A Shot in the Rear, Not a Shot in the Dark

Application of a Mass Clinic Framework in a Public Health Emergency

The Centers for Disease Control’s (CDC) guidelines for providing emergency smallpox vaccinations proved useful and practical during a hepatitis A outbreak.

In August and September 2003, tainted green onions from an eastern Tennessee restaurant led to 65 cases of hepatitis A. After tests confirmed hepatitis A in employees and patrons, two regional health departments established a single mass-site clinic. The health departments estimated that roughly 6,000 patrons had eaten at the restaurant during the spread of the outbreak. The mass clinic provided immune serum globulin (ISG), a hepatitis preventive.

This article describes the mass clinic built in response to the Tennessee hepatitis outbreak; the authors present statistics from the four days that the clinic operated; in addition, the article discusses how the Tennessee mass clinic applied CDC guidelines.

Key Findings:

  • Mass clinic staff provided 1.45 ISG doses per person-hour.
  • Over the clinic’s four days, the mean time from triage to injection was 9 to 6 minutes per person.

Two regional health departments in east Tennessee successfully adapted CDC guidelines for providing smallpox vaccines in emergency mass clinics. The Tennessee hepatitis A mass clinics can serve as a guide for responding to future outbreaks.

April Issue of Health Affairs Focuses on Patient Safety and Health Care Quality

  1. 1. The Ongoing Quality Improvement Journey
  2. 2. A Road Map for Improving the Performance of Performance Measures
  3. 3. The Trade-Off Among Quality, Quantity, and Cost
  4. 4. Global Trigger Tool' Shows that Adverse Events in Hospitals May be Ten Times Greater Than Previously Measured
  5. 5. Preventing Bloodstream Infections
  6. 6. Measuring the Performance of Individual Physicians by Collecting Data from Multiple Health Plans
  7. 7. Measuring Health Care Performance Now, Not Tomorrow
  8. 8. Despite Improved Quality of Care in the Veterans Affairs Health System, Racial Disparity Persists for Important Clinical Outcomes
  9. 9. The Importance of Transitional Care in Achieving Health Reform
  10. 10. An Early Status Report on the Beacon Communities' Plans for Transformation Via Health Information Technology
  11. 11. A Comparative Study of 11 Local Health Department Organizational Networks
  12. 12. Public Health Performance
  13. 13. A Self-Assessment Process for Accreditation Preparedness
  14. 14. Public Health Delivery Systems
  15. 15. Regionalization in Local Public Health Systems
  16. 16. Public Health Services and Systems Research
  17. 17. A Shot in the Rear, Not a Shot in the Dark
  18. 18. What Predicts Local Public Health Agency Performance Improvement?
  19. 19. Growth of a Scientific Community of Practice
  20. 20. Evolution of Coauthorship in Public Health Services and Systems Research
  21. 21. Resources that May Matter
  22. 22. Evidence Links Increases in Public Health Spending to Declines in Preventable Deaths
  23. 23. Public Health Financial Management Competencies
  24. 24. Decision Science
  25. 25. Public Health Financial Management Needs
  26. 26. Data-Driven Management Strategies in Public Health Collaboratives
  27. 27. Using Geographic Information Systems to Match Local Health Needs with Public Health Services and Programs
  28. 28. Public Health Systems and Services Research
  29. 29. Local Public Health Capacities to Address the Needs of Culturally and Linguistically Diverse Populations
  30. 30. A Needs Assessment for Data and Methods in Public Health Systems Research
  31. 31. Mapping the Multidisciplinary Field of Public Health Services and Systems Research