and key stakeholders regarding potential clinic sites

     
Site requirements
Adequate space for cohorting patients from the general public      

Adequate space for two to three registration tables out the front of the site building or inside with adequate social distancing

     
Adequate space to maintain social distancing in entire area      
Wheelchair access      
Accessible parking      
Good public transport access      
Undercover weather area      
One way flow i.e. one entry and one exit      
Separate, lockable room for stock storage      
Tea / bag room for staff      
Testing pod requirements
Privacy screens      
Seat for patient (must be cleanable with wipes)      
Bench or table for storage      
Garbage bin      
Bubbles/stickers/toys for paediatric patients      
Administration area requirements
Two to three tables and adequate chairs      
Timer (to indicate two-hourly PPE change)      
Nursing station requirements
One to two tables and chairs      
ICT requirements
5 computers      
Label printer      
Side printer      
Wi-Fi Router      
Workforce requirements
Two to three nurses for registration tables      

Three to four swabbing nurses

  • One paediatric nurse at each site required
     
Two to three administration staff      

Senior Nurse

  • Clinic flow coordination
  • Labelling swabs
  • Collect registration forms from front tables for distribution amongst administration staff
  • Determine which patient is swabbed next
     

Nurse Manager

  • Oversee entire clinic
  • Allocates meal breaks
  • Manages verbal complaints
  • Allocate daily staff roles/responsibilities
     

Logistics and Inventory Coordinator

  • Collects stock from RNSH and transports to clinic
  • Coordinates set-up and dismantle of clinic with N&M Operations
  • Perform second daily stocktake
  • Order equipment through Team Lead – Performance Support Team
     

One to two ICT staff for initial clinic set up

  • Initially flagged with Director ICT by Director N&M
     
Pathology requirements
Pathology swabs from Team Lead – Performance Support Team      
Pathology bags from NSW Pathology      
Eskies from NSW Pathology      

Twice daily swab pick-ups performed by Nursing and Midwifery (12pm and 3pm) or as negotiated with Pathology North by Director Nursing and Midwifery

     

Pathology request forms printed by Nursing and Midwifery team

     
PPE requirements      
Full PPE for swab Nurses (gown, mask, gloves, face shield)      
Full PPE for registration Nurses (NO face shields)      
Masks for Administration staff      
Masks for all patients (to sit at registration tables)      
Equipment requirements      
Wipes for registration tables and pods      
Tape to mark social distancing requirements      
Hand sanitiser for registration tables and inside building      
Plastic tubs for storage purposes      

Information sheets for patients SMS results information and registration forms

     
Miscellaneous      

NAP location created/assigned and provided by Performance Team

     
Rubbish disposal required by NSLHD      
Labels, tissues and gloves ordered through Nursing & Midwifery Directorate      

Miscellaneous items as required e.g. First Aid Kits, clocks, timers, stationery

     
Corporate communications      
Corporate Communications team advised of new site      
Promotion of new site through social media/other platforms      
NSLHD website and intranet updated      

Ministry advised of new sites for Ministry website and intranet updating

     

Corporate Communications order and supply Frames and Canvases

     

Appendix 2: Example – Route Maps for Drive-Through COVID-19 Screening Clinics 

Example – WSLHD Drive-Through Clinic Map



Example – SLHD Drive-Through Clinic Map



Appendix 3: Request for St John’s Ambulance Australia (NSW) COVID-19 support services

Request for St John’s Ambulance Australia (NSW) COVID-19 support services. Please complete form​​ (example below) and submit to MOH@JasminCovid19Ops@health.nsw.gov.au​

Your Ref:
EXECUTIVE LEAD Name, Position
Contact Name, po​sition, contact number
Start/End date DD/MM/YY  - DD/MM/YY
Location requested <1 per form>

Type of Suppor​​t requested Ple​ase tick box
Staff only* - please provide detail of request below  
Equipment only** - please provide detail of request below  
Both staff and equipment – please provide detail of the request below  
Reason for request for additional services​



*​​Staff  - skills required Number requested
Admin support  
Patient education/screening  
Conduct COVID-19 swabbing  
Traffic controller
​Other - please specify



​​**Equipment  Number requested
Traffic cones  
Marquee (3M long x 3M wide x2M high​  
Tables  
Chairs
​Ambulances, vans, utility and passenger vehicles
​Other equipment – please provide detail





Appendix 4: Example – Swabbing in the SWSLHD Aboriginal Community – Aboriginal Chronic Care Program (ACCP)​

    Identify​

  1. Identify that client or family member potentially has COVID-19. Client has cough, fever, sore/scratchy throat or SOB.
  2. Discuss/consult with ACCP clinical team leader clients current health issue or concern and appropriateness for swabbing. If determined to be appropriate, organise an appropriate time to visit to swab client and/or family members.
  3. Organise

  4. Clinical Team Leader to organise appropriate staff to attend the home visit for swabbing, and equipment as outlined above.
  5. Staff are to ensure full PPE before entering the home*. Affected clients are asked to wear a mask at all times that staff are within vicinity of client.
  6. Procedure

  7. Swabbing of clients should be undertaken and collected as per Swabbing training by SWSLHD Primary & Community Health, appropriately labelled and secured in an appropriate pathology bag with a pathology request
  8. Follow up

  9. Once exited from home of symptomatic clients, all PPE should be removed and disposed of in a clinical contaminated waste bag – secured at top once all contaminated items are retained in bag*.
  10. Swab is to be transported directly to Liverpool Hospital Pathology for testing
  11. Quality assurance

  12. All contaminated waste needs to be disposed of in an appropriate clinical waste bin, and any items potentially contaminated that are not disposable – thoroughly cleaned.
  13. Ensure documentation in clients note (as per facilities documentation guidelines) and scheduling is completed.

* Consult COVID-19 guidance on use of personal protective equipment (PPE) in non-inpatient health care settings, during the COVID-19 outbreak​


Appendix 5: Example – SLHD drive-through screening and swabbing process

Drive-through screening station

  • ​Signals to driver to stop at designated space and switch off engine
  • Complete Screening Form with required details
  • Direct person to proceed slowly to testing area advising they must switch off engine when stationary/ parked in waiting or swabbing bays

Drive-Through Swabbing Station (2 x Staff at each swabbing bay)

Swab Staff 1
  • Direct driver to proceed slowly into the swabbing bay indicated.
  • Confirm persons details and write name and DOB onto MRN sticker and attach to swab tube
  • Drive Through staff to swab person in their car
  • If unable to reach, ask person to step out of the car and sit on the chair provided to collect the swab
  • If swabbing young children sit them on parent’s lap in front seat of vehicle - refer to paediatric swab collection guideline - Appendix 3
  • If swab kit involves snapping stick after placing into transport medium bottle but does not break in right spot, trim the top with scissors. Ensure lid is secured tightly on the medium bottle.
Swab Staff 2
  • Issue a downtime MRN if not already allocated by admin staff
  • Document persons details on the MRN list sheet
  • Document person name and DOB on one MRN sticker to attach to swab stick container
  • Place MRN sticker onto Screening Form and Pathology Order Form (unless printing form when ordering test)
  • Ensure person’s full name ,DOB and contact details- phone and email is clearly documented onto both screening and pathology form
  • Hold specimen bag open for swabbing staff to place specimen into
  • Following swab collection issue an information flyer and advise if symptomatic to remain in home isolation until contacted with swab results. If asymptomatic must maintain social distancing. Results may take up to 48hrs. (CGU negative results, PHU positive results)
Clerical Staff
  • Clerical Staff set up with lap top in appropriate space with power source
  • Collect Screening Forms from Swab Teams
  • Using laptop provided complete a quick registration for all persons presenting for swabbing with the minimum required patient details
  • Use location as allocated (specific site) - SLHD Drive Through


Appendix 6: Example – SLHD Patient Registration Process

SLHD COVID-19 Testing Drive-Through Patient Registration

The governing principle for the SLHD COVID-19 Drive Through Clinics it to provide an efficient and effective process for members of the community to access screening and where appropriate testing for COVID-19. This is accomplished by ensuring that we have a traffic management plan that ensures a safe pathway for vehicles to process through the clinic. That systems are in place to cater for quick and efficient registration process that covers both live registration and down-time registration pathways and we have plans and process to deal with surge situations. It is essential for the eMR team to build a location for the Drive through and ICT to install a network enabled printer in order to print MRN labels and pathology forms.

Two models are available with ability to quickly switch between each as the demand and capability dictates.

Business as Usual model: Live registration and processing of people through the eMR system. 

Live registration

  • Testing stations are established with easy entry and exit points
  • Person enters the Drive Through site following signage and/or instructions
  • Drive Through Team member directs driver where to stop and requests they turn off vehicle e​ngine
  • Occupants must remain in vehicle unless otherwise directed by a Drive Through Team
  • Administrative officer (AO) complete a registration with the minimum required patient details as listed later in this document.
  • AO generates a new MRN or finds patient has existing MRN and prints MRN labels and places under windscreen wipers of persons vehicle
  • Person is directed towards the swabbing area
  • Drive Through staff confirm patient details, complete screening form and collect swab.
  • Drive through staff attach MRN label to screening form and specimen tube.
  • Drive Through staff advise person of the test result reporting process and issue an information flyer with the persons MRN label attached
  • Driver slowly exits testing bay following signage and/ or directions to exit Drive Through site
  • Drive Through staff submit the screening forms to the team leader
  • Drive-Through Team Leader ensures all persons swabbed have pathology orders placed in Powerchart.

Surge and downtime model: Use of downtime MRN with subsequent registration and pathology ordering through the eMR.

Surge and downtime registration

  • Testing stations are established with easy entry and exit points
  • Person enters the Drive Through site following signage and/or instructions
  • Drive Through Team member directs driver where to stop and requests they turn off vehicle engine
  • Drive Through Team member completes a COVID-19 Screening Form and issues a Downtime MRN (unless presenting for a repeat swab – they will have a pre-existing MRN)
  • Person is directed towards the swabbing area by the Drive Through Team
  • Drivers must switch off their vehicle engine whenever stationary in the Drive Through
  • Occupants must remain in vehicle unless otherwise directed by a Drive Through Team
  • Person moves forward to testing bay to be swabbed by the Drive Through Team
  • Drive Through staff confirm patient details and collect swab.
  • Drive Through staff advise person of the test result reporting process and issue an information flyer and copy of persons allocated MRN
  • Driver slowly exits testing bay following signage and/ or directions to exit Drive Through site
  • Drive Through staff submit the screening forms to the administrative staff
  • Administrative staff complete a quick registration in eMR
  • Drive-Through Team Leader ensures all persons swabbed have pathology orders placed in Powerchart.

NB: Process order may vary slightly at each site, but all persons must be screened and registered on eMR with the minimum details documented as follows:

  • Full name
  • Date of Birth
  • Address
  • Contact number
  • Email
  • NOK contact details

Appendix 7: Example - SLHD testing centre staff requirements/responsibilities

SLHD facility responsible for specific site

  • Develop a roster for the drive-through testing centre aiming for consistent staff.
  • Ensure that rostered teams comprise of as a minimum 8 staff:
    • 1 Team Leader​
    • 5 staff – at least 2 for swabbing, 3 for screening/ documenting
    • 2-4 administrative officers.
  • Ensure all rostered staff are screened on presenting to work each day as per current COVID-19 screening criteria.
  • Maintain up to date communication with rostered staff, facilities and services about changing requirements
  • Ensure rostered staff are made aware via email of meeting points, parking / travel arrangements and requirements of their role.
  • Monitor and maintain equipment/supplies

Suggested skill mix of health team

S​​pecific roles to be allocated on the day by the Team Leader
Team Leader Senior RN / CNE / CNC /NUM
Station 1 – Swabbing RN/ Allied Health
Station 1- Documenting AIN/EN/RN/ Allied Health
Station 2 – Swabbing RN/ Allied Health
Station 2- Documenting AIN/EN/RN/ Allied Health
Station 3 – Swabbing RN/ Allied Health
Station 3- Documenting AIN/EN/RN/ Allied Health
Clerical staff Must have patient registration experience

Team Leader Responsibilities (1 x staff member):

  • Ensure all staff are orientated to the site and procedures and complete the orientation form for each
  • Be a resource person and point of escalation for the team
  • Ensure Drive Through Team have adequate breaks throughout the day
  • Be a liaison between the Drive Through Team and the Site Operations Manager
  • Co-ordinate the flow through the Drive Through
  • Manage any issues raised by Drive Through Team
  • Escalate any issues to SLHD Disaster Controller < insert number> or via the SLHD COVID-19 Operations Centre <insert number>

Before arrival:

  • Bring equipment to site
  • Liaise with Site Owners/Managers for access to site daily and storage for equipment

On arrival:

  • Greet Drive Through Team members, advising where they can park their cars
  • Direct staff to complete the sign in log
  • Orientate all new staff to the Drive Through site
  • Brief Drive Through Team about requirements and roles, and ensure all staff members are aware of screening criteria and process.
  • Allocate staff to roles appropriately according to skill level.

Before commencing screening ensure:

  • Administrative officer is set up with a laptop connected to power source and able to complete a quick registration for all persons swabbed.
  • Screening forms are collected from swab stations and given to admin officer to enable them to complete the task.
  • Testing stations are set up with required equipment in bays established with easy entry and exit pathways as well as any barriers/ witches hats used for safety.

On completion:

  • Ensure all Screening Forms are collected and delivered daily to the relevant Facility’s Patient Information Managers.
  • Ensure all clinical waste is collected and disposed of at the relevant overseeing Facility
  • Ensure swabs taken are secured in the plastic box and delivered to the relevant Microbiology Laboratory
  • Notify rpavirtual of any person who presents for repeat COVID testing
  • Report numbers of swabs collected at the SLHD COVID-19 Operations Centre catch up Zoom meeting daily at 2pm

Before leaving the drive-through site:

  • Secure all equipment in allocated space
  • Lock all doors as required as per site managers instructions


Appendix 8: Example - SLHD drive-through clinic staff orientation

Drive through clinic orientation

Employee Name​
Employee Number​​
​Date of Orientation

Instruction for Managers

This checklist is to assist managers to orientate new staff to the SLHD COVID-19 Drive-Through Clinics.

Orientation Item​​ Tick to Indicate Completion
General Items
Introduction to team and roles within the team  
Orientation to available amenities including storage of personal belongings  
Uniform requirements including wet/cold weather attire and heat/sun protection  
Relevant policies and procedures  
Remind staff to stay at home if they experience symptoms of cough/cold/flu  
Respiratory Swabbing
Arrange for respiratory swabbing competency assessment if required  
Review swabbing process including administrative responsibilities  
Discuss different swabs available (nasal, throat, nasopharyngeal)  
Highlight process for fast tracking SLHD employee swabs  
Discuss requirement to cut swabs to size if they do not fit (prevent lid from popping off)  
Personal Protective Equipment
Review PPE requirements for each role in the clinic  
Review application and removal process for PPE  
Review PPE and hand hygiene requirements between each patient  
Risk Management
Discuss management of unwell patients (if appropriate)  
Discuss any other risks relating to the site e.g. traffic management  
Fire safety – evacuation point, fire equipment locations  
Code black – calling for assistance/duress (security or call 000)  
First aid process  
Safety huddle requirements  
Education Requirements
Identify any specific education requirements relating to PPE, Infection Control for swabbing  

Appendix 9: COVID-19 notification of testing site - Community flyer


COVID-19 notification of testing site - Community flyer


Appendix 10: Example - SVHN COVID-19 clinic stores order sheet

​​​Product Quantity Description
Gloves    
Small    
Medium    
Large    
Hand Rub/Wipes    
Cutan 400ml    
V-Wipes    
Gowns    
Regular    
Large    
Blue chemo gowns    
Face Mask    
P2/N95 Small    
P2/N95 Regular    
Face mask (ear loops)    
Visor Mask    
Face shield    
Surgeons cap    
Swabs    
Viral swab (adult)    
Paperwork    
Pathology forms    
SydPath Specimen bags    
MRN stickers    
Patient detail labels    
ED Registration form    
Miscellaneous    
Comfeel    
Garbage bags    
Pens    
Masking Tape    
Red plastic bags    
Scrubs    
Information Pamphlet    


Appendix 11: Example - SLHD equipment reequired for drive-through clinic

Equipment Quantity

Order requirements

Gowns    
Surgical masks    
Gloves (small, medium, large)    
Alcohol pump bottles    
Goggles    
Various sized theatre scrubs    
Wet weather jackets    
Warm fleece jackets    
Pens    
Downtime MRNs    
Screening & Patient Detail Form    

Copies of SLHD drive-thorugh procedure

   
Clinical Waste bags    
Viral swabs    
Laboratory request forms    
Pathology / Biohazard bags    

Laptops x 3-4
(return to Sue McGrady SLHD Disaster Unit when site deactivated)

 ​​  

Mobile Phones x 2
(return to Sue McGrady SLHD Disaster Unit when site deactivated)

   
Signage, directions, stop, engine ​off etc    


Appendix 12: Example – SLHD guidelines for collecting Nose and throat swabs from children

COVID-19 infection is uncommon in children and usually mild. Parents worried about their children should be encouraged to present to their GP or an emergency department, irrespective of having had a COVID-19 swab collected. There is a risk of serious illness being missed if families are falsely reassured by having had COVID-19 swabs taken. If a child presenting for a swab looks unwell or the parent / operator is worried, call an ambulance.

  • There are no specific swab kits designed for use in children. Use an appropriate swab kit for viral PCR as available and recommended by NSW Health Pathology
  • Operators without specific experience in paediatrics or who are not comfortable with the procedure should NOT collect swabs from young children - especially under the age of 6 months
  • As a first preference, use the standard kits containing 2 swabs and a red-topped vial of viral transport medium where available
    • The thinner swab is used for the child’s nose – put the swab gently into the nose until you meet slight resistance; never use force to advance the swab further into the nose.
    • The thicker swab is used for the child’s throat. A tongue depressor may be required. Force should neverbe used to open the child’s mouth.
  • If these swab kits are not available, use another approved swab. If the available swab does not fit into the opening of the child’s nose, abandon the procedure.
  • The parent / caregiver should hold the child during swab collection:
  • Preschool and younger school aged children should sit facing forwards on a parent / caregiver’s lap, with their head back against the parent’s chest
  • One of the parent’s arms should hold the child’s torso and arms still, like a firm cuddle
  • The other of the parent’s arms should hold the child’s forehead back gently but firmly so they can’t withdraw anywhere while the swab is being taken
  • Force should never be used to open the child’s mouth or to introduce a swab into the nose or mouth.
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Page Updated: Tuesday 14 July 2020
Contact page owner: Health Protection NSW